Ferritin Test

Serum ferritin is a blood test commonly performed independently or as part of an iron profile test. Ferritin is a protein found in the blood. Its levels help to estimate the levels of iron in the body. It is also an acute-phase reactant produced during inflammation.

Ferritin is the major form in which iron is stored in the body. Its levels are essential to estimate in case of suspected iron overload or iron deficiency. Ferritin is not normally present in the blood in large quantities. It is present mainly in the liver and spleen. These are the organs where iron is stored.

As the body continues to produce new cells in the blood, a small amount of ferritin is released into the blood. Its main purpose is to act as a reserve for when enough iron is not available.

High ferritin levels usually cause stomach aches, joint pain, weakness or fatigue and chest pain. It may also damage the liver. This condition requires early intervention and treatment.

Low ferritin levels are usually accompanied by tiredness, headaches, shortness of breath and tachycardia (increased heartbeat rate). A mild deficiency may go unnoticed and symptoms are usually seen with severe deficiency.

Ferritin levels reflect the amount of iron in the body. The good news is that with correct lifestyle changes and diet modifications, many of these conditions that cause iron deficiency can be managed with medicines. There are several foods that are rich sources of iron. This includes green, leafy vegetables, dried fruits, red meat and seafood. One can incorporate them into their diet.

Iron deficiency is the most common cause of anaemia in India. Low levels of ferritin are seen in iron deficiency. This has largely been attributed to nutritional causes.

A simple venous blood sample is sufficient to test blood levels of ferritin. The levels are detected in the serum, which is a component of the blood. This sample may be drawn from any of your prominent veins, the most common being the vein in your arm. It does not require any prior preparation.

Liver damage, Ulcers, Hemochromatosis, Anaemia

The serum ferritin test measures the level of ferritin protein. In very simple terms, ferritin is the form in which iron is stored in the body. Ferritin is carried by the red blood cells (RBC). RBCs play the vital function of carrying oxygen from your lungs with the help of iron. Iron deficiency anaemia is very common and usually results from a deficiency of iron in the diet. In this condition, ferritin levels are very low. It indicates inadequate iron stores in the body.

It is also needed in case of genetic disorders such as hemochromatosis and porphyrias. These result in elevated levels of ferritin. Serum ferritin levels are also high in case of organ dysfunction and are a marker of inflammation in the body. It means that in case of any infection or acute disease, the levels may rise.

The symptoms of low ferritin levels include:

• Pale skin
• Unexplained fatigue
• Weakness/exhaustion
• Longstanding headaches
• Dizziness
• Difficulty in breathing
• Higher pulse rate
• Irritability
• Leg ache

The symptoms of high ferritin levels include:

• Stomach ache
• Chest pain and irregular pulse or palpitations
• Weakness that remains persistent
• Pain in the large joints such as knees and elbows

These are some of the symptoms for which a doctor may prescribe a ferritin test.

The test is a part of a routine examination. It is performed commonly if your complete blood count reveals that you have low levels of haemoglobin, known as anaemia. Iron deficiency anaemia is very common and ferritin levels form a part of its diagnosis. Your symptoms and blood iron levels determine the exact frequency of the test. Ferritin levels are raised in COVID-19 infection-related inflammation, serum ferritin levels are repeated frequently to monitor the treatment and patient response.

If you have a chronic condition or require frequent blood transfusions, regular testing of ferritin levels is performed. It is also recommended for those who have chronic conditions such as ulcers.

Before the Test

Usually, an serum ferritin test doesn't need any special prep. If you're taking this test with another one, your doctor might tell you to avoid eating certain foods. It's always a good idea to talk to your doctor before the test to get the best results.

During the Test

The phlebotomist will take a blood sample from a vein in your arm. Here's what you can expect:

• The spot where they're going to insert the needle is cleaned with an antiseptic.
• A band/tourniquet will be wrapped around your arm to make your veins stand out more.
• A needle will be guided into the vein to draw the blood sample. This might take a couple of seconds, and you might feel a quick pinch.
• The sample blood will be collected in a vial/small tube with your details on it.

After the Test

After the Blood is Collected:

• A bandage will be applied over the puncture spot to stop the bleeding.
• You might develop a bruise, but feeling dizzy is rare. You might be asked to sit down for a bit.
• If you notice any bleeding, pain, or a rash at the puncture site, let your doctor know.

Serum ferritin is an individual test. It only measures the levels of a single protein, that is, ferritin. It may be included as a component of a test known as an iron profile.

In case of low haemoglobin levels, the iron profile test may be advised. This also measures serum iron levels and total iron-binding capacity (TIBC).

Serum ferritin levels give an estimate of iron stores in the body. Serum ferritin test as a standalone test may be advised if you are prone to high iron levels due to iron storage disorders such as hemochromatosis. This results in high levels of iron and consequently, high ferritin levels.

The standard levels of serum ferritin for adults lie between 13 - 322 ng/mL. You may also get the following values in some labs:

• Normal serum ferritin level for men: 24 to 336 micrograms per litre
• Normal serum ferritin level for women: 11 to 307 micrograms per litre

The normal values and reference ranges of the test may vary from lab to lab. Please refer to the ranges mentioned in the report and consult a doctor to understand the interpretation of lab reports.

The results of the serum ferritin levels above or below the normal range require additional tests and investigations. Certain medications may also interfere with serum ferritin levels. In case of any derangement in levels, your doctor may review all the components of the iron profile to pinpoint a specific cause.

The causes of high ferritin levels include:

• COVID-19 (during cytokine storm)
• Hemochromatosis (a genetic disorder causing the body to store large amounts of iron)
• Chronic inflammation, for example, rheumatoid arthritis
• Liver failure (it might indicate a worse outcome in such cases)
• Hyperthyroidism (an overactive thyroid gland)
• Blood cancers, including leukaemia and Hodgkin's lymphoma
• Repeated blood transfusions
• Alcohol abuse

One of the main causes of low serum ferritin levels is iron deficiency. Iron deficiency anaemia manifests in various ways. It mainly indicates that the ability of your body to carry vital oxygen is reduced. The main causes for low ferritin include:

• Iron deficiency anaemia (likely due to nutritional deficiency of iron)
• Chronic heavy periods and excess blood loss during menstruation
• Stomach ulcers (peptic ulcers) - these also cause chronic blood loss
• Internal bleeding
• Loss of blood in stools due to infections or tumours
• Malabsorption or the inability to correctly absorb nutrients from food

Depending on the city and the lab, the cost of a Ferritin test can differ. Generally, the price for a Ferritin test ranges from INR 369 to INR 898. Here's a breakdown of the average expenses for a Ferritin test in several key cities in India: