What is ferritin?
The protein ferritin is used to store iron in the body cells. In its unbound form, iron is toxic to the body. By binding the substance, ferritin provides important protection for the body and is also an important parameter in blood diagnostics.
Iron is required, for example, for the formation of the red blood pigment hemoglobin and transports the oxygen in the body through the bloodstream.
When and how is ferritin measured?
Various diseases such as iron deficiency or iron storage diseases can be determined using the ferritin value. The ferritin value can also be increased in the case of inflammation or tumors. Because of its importance in connection with tumors, ferritin is also referred to as a “tumor marker”. Its concentration measurement is used as standard in tumor diagnostics. The measurement takes place in the blood serum, i.e. the liquid part of the blood.
Other important laboratory values in connection with ferritin are the iron value in the blood and the values for transferrin, transferrin saturation, hemoglobin and erythrocytes (red blood cells). Depending on the suspected disease, other laboratory values may also be of importance.
There are now even home tests that promise to automatically check the iron and ferritin levels (e.g. One+Step® or Cerascreen®). In fact, they work quite well, but for more reliable results, a blood test from your family doctor is recommended.
What is the normal blood level of ferritin?
The normal laboratory value for ferritin (abbreviation: FERR or FT) in the blood differs according to age and gender. The following table provides an overview of the normal values for children and adolescents, women and men. The ferritin value is given in micrograms per liter (µg/l).
Two different ferritin values are given for adult women, because the normal value changes significantly when the menopause is reached . Because up until the so-called menopause, women lose blood every month through their menstruation and therefore also iron. Ferritin also increases after the menopause, since it is now required to a greater extent for iron storage due to the absence of iron loss.
Please note that the limit values differ from laboratory to laboratory and can therefore vary.
When is ferritin elevated?
There are a number of possible reasons for an elevated ferritin level. In some cases it is relatively harmless, but it can also indicate serious illnesses.
The most common cause of high ferritin levels is inflammation in the body. Ferritin is one of the so-called “acute phase proteins” and increases even with minor tissue injuries, but also with infections. Even a cold or influenza (flu) can lead to increased ferritin.
Tumors are also usually associated with an increased ferritin value, as they cause non-specific inflammatory reactions in the body. Liver tumors in particular lead directly to an increase in ferritin. Because the liver cells serve as the primary storage location for ferritin, so that it can accumulate in the blood to a large extent if the liver cells are damaged.
Excessive alcohol consumption has a similar effect as tumors, because the resulting liver damage also releases a large amount of ferritin, which is why the ferritin value is too high. In addition, regular consumption of alcohol increases the iron overload in the liver, so that more ferritin is required for binding and storage.
Excess iron (hemochromatosis) can also increase ferritin levels. Iron storage disease is characterized by increased iron absorption in the upper small intestine, which over the course of several years can lead to damage to numerous organs, in particular the pancreas , spleen, thyroid, but also the skin and joints. The liver in particular is at risk: the risk of hepatocellular carcinoma is significantly increased by haemochromatosis.
Other possible causes of excess ferritin include:
- Hemolytic anemia (anemia caused by premature destruction of the cell membrane of the red blood cells and the associated destruction of the erythrocytes)
- Overdose of iron tablets
- Frequent blood transfusions
Since the causes of an increased ferritin value can be very different, a precise medical diagnosis is essential. Tumors in particular must be identified quickly so that effective treatment is possible. A ferritin value over 500 also indicates acute liver cell damage, which also requires urgent therapy.
What are the Symptoms of Ferritin Excess?
Since the ferritin level is closely linked to the iron level and an elevated ferritin level usually also indicates a high iron level, the symptoms are very similar to those of iron overload. Frequent tiredness and general weakness are noticeable, which can only be adequately eliminated by rest and sleep. There is also joint pain and, over time, a bronze discoloration of the skin due to iron deposits.
The symptoms are generally very similar to those of anemia. A blood count can clarify the underlying causes.
What does low ferritin mean?
The possible causes of a reduced ferritin value are as numerous as with an excess and are also strongly related to the iron value.
The most common cause of low ferritin is iron deficiency. If less iron is available, less ferritin is required for binding and storage. Iron deficiency is usually caused by chronic bleeding, for example by a stomach ulcer , inflammation of the mucous membranes of the small or large intestine, bleeding in the urinary tract or diseases of the uterus. In women, blood is also lost during menstruation. In the laboratory, iron deficiency also shows an increased concentration of transferrin, the transport protein of iron.
Digestive disorders that are associated with reduced or no absorption of iron from food in the intestines, so-called malabsorption disorders, can also cause a ferritin deficiency due to the reduction in iron. Due to inflammation of the small intestine or the lack of certain enzymes, iron absorption is insufficient. A well-known example is celiac disease (sprue), an intolerance of the small intestine to gluten that can lead to severe inflammation. Because inflammation, in turn, increases ferritin, it often obscures what is actually a low level, resulting in normal or even elevated levels.
Other known causes of low ferritin include the following:
- Loss of protein (may indicate kidney disease)
- Malnutrition (e.g. avoiding animal foods without an adequate substitute)
- Strong growth phase in children and adolescents
- pregnancy and breast feeding period
During pregnancy, the woman’s iron requirement is significantly higher, which can lead to reduced ferritin levels. This is normal, but in the case of a pronounced deficiency, the administration of iron supplements is recommended after consulting a doctor.
What are the symptoms of a ferritin deficiency?
The symptoms of ferritin deficiency are identical to those of iron deficiency. In some cases, similar symptoms occur with an excess of ferritin, for example general weakness and tiredness.
Typical deficiency symptoms are also the following:
- Poor concentration and forgetfulness
- Physical weakness and shortness of breath
- paleness
- Hair loss and brittle fingernails and toenails
- sleep disorders
- susceptibility to infections
- Listlessness and depressive mood up to depression
- headache
How can you increase your ferritin level?
A reduction in ferritin levels is almost always the result of iron deficiency. Therefore, first of all, the iron stores should be replenished in order to increase the ferritin value. According to medical recommendations, this can be achieved with iron preparations in tablet form or as an infusion; in the case of a very severe and acute deficiency, a blood transfusion may also be necessary.
In addition, a change in eating habits may be advisable. An iron-rich diet can quickly help stabilize ferritin levels. Animal iron can be better absorbed in meat than vegetable iron. In addition to meat, especially liver, iron-rich foods also include oatmeal, wheat bran and green vegetables such as chard .
A sufficient supply of vitamin B12 and vitamin C is also important, as both have been shown to promote iron absorption. Vitamin B12 is mainly found in meat and fish, while vitamin C is mainly found in fruit and vegetables.
