What do elevated ferritin test results indicate?

Posted by Master, Doctor Pham Thi Thuy Nhung - Dean and Master, Doctor Do Thi Hoang Ha - Laboratory Department - Vinmec Hai Phong International General Hospital.

The ferritin test will help the doctor know how much iron the body is storing. If the ferritin test shows a lower than normal level of ferritin in the blood, it means the body's iron stores are low. Conversely, when the ferritin test results are higher than normal, there is a possibility that the patient has iron overload.

Ferritin is an iron storage protein, free ferritin in the serum reflects the concentration of iron stores and is used as a laboratory indicator to evaluate the level of iron stores in the body. For the quantitative ferritin test, a normal healthy person ranges from 20 to 250 ng/ml (for men), women range from 10 to 120 ng/ml.
A quantitative ferritin test will help your doctor understand how much iron your body is storing. If the ferritin test shows a lower than normal level of ferritin in the blood, it means the body's iron stores are low. Conversely, when the ferritin test results are higher than normal, there is a possibility that the patient has iron overload.

If the ferritin test result is higher than normal, it also means that the body is storing too much iron.
A high ferritin test can also be a sign of some diseases such as Thalassemia, hepatitis, rheumatoid arthritis, some acute and chronic inflammatory diseases, hyperthyroidism, alcohol abuse, diabetes Type 2, repeated blood transfusions without chelation, or certain cancers (liver, pancreatic, bronchial, neurological, malignant lymphoma, leukemia) can also cause high levels of ferritin in the blood.
Alternatively, a high ferritin test can also be caused by a mutation in the HFE gene. The HFE gene has two common mutations, C282Y and H63D. If a person inherits 2 abnormal genes, they can develop iron overload. Mutations in these genes reduce the control of iron absorption during digestion and alter the distribution of iron to different parts of the body. However, this is a very rare group of causes in Asians.

When the ferritin test results are above normal, your doctor may order additional tests to help find the underlying causes so that you can get the best treatment.
Treatment for high ferritin levels depends on the underlying cause. Inherited hemochromatosis can be treated with intravenous blood injection. This is a procedure to remove blood from the body. Initially, the patient was drawn about 470ml of blood, taken 1-2 times a week. Then, when the patient's iron levels have returned to the normal ratio, blood draws are performed less frequently, either monthly, or without chelation therapy. The amount of blood and frequency of removal will vary depending on the age, health, and ferritin levels of each patient. Patients will need treatment on an ongoing basis to maintain normal blood ferritin levels.
People with other causes of high ferritin test results may require additional treatment, such as chelation drugs for patients receiving 10 to 20 units of blood transfusion, or patients with thalassemia Serum ferritin >1000 ng/ml or a combination of drugs to prevent conditions such as liver disease and diabetes.

In summary, when a patient has signs of suspected iron metabolism disorder, it is necessary to do a quantitative ferritin test to be able to properly assess the disease condition and find the cause as well as appropriate treatment measures. fit.
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