What is the Ferritin test?

Posted by Doctor Le Ngoc Hung - Head of Laboratory Department - Vinmec Central Park International General Hospital

Your body relies on iron in red blood cells to carry oxygen. Without enough iron, your red blood cells cannot provide enough oxygen. However, too much iron is also not good. Both high and low iron levels are serious problems. If your doctor suspects that you have an iron deficiency or an iron excess, they will also order a ferritin test. This test measures the amount of iron stored in the body, giving your doctor an overview of your iron level.

Ferritin is not the same substance as iron in your body. In fact, ferritin is an iron-containing protein that releases iron when the body needs it. Ferritin exists inside your body's cells, only in very small amounts circulating in the bloodstream.
The highest concentrations of ferritin are typical in hepatocytes and the immune system (retinal endothelial cells).
Ferritin is stored in your body until it is used to make more blood cells. The body will signal the cells to release ferritin. Ferritin is then attached to another substance called transferrin.
Transferrin is a protein that will bind with ferritin to transport ferritin to the place where blood cells are formed. Visualize transferrin as a taxi that transports iron.
Although it is very important for the body to have normal iron levels, having an adequate amount of iron stores is also important. If the body does not have enough ferritin, iron stores will decline very quickly.

Knowing that your body has too much ferritin or a deficiency will help your doctor assess your total iron level. The more ferritin, the more iron is stored in your body.

Your doctor may order a ferritin test if you have symptoms related to low ferritin levels: unexplained fatigue, dizziness, chronic headache, unexplained weakness, ringing in your ears, or irritability , leg pain, difficulty breathing.

You may also have high levels of ferritin, which also causes unpleasant symptoms: stomach pain, nervousness, chest pain, unexplained fatigue, joint pain, weakness for no reason.
Ferritin levels may increase as a result of organ damage, such as the liver and spleen. The Ferritin test can also be used to monitor your health, especially if you are on an iron regimen that can increase or decrease iron levels in your blood.

The ferritin test requires only a small amount of your blood for an accurate reading.
Your doctor will ask you not to eat for 12 hours before taking a blood sample. As recommended by the American Association of Clinical Chemistry, the more accurate the test is done the morning after you have not eaten overnight.

Your blood ferritin level is first checked to be within the normal range. Normal reference range for ferritin:
20 to 500 nanograms per milliliter of blood in men 20 to 200 nanograms per milliliter of blood in women

Decreased ferritin levels indicate an iron deficiency, which can happen if you are not getting enough iron in your diet.
Another condition that affects iron levels is anemia, meaning you don't have enough red blood cells for iron to attach to.
A few more causes are as follows:
Excessive menstrual blood loss Decreased iron absorption from the stomach Visceral bleeding Being aware of low or normal ferritin levels helps your doctor better assess the cause.
For example, people with anemia have low blood iron and low ferritin.
However, a person with a chronic illness may have low blood iron levels but ferritin may be normal or high.

Ferritin is elevated under these conditions.
For example, the disease increases iron overload (iron overload), due to the body absorbing too much iron.
Other conditions causing increased iron: rheumatoid arthritis, hyperthyroidism, Still's disease in adults, type 2 diabetes, blood cancer, Hodgkin's lymphoma, iron poisoning, frequent blood transfusions, liver disease ( hepatitis C),..
Ferritin is also considered an acute reactant. This means that when the body is inflamed, the blood ferritin increases. That's why ferritin is elevated in patients with liver disease or cancers, like Hodgkin's lymphoma.
For example, hepatocytes store ferritin. When a person has liver damage, ferritin in the cells leaks out, increasing ferritin in the blood.
The most common causes of elevated ferritin are obesity, inflammation, and daily alcohol consumption. The most common cause of hereditary elevated ferritin is iron overload.
If your ferritin test levels are elevated, your doctor will order more tests to better understand your iron levels. Includes:
Serum iron test, which measures the level of circulating iron in your blood. Total iron binding capacity (TIBC) test: measures the amount of transferrin in your blood. To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.
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