Ferritin: normal, high and low values

Ferritin: normal, high and low values

What is ferritin?

There s-ferritin it is a contained protein predominantly at the level of the following organs: liver, spleen, skeleton and bone marrow. Ferritin can contain up to 4,500 iron ions, in the state of ferrous ion (Fe3 +). It represents the main form of iron storage in our body and, therefore, ferritin turns out to be a very reliable parameter about the availability of iron. In clinical practice, it is measured from the blood sample and is called ferritinemia. Although most ferritin is found in the tissue, ferritinemia is directly proportional to the concentration of tissue ferritin (the predominant component). Please note, iron is ferritin They are NOT synonyms.

What is the role of ferritin?
Ferritin, contained at the cellular level, firstly allows an accumulation of iron and then, in conditions of need, a rapid release of the same, with the aim of making it readily usable. Another form of iron storage is represented by thehemosiderin. Unlike hemosiderin, the iron deposits associated with ferritin are readily usable (therefore it is faster to use).

Ferritin, in addition to being a representative parameter of the body's total iron reserve status, represents a inflammatory parameter, its evaluation is therefore very useful in the diagnosis and follow-up of chronic diseases. Following an inflammatory state, the ferritin increase is independent from the iron content.


Ferritin is the measure of the amount of iron present in the body's tissues. It is also used as a marker of inflammation.

Ferritin normal values

Ferritin values vary as a function of age, sex and paraphysiological conditions, such as pregnancy.

  • Children: 6 - 55 ng / mL or micrograms / L
  • Women: 20 - 200 ng / mL or micrograms / L
  • Men: 20 - 500 ng / mL or micrograms / L
  • Pregnant women: 10 - 150 ng / mL or micrograms / L

NB Alterations in the normal range of ferritin can arise both as a result of overt pathologies, and as transient non-pathological forms (eg from altered nutrition). Ferritin in pregnancy is reduced physiologically.

High blood ferritin - hyperferritinemia

Ferritin values above the normal range, in blood tests, are caused by an increase in the amount of iron contained in the body (high iron). The ferritin will then be high.

High values - high ferritin

Ferritin is considered high when the values exceed:

  • Man > 500 ng / mL
  • Woman > 200 ng / mL
  • Pregnant woman > 180 ng / mL

Causes of high ferritin

What are the causes of hyperferritinemia? Ferritin can be elevated due to several conditions:

  • Hemochromatosis: condition that involves a greater absorption of iron in the intestine - therefore, of the iron introduced through food. It may be due to mutations in hepcidin, a protein produced by the liver.
  • Porphyria: A group of rare diseases resulting from an enzymatic alteration involved in the synthesis of heme (non-protein constituent of hemoglobin).
  • Infections chronic
  • Liver disease
  • Hyperthyroidism
  • Leukemia
  • Hodgkin's lymphoma
  • Neoplasms
  • Alcohol abuse
  • Multiple blood transfusions
  • Abuse of iron-rich foods or iron-rich supplements
  • Hemophagocytic syndrome (ferritin> 3000 ng / mL)
  • Still's disease (ferritin> 3000 ng / mL)

High ferritin symptoms

What are the symptoms of high ferritin? Symptoms associated with elevated ferritinemia may vary depending on the underlying cause of this increase.

Most frequently there are:

  • Stomach ache
  • Joint pain
  • Sense of weakness
  • Asthenia
  • Chest pain

High ferritin: what does it involve? When to worry?

An increase in ferritin levels may indicate genetic diseases (e.g. hemochromatosis and hemosiderosis), of a nutritional intake excessive, of infectious states is inflammatory (benign conditions) and, last but not least, of malignant pathologies (leukemias, lymphomas or various neoplasms). The value can be completely asymptomatic or associated with a more peculiar symptomatic procession. The evaluation of ferritinemia appears to be a decisive examination in some clinical conditions such as: Still's disease is Hemophagocytic syndrome, these are frequently associated with states of notable hyperferritinemia (ferritin> 3000 ng / mL).

In case of positive blood tests for an increase excessive of ferritin, the doctor, depending on the patient's clinical history, may recommend carrying out diagnostic investigations, in order to identify the triggering cause. An increase in ferritin is not necessarily associated with dangerous conditions.
Being an inflammatory parameter, it is very useful in the diagnostic evaluation and monitoring of chronic pathologies.

Low blood ferritin - hypoferritinemia

Low ferritin values indicate a condition of reduced iron content in the body. One of the most frequent forms of low ferritin is iron deficiency anemia, a form of anemia caused by iron deficiency (or by impaired absorption, or by increased elimination).

Low ferritin values

THE low ferritin values I'm:

  • Children: <5 ng / mL
  • Women: <20 ng / mL
  • Men: <20 ng / mL
  • Pregnant women: <10 ng / mL

Causes of low ferritin

What are the main ones causes of hypoferritinemia? The most frequent causes of low ferritin in the blood are:

  • Iron deficiency anemia (iron deficiency anemia).
  • Nutritional deficiencies (malnutrition, excessive diet, vegetarian or vegan diet in which there is low iron content).
  • Reduced intestinal absorption (e.g. chronic inflammatory bowel diseases: celiac disease, diarrhea)
  • Hemorrhages (e.g. trauma, ulcers, etc.)
  • Dripping (e.g. gastrointestinal dripping)
  • Pregnancy
  • Chronic hemolytic anemia
  • Rheumatoid arthritis 

Symptoms of low ferritin

What are the symptoms of hypoferritinemia? Symptoms of low blood ferritin are often symptoms of iron deficiency. Symptoms of low iron include:

  • Exhaustion
  • Pallor
  • Anorexia
  • Lack of appetite
  • Irritability
  • Increased susceptibility to cold
  • Hair loss

Low ferritin in pregnancy

Normally, ferritin values in pregnant women are reduced to meet the needs of the fetus. However, the values should be in the range 10-150 ng / mL. According to ministerial directives, it is always advisable to monitor the ferritin between the 28th and 32nd week. In the presence of values below the normal range, also taking into consideration the triggering cause of this condition, the doctor may suggest following a diet rich in iron or administering special supplements. It is extremely important that the picture is normalized as, if it does not, it could have some severe repercussions on both fetus than on mother.

Anemia, i.e. a lack of hemoglobin (a protein found in red blood cells, responsible for the transport of O2), can cause impaired oxygenation of the fetus, thus compromising the correct development of the vital organs of the same. Furthermore, during childbirth, the woman experiences blood loss (haemorrhages), therefore it is advisable that the haematological profile is normal in order to avoid complications. If at the end of pregnancy the woman still has a state of hypoferritinemia (and consequent anemia), it may be necessary to have a blood transfusion.

Ferritin and diet: what to eat

Low ferritin: what to do?
In the presence of low ferritin levels, compatibly with what is recommended by your doctor, it may be useful to follow an iron-rich diet.

Foods rich in iron I'm:

  • Lentils
  • Beans
  • Red meats
  • Egg yolk
  • Dried fruit
  • Oats
  • Apricots

A diet rich in iron can also be useful to associate foods rich in C vitamin (carrots, oranges, kiwis, pineapples, strawberries, cherries, spinach, broccoli, lettuce, peppers, potatoes etc).

High ferritin: what to eat?

If you have high levels of iron in your blood, it may be helpful to ask your doctor for directions and start following one low iron diet or stop taking iron-rich supplements.

Therefore, it is useful to reduce the consumption of red meat (maximum 2 times a week), prefer the fish or, alternatively, the White meat. Limit the consumption of eggs, cheeses and nuts. Don't abuse alcohol. Introduce daily, several times a day, fruit is vegetables.

If it is high ferritin in the presence of a tumor, it is advisable to follow the dietary indications recommended by the nutritionist oncologist. It is scientifically proven that proper nutrition in the cancer patient can improve the individual's prognosis.

NB Nutrition cannot and must not replace the chemotherapy, radiotherapy or surgical treatments proposed by the oncologist. The diet of the cancer patient represents a complementary regimen.

High ferritin in pregnancy

In the presence of an increase in ferritin during pregnancy (values> 180 ng / mL) it is advisable to consult a doctor. Compared to a finding of hypoferritinemia in pregnancy, the presence of high levels of ferritin is a much rarer condition, but this does not mean that undervalued. The parameters may vary according to the different analysis laboratories, so it is advisable to compare your results with the reference ranges present in the report itself.

 Exam preparation and complementary exams

The biological sample from which ferritin is evaluated is the blood sample, or blood. The sampling must be carried out without food, and preferably in the morning. Evaluation of serum ferritin is often associated with evaluation of transferrin. Transferrin is the main one transport protein of iron in the blood.

In conditions of increased iron requirement, our body draws on the iron deposits, which will be transported by the transferrin. On such occasions, an increase in transferrinemia (high blood transferrin) may be observed. If, on the other hand, the iron deposits are reduced, despite the increased need for iron, the stocks are unable to meet the needs of our organism and the circulating iron is also reduced, thus obtaining a low transferrin value. A normal amount of iron is associated with normal transferrin values.

Another important parameter is the sideremia. What does sideremia mean? The sideremia represents the value of circulating iron at the blood level, or the share linked to transferrin. The values vary according to the sex, age and clinical condition of the patient.

Serum iron - sideremia

Ferritin and sideremia represent gods fundamental parameters in the assessment of availability and iron deposits. Given that ferritin represents the amount of iron storage and sideremia, on the other hand, represents the amount of circulating iron, these should not be confused. Both are evaluated through a blood sample, but the value of ferritinemia is directly proportional to that of the deposits in the tissues, which we remember to be the preponderant share of iron deposits, while sideremia evaluates the quantity of circulating iron (i.e. the iron present in that given moment in the blood).

Cases of normal / high ferritin and low ironmia they can occur in the presence of forms of chronic anemia, in which iron deficiency is not the cause of the anemia, or in the presence of some inflammatory diseases (eg vasculitis) in which iron is present but is "sequestered".

As a result of an excessive need for iron, blood tests will show a reduction in ferritin (deposition rate) and a normal value of sideremia, or the amount of iron circulating in the blood at that time. This condition (low ferritin and normal iron) indicates an increase in the body's demands for iron, which then draws on its own deposits. When the available ferrò is exhausted, and the stocks have not been appropriately "replenished", a condition of low ferritin and low ironmia.

Normal values sideremia:

  • Men: 65 to 175 mcg / dL
  • Women: from 50 to 170 mcg / dL
  • Children: from 50 to 120 mcg / dL
  • Babies: from 100 to 250 mcg / dL

High ironemia:

  • Women > 170 mcg / dL
  • Men > 175 mcg / dL

Low ironemia:

  • Women <50 mcg / dL
  • Men <65 mcg / dL



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