Increased ferritin

Increased ferritin means an excess of this protein, which serves to store iron, in the body.

An increased or decreased ferritin level indicates that a disorder changes the concentration of iron in the body.

The serum iron, on the other hand, indicates the total iron in the blood.

Iron is very important for bodily functions: it allows the transport of oxygen to the periphery and converts it into energy. It also promotes various organ reactions. However, free iron has various toxic effects in the body. Therefore, the role of ferritin is very important. Ferritin is a protein that binds iron and is present in two forms, an intracellular and an extracellular: its function is iron storage and its controlled release.

Transferrin is a protein of the blood that binds the absorbed iron from the intestine and transports it into the entire organism.
Usually, the iron content in plasma is bound to the transferrin: each transferrin molecule transports two iron atoms to the organs and tissues that need it most.
About 60% of the iron present in the organism is contained in haemoglobin, the most important transport protein for oxygen in the blood. Another 30% of iron is bound to ferritin (which is present throughout the body), although this percentage is significantly higher or lower in some cases of anemia.

In addition, a small amount of iron belongs to myoglobin, a protein synthesized in muscle cells. When the deposits of iron in the organism rise above normal levels, a greater amount of iron accumulates in certain organs, such as the liver, in ferritin molecules or in an organic complex called hemosiderin. An excessive amount of iron in the organs (pancreas or heart) impairs their functioning.

Normal values of ferritin
As a rule, men have higher levels of iron in their blood than women. Although laboratory values may vary, the majority of normal values for men are between 65 and 176 μg/dl, while the reference range for women is between 50 and 170 μg/dl. When laboratories quantify the iron contained in plasma, they evaluate the iron bound to transferrin: normally, 25-35% of the transferrin present in the plasma is used to transport iron. When laboratories measure the iron in plasma, they usually also measure the amount of transferrin and calculate the percentage of transferrin molecules used to bind iron.
A patient may have elevated ferritin, but normal or decreased transferrin.

Normal values of ferritin in adults and children
These are the normal levels of ferritin, divided by age group/sex.

• Infants: 25-200 ng/ml
• Infants 2-5 months: 50-200 ng/ml
• Children and adolescents between 6 months and 15 years: 7-142 ng/ml
• Women: 18-160 ng/ml
• Men: 18-270 ng/ml

When to worry?
A ferritin level above 500 or 1000 ng/ml is severe and indicates an abnormal accumulation of iron in the organism. This can be caused by a dangerous disease called hemochromatosis.

What are possible causes of elevated ferritin levels?

Hemochromatosis
There is a familial form: congenital hemochromatosis. However, there are also acquired forms.
Some conditions cause a drop in the number of red blood cells, including:

• Chronic alcoholism
• Thalassemia
• After surgery, there may be a drop in red blood cells and hemoglobin due to hemorrhage
• Some forms of anaemia, for example Mediterranean anaemia (microcytosis) or congenital or acquired anemia of the iron transport defect in atransferrinemia

Over time, this disorder leads to hemochromatosis.
In addition, acquired hemochromatosis can be caused by blood transfusions because these lead to excessive iron deposits in the body.
High concentrations of ferritin in the blood are also caused by:

1. Hodgkin’s lymphoma
2. Blood tumors such as leukemia, which is why this protein is used as a tumor marker
3. Infection
4. diseases that lead to systemic inflammation (or rheumatism), such as rheumatoid arthritis or lupus
5. An iron-rich diet or vitamin supplements, especially vitamin B12
6. Hepatopathies or liver disease
7. Hyperthyroidism
8. Diabetes mellitus type 2

During pregnancy, women have a low ferritin, especially in the last weeks of pregnancy.

What are the symptoms of increased or decreased ferritin?

The concentration of ferritin in the blood is mainly measured when the doctor considers a special blood test of the patient necessary.
In the early stages, symptoms go unnoticed with elevated ferritin levels, but some symptoms appear over time.
These symptoms include:

• Generalized pain, especially in the joints
• Dark discoloration of the skin
• Weakness
• Fatigue
• Abdominal and stomach pain
• Loss of libido (sex drive)
• Palpitation

There are also symptoms caused by low levels of ferritin in the blood. Here are the main ones:

• Fatigue and unexplained weakness
• Vertigo
• Chronic headaches
• Tinnitus (ringing in the ears)
• Irritability
• Pain in the legs
• Shortness of breath

What does the examination of ferritin consist of?

Our organism uses iron to transport oxygen to the cells: if there is a lack of iron, the cells can die because they lack oxygen. In addition, this causes various unpleasant symptoms for the patient. But even an increased iron concentration in the blood can be dangerous.

If the doctor suspects a deficiency or excess of iron, he usually prescribes a ferritin determination.
This simple blood test measures the amount of iron stored in the body.
However, ferritin does not indicate the amount of iron in the body: it is a protein that stores and releases iron when the body needs it.
The greater the amount of ferritin in the blood, the greater the iron deposits in the body.

Ferritin concentrations may also be elevated due to problems with the organs, such as the liver and spleen. This examination is therefore also used to monitor the general health of the patient, especially if he suffers from deficiency or iron overload in the blood.

Diagnosis

The doctor prescribes the determination of ferritin if the patient suffers from any of the previously mentioned symptoms caused by an abnormal concentration of ferritin in the blood.

How is the ferritin examination performed?
To study ferritin, only a small amount of blood is needed to accurately quantify the ferritin concentration in our body.
Before the blood test, the nurse places a tournitour tube around the patient’s arm to make the superficial veins on the forearm more visible. After cleansing the skin with a swab and disinfectant, a small cannula is inserted into the vein and the patient’s blood is taken: the blood tube is sent to a laboratory for analysis.

How is elevated ferritin in the blood treated? Therapy and natural remedies

If the ferritin level is not in the reference range, the doctor prescribes drug therapy and the patient must change his lifestyle habits to speed up the healing process.

Drug therapy – The simplest and necessary measure for the patient with elevated ferritin: the doctor prescribes chelating agents such as deferoxamine (Desferal®), which bind to the iron.
A complex is formed, which is filtered through the kidney and excreted in the urine or via the bile.
Patients with high concentrations of ferritin in the blood must refrain from any intake of vitamins and minerals via supplements and antioxidants containing iron.
Of all dietary supplements, vitamin C supplements must be avoided: Vitamin C increases the concentration of iron in the blood and thus harms people who have high ferritin levels. The doctor also prescribes milk thistle to these people.

Blood donation – Blood donation (and bloodletting) is the easiest way to reduce elevated ferritin levels.
If blood is taken from the organism, the amount of ferritin in the blood decreases with the iron concentration.
Patients with high ferritin levels can donate blood more often. However, one must not suffer from AIDS, hepatitis or other infectious diseases that could infect the recipient.
Before donating blood, patients are advised to consult the family doctor to have their state of health checked.

What should you eat? Recommended diet and diet for elevated ferritin

Limit iron-rich foods – Iron is one of the most important elements for the overall health of the patient and determines the amount of ferritin in the blood. If the doctor diagnoses a high level of ferritin in the blood, the patient should implement some recommendations to reduce ferritin levels to prevent a further increase.

Iron is a substance that is ingested daily with food: for these patients it is important to avoid all foods high in iron.

Foods
to avoid foods that are high in iron include:

• Green leafy vegetables
• Corn
• Watermelon
• Broccoli
• Potatoes
• Different types of beans
• Nuts
• Seed
• Cereals such as whole grain rice
• Wholemeal bread
• Oatmeal, etc.

People with high concentrations of ferritin in their blood need to avoid these iron-containing foods. If the patient takes dietary supplements, he must make sure that they do not contain iron.
Very important is the avoidance of foods that contain yeast. It is best to change eating habits after consulting your family doctor.

• Increased iron in the blood, causes and symptoms
• Increased hematocrit in the blood, causes and symptoms
• Hemochromatosis: symptoms, diagnosis and treatment