Ferritin 

Updated: Jan 16, 2014
  • Author: Bishnu Prasad Devkota, MD, MHI, FRCS(Edin), FRCS(Glasg), FACP; Chief Editor: Eric B Staros, MD  more...
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Reference Range

Ferritin is the cellular storage protein for iron. It is present in small concentrations in blood, and the serum ferritin concentration normally correlates well with total-body iron stores, making its measurement important in the diagnosis of disorders of iron metabolism. [1]

The reference range of ferritin is as follows:

  • Males: 23-336 ng/mL
  • Females: 11-306 ng/mL
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Interpretation

Ferritin levels are increased in the following:

Ferritin levels are decreased in the following:

  • Iron deficiency
  • Hemodialysis
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Collection and Panels

Collection: Tiger top or red tube

Panel: Iron panel usually includes ferritin

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Background

Description

Ferritin is the cellular storage protein for iron. Its molecular weight is about 440 kilodalton. It is a 24-subunit protein that consists of light and heavy chains and can store up to 4500 atoms of iron. Ferritin is an acute-phase reactant that coordinates cellular defense against oxidative stress and inflammation along with transferrin and its receptor. [2] Usually, human plasma contains little ferritin; however, plasma ferritin levels are markedly increased in persons with excess iron.

Serum ferritin levels can be measured with a sensitive and specific immunoassay, serving as an index of body iron stores. [3]

Iron is stored either as hemosiderin or ferritin. Ferritin is water-soluble, while hemosiderin is water-insoluble. Ferritin is found in virtually all cells of the body and in tissue fluids. Ferritin in lysosomes is converted into hemosiderin upon partial degradation of its protein shell by lysosomal enzymes. [4] By contrast, ferritin that is degraded within the cytosol results in complete release of the iron. [5]

Ferritin is present in small concentrations in blood. The serum ferritin concentration normally correlates well with total-body iron stores, making its measurement important in the diagnosis of disorders of iron metabolism. [1]

Indications/Applications

Ferritin testing is indicated for the following:

  • To predict and monitor iron deficiency
  • To monitor response to therapy or compliance with treatment
  • To differentiate iron deficiency from chronic disease as a cause of anemia
  • To monitor iron status in patients with renal diseases with or without dialysis
  • To conduct population studies of iron level and response to supplements
  • To detect and monitor response to iron depletion therapy in iron overload states [2]

Considerations

In hepatic, inflammatory, and malignant conditions, the ferritin level may be normal. In these scenarios, bone marrow stain of iron may be necessary to exclude iron deficiency. [2]

Transferrin saturation is more sensitive in early hemochromatosis; serum ferritin is used to confirm the diagnosis of iron excess.

A high serum ferritin level is also an indication for liver biopsy.

Ferritin level increases with age, and the level is higher in men than women. It is particularly high in women taking contraceptives and in persons who eat red meat (in contrast to vegetarians).

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