Elevated ferritin levels can either mean excessive iron in the blood or an acute inflammatory reaction. It can be an indicator for malignancy, coronary artery, sideroblastic anemias, neurodegenerative disorders or hemophagocytic syndrome.
Iron is very essential for the normal functioning of the body. It facilitates the transport of oxygen throughout the body and converts it into energy. It also acts as an enzymatic co-factor in several other reactions. However, free iron has toxic effects on the body. This is where ferritin comes into play. Ferritin is a protein that binds with iron and exists both intracellularly and extracellularly. Its function is to store iron and release it in a controlled manner.
As mentioned above, free iron that is absorbed by the body is toxic to cells. Ferritin stores this iron in a non-toxic form, and then transfers it to the areas where it is required, thus protecting the lipids, DNA, and proteins from the toxic effects of iron. It acts as a buffer against iron deficiency and iron surplus in the human body. In short, it releases more iron in case of iron deficiency, and lesser in case of iron overload. Ferritin is present in the blood serum, and under normal conditions, it correlates with the total iron deposits in the body. It is also found in the mitochondria of body cells. Mitochondrial ferritin is a metal-binding protein, and plays roles pertaining to molecular functioning. It takes part in ferroxidase activity (conversion of iron from ferrous to ferric forms), oxidoreductase activity (catalyzing the transfer from one molecule to another), iron ion binding, ferric iron binding, transition as well as metal ion binding activity. Since, ferritin participates in a number of biological processes that are vital to life, it is very important that it is present in an optimum concentration in the body. Any rise or fall in its level may result in numerous health issues.
The normal values of ferritin count are as follows:
| Age | Normal Ferritin Level |
| Newborns | 25-200 ng/mL or 25-200 mcg/L |
| 1 – 5 months | 50-200 ng/mL or 50-200 mcg/L |
| 6 months – 15 years | 7-140 ng/mL or 7-140 mcg/L |
| Adult Females | 18-160 ng/mL or 18-160 mcg/L |
| Adult Males | 18-270 ng/mL or 18-270 mcg/L |
In the initial stage, high ferritin level symptoms usually go unnoticed. It is mostly determined when a blood test is conducted to check the levels of ferritin in the body. However, there are some symptoms that are identifiable with the passage of time. These include:
• Pain throughout the body, especially the joints
• Darkening of the skin
• Lethargy
• Fatigue
• Pain in the abdomen
• Lack of sex drive
• Cardiac problems
Causes of High Ferritin
Genetic predisposition is the basic reason behind high ferritin levels in the body. However, it can occur due to many non-genetic factors as well. The non-genetic causes of high ferritin levels include:
• Blood disorders
• Chronic hepatitis
• Excessive iron intake
• Chronic transfusion therapy
High levels of ferritin can be a sign of diseases like:
• Alcoholic liver disease
• Megaloblastic anemia
• Hodgkin’s lymphoma
• Hemolytic anemia
• Hemochromatosis
Diagnostic Tests
Diagnosis is done by carrying out two simple blood tests. These are transferrin saturation and serum ferritin. In case of both the tests, fasting is a necessity. These tests are generally ordered because serum ferritin level is directly related to the amount of iron present in the blood. If these tests show high levels of iron, then other serum tests like total iron binding capacity (TIBC) and unsaturated iron binding capacity (UIBC) may also need to be conducted.
Treatment Options
The treatment for high ferritin aims at reducing its level and bringing it back to normal. The most common treatment is therapeutic phlebotomy. In this procedure, blood is drawn from the body so as to remove iron from the organs where it has been stored in excess. Usually, one unit of blood is drawn once or twice a week. One might have to undergo therapeutic phlebotomy on a weekly basis till the excess ferritin or iron has been removed from the body. The level of ferritin in the blood is monitored continuously throughout the treatment. The length and frequency of the treatment depends upon gender, age, reason for diagnosis, and severity of the symptoms. Once the optimum levels of ferritin have been reached, the frequency of the sessions is reduced to only twice or thrice a year.
Chelation may also help in treating high ferritin levels. It is a process of removing a heavy metal from the bloodstream. Chelates bind to the excess metal in the blood and help in its removal. Phytic acid (present in the hull of nuts and seeds), natural amino acids, and ethylenediaminetetraacetic acid (EDTA) are good chelates. However, the intake of chelates should be done only after consulting a doctor. It is necessary that the process is carefully monitored. There is a possibility that the chelates might bind with other metals like zinc, and minerals like calcium, and its excessive intake could result in deficiency of iron.
Another way of treating elevated ferritin levels is by following a suitable diet plan. Individuals with this condition may be advised to reduce the intake of iron-rich foods such as spinach, beans, red meat, raisins, dried apricots, dried peaches, as well as supplements that contain iron.
Iron deposition can lead to organ damage. Women lose iron or ferritin through blood loss during menstruation, thus saving them from the danger of organ damage to some extent. If high ferritin levels do not cause an organ damage, one can lead a healthy and normal life after undergoing successful therapeutic phlebotomy. However, in case of organ damage, the individual will have to restrict the progression of high ferritin levels to avoid further damage. One might also notice reduction in the symptoms and discomfort.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for professional medical advice.
