From the Guidelines
Slightly elevated ferritin levels can be caused by several conditions beyond iron overload, including inflammation, infection, liver disease, and metabolic syndrome, as ferritin is an acute phase reactant that increases during inflammatory processes 1.
Causes of Elevated Ferritin
Some common causes of slightly elevated ferritin levels include:
- Inflammation or infection, as ferritin is an acute phase reactant that increases during inflammatory processes
- Liver disease, such as hepatitis or fatty liver disease, which can elevate ferritin as the liver is responsible for storing iron and producing ferritin
- Alcohol consumption, even moderate amounts, which may raise ferritin levels temporarily
- Metabolic syndrome, characterized by obesity, insulin resistance, and high blood pressure, which is frequently associated with elevated ferritin
- Certain medications like iron supplements, which can naturally increase ferritin
- Less commonly, thyroid disorders, particularly hypothyroidism, may cause mild ferritin elevation
- Some cancers, especially leukemia and lymphoma, can also increase ferritin production
Diagnostic Approach
If you have slightly elevated ferritin, your doctor may recommend additional tests to determine the underlying cause, including:
- C-reactive protein to check for inflammation
- Liver function tests
- Possibly a complete blood count
Management
Lifestyle modifications such as reducing alcohol intake, losing weight if overweight, and managing chronic conditions may help normalize ferritin levels. It's essential to follow up with your healthcare provider as persistent elevation could indicate a condition requiring treatment, as seen in a study where very high levels of ferritin were associated with disease activity in adult-onset Still's disease 1.
From the Research
Causes of Slightly Elevated Ferritin
- Inflammation: Slightly elevated ferritin levels can be caused by inflammation, as ferritin is an acute phase reactant 2, 3.
- Infection: Infections, such as severe infections, can also lead to elevated ferritin levels 2, 3.
- Iron overload: Iron overload, which can occur in conditions such as hemochromatosis, can cause elevated ferritin levels 4, 5.
- Liver disease: Liver disease, including non-alcoholic fatty liver disease (NAFLD), can also be associated with elevated ferritin levels 5, 6.
- Hematological malignancies: Certain hematological malignancies, such as diffuse large B-cell lymphoma, can cause hyperferritinemia 2, 3.
- Autoimmune disorders: Autoimmune disorders, such as adult-onset Still's disease (AOSD), can also lead to elevated ferritin levels 3.
- Other conditions: Other conditions, such as cardiovascular disease, endocrinological disorders, and malignancies, can also cause hyperferritinemia 3.
Specific Conditions Associated with Elevated Ferritin
- Non-alcoholic fatty liver disease (NAFLD): Elevated ferritin levels have been associated with an increased risk of NAFLD in postmenopausal women 6.
- Hemophagocytic lymphohistiocytosis (HLH): Marked hyperferritinemia can be indicative of HLH, a rare but life-threatening condition 2, 3.
- Adult-onset Still's disease (AOSD): Elevated ferritin levels can be a diagnostic marker for AOSD, a rare autoimmune disorder 3.