From the Guidelines
High ferritin levels in the blood indicate excess iron storage in the body, and if you have high ferritin, you should consult with a healthcare provider for proper evaluation and treatment, as elevated ferritin levels can lead to serious health complications, including organ damage and increased risk of mortality 1. The normal range for ferritin is typically 20-250 ng/mL for men and 10-120 ng/mL for women, though reference ranges may vary between laboratories. Some key points to consider when evaluating high ferritin levels include:
- Common causes of high ferritin levels, such as hemochromatosis, inflammation, liver disease, alcohol consumption, metabolic syndrome, and certain anemias 1
- The importance of additional tests, such as transferrin saturation, complete blood count, and liver function tests, to determine the underlying cause of high ferritin levels 1
- Treatment options, including phlebotomy, dietary modifications, and iron chelation therapy, which may be recommended depending on the underlying cause of high ferritin levels 1
- The need for regular monitoring of ferritin levels to track progress and adjust treatment as needed, as failure to control ferritin levels can increase the risk of heart disease and other complications 1
In terms of treatment, phlebotomy is often recommended for patients with iron overload conditions, with 500mL of blood removed every 1-2 weeks until ferritin levels normalize 1. Dietary modifications, such as limiting red meat, iron-fortified foods, and vitamin C with meals, may also be recommended to reduce iron intake. For patients with inflammatory conditions causing high ferritin, treating the underlying inflammation is the primary approach, and iron chelation therapy may be considered in certain cases 1.
Overall, high ferritin levels require prompt evaluation and treatment to prevent serious health complications, and regular monitoring of ferritin levels is crucial to ensure effective management of the condition 1.
From the FDA Drug Label
A 25% increased risk for acute kidney injury was observed with each 250 mcg/L decrease in serum ferritin starting at 1250 mcg/L (95% CI: 1.01 to 1. 56). Among pediatric patients with a serum ferritin <1000 mcg/L, those who received deferasirox tablets for oral suspension dosage >30 mg/kg/day, equivalent to 21 mg/kg/day deferasirox tablets compared to those who received lower dosages, had a higher risk for acute kidney injury (OR=4.47,95% CI: 1.25 to 15. 95), consistent with overchelation.
The relationship between high ferritin levels and deferasirox treatment is not directly addressed in terms of a specific ferritin threshold. However, the label does indicate that low serum ferritin levels (<1000 mcg/L) are associated with a higher risk of acute kidney injury when deferasirox is administered at higher doses.
- Key points:
- Serum ferritin levels are inversely related to the risk of acute kidney injury in pediatric patients treated with deferasirox.
- High ferritin levels are not directly associated with a specific risk in the label.
- The label does provide information on the risks associated with low serum ferritin levels in the context of deferasirox treatment 2.
From the Research
High Ferritin Levels
- High ferritin levels can be a sign of iron overload, which can be caused by various factors such as genetic disorders, transfusional iron intake, or environmental factors 3.
- Iron overload can lead to serious clinical implications, including organ damage and increased risk of infections 3.
Treatment Options
- Phlebotomy is the initial treatment of choice for hereditary hemochromatosis, while chelation is a mainstay in the treatment of transfusional siderosis 3.
- Iron chelation therapy (ICT) can help reduce serum ferritin levels and improve hematopoiesis in patients with aplastic anemia 4.
- Deferasirox is an oral iron chelator that has been shown to be effective in reducing serum ferritin levels and improving iron overload in patients with various types of anemia 5, 6.
Combination Therapy
- Combining iron chelators such as deferasirox with hydroxyurea can provide an additional benefit of iron chelation in patients receiving chronic transfusion therapy 7.
- This combination therapy has been shown to improve serum ferritin levels, liver iron concentration, and other biochemical markers in patients with sickle cell disease 7.