From the Guidelines
A ferritin level of 221.4 ng/mL in a 46-year-old male is within the normal reference range and does not indicate iron deficiency or iron overload. This value is not concerning without other clinical symptoms or abnormal lab values, as ferritin is a protein that stores iron in the body and its blood level serves as a good indicator of total body iron stores 1. While this particular value is in the upper half of the normal range, it is essential to consider that ferritin is also an acute phase reactant, meaning it can be elevated during inflammation, infection, or liver disease independent of iron status 1. Some key points to consider include:
- The normal reference range for ferritin in adult men typically spans from approximately 20-300 ng/mL 1
- Ferritin levels can be influenced by factors other than iron stores, such as inflammation or liver disease 1
- Additional testing, such as transferrin saturation, may be warranted if the patient has symptoms suggesting iron overload or a family history of hemochromatosis, despite a normal ferritin level 1
- Regular monitoring of ferritin levels is only necessary if there are specific clinical concerns or risk factors for iron metabolism disorders 1. It's crucial to evaluate the patient's overall clinical presentation and medical history to determine the best course of action, rather than relying solely on the ferritin level 1.
From the Research
Significance of Ferritin Level
- A ferritin level of 221.4 ng/mL in a 46-year-old male is below the threshold for iron overload as indicated by studies 2, 3, 4, 5, 6.
- The optimal cutoff value for iron overload using serum glycosylated ferritin level was found to be >587.55 ng/mL 2.
- Hyperferritinemia, which is characterized by elevated serum ferritin levels, can be caused by various conditions including non-human immunodeficiency virus infection, solid tumor, liver dysfunction, renal failure, and hematological malignancy 3.
- A study on hemodialysis patients with iron overload found that the administration of an oral iron chelator, deferasirox, caused significant reductions in transferrin saturation and ferritin levels 4.
Comparison with Study Findings
- The ferritin level of 221.4 ng/mL is significantly lower than the levels observed in patients with extreme hyperferritinemia, which can be associated with poor prognosis and critical clinical situations 5.
- The study on HFE hereditary hemochromatosis found that male C282Y homozygotes with a serum ferritin level of 1000 μg/L or more were more likely to report fatigue, use of arthritis medicine, and a history of liver disease 6.
- However, the ferritin level of 221.4 ng/mL is not indicative of iron-overload-related disease as defined in the study on HFE hereditary hemochromatosis 6.