Can elevated ferritin levels cause hypercalcemia?

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Last updated: March 19, 2025View editorial policy

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From the Guidelines

Elevated ferritin levels do not directly cause hypercalcemia, as ferritin and calcium are regulated by different mechanisms in the body. Ferritin is a protein that stores iron, while calcium levels are regulated by parathyroid hormone, vitamin D, and kidney function 1. However, certain medical conditions can cause both elevated ferritin and calcium levels simultaneously, such as inflammatory conditions, cancers, and hyperparathyroidism. Hemochromatosis, a genetic disorder causing iron overload, can also affect multiple organ systems, including the parathyroid glands, potentially influencing calcium metabolism indirectly.

Some key points to consider:

  • Ferritin and calcium are independent laboratory findings with different underlying causes
  • Certain medical conditions, such as inflammatory conditions and hyperparathyroidism, can cause both elevated ferritin and calcium levels
  • Hemochromatosis can affect multiple organ systems, including the parathyroid glands, potentially influencing calcium metabolism
  • If you have both high ferritin and high calcium levels, it's essential to consult with a healthcare provider for proper evaluation and treatment

The most recent and highest quality study on this topic is the 2022 EASL clinical practice guidelines on haemochromatosis, which provides guidance on the diagnosis and management of haemochromatosis, but does not directly address the relationship between ferritin and calcium levels 1. However, it highlights the importance of assessing iron status and other laboratory parameters, such as parathyroid hormone and vitamin D levels, in patients with suspected iron overload disorders.

In clinical practice, it is crucial to evaluate patients with elevated ferritin and calcium levels comprehensively, considering the potential for underlying conditions that may require specific treatment. This evaluation should include additional blood tests and possibly imaging studies to determine the cause of the elevated levels and to guide treatment decisions 1.

From the Research

Elevated Ferritin Levels and Hypercalcemia

  • There is no direct evidence in the provided studies to suggest that elevated ferritin levels cause hypercalcemia 2, 3, 4, 5, 6.
  • The studies primarily focus on the relationship between elevated ferritin levels and various conditions such as hemochromatosis, iron overload syndromes, and inflammatory diseases 2, 3, 4, 5, 6.
  • Hyperferritinemia is associated with a range of conditions, including malignancy, infections, and hemophagocytic lymphohistiocytosis/macrophage activation syndrome 5, 6.
  • Extreme hyperferritinemia is associated with a poor prognosis, including increased mortality and ICU transfer rates 6.
  • The provided studies do not investigate the relationship between ferritin levels and calcium levels, and therefore, do not provide evidence to support a causal link between elevated ferritin levels and hypercalcemia 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Iron chelation with deferasirox in a patient with de-novo ferroportin mutation.

Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS), 2015

Research

Causes and significance of markedly elevated serum ferritin levels in an academic medical center.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2013

Research

Extreme Hyperferritinemia: Causes and Prognosis.

Journal of clinical medicine, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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