From the Guidelines
Iron supplements can cause ferritin levels to rise, as the body absorbs the iron and stores excess amounts as ferritin, leading to increased ferritin levels in the blood. Ferritin is a protein that stores iron in your body, and its blood levels reflect your total body iron stores. When you take iron supplements, the intended effect is to increase iron stores, which is reflected by rising ferritin levels 1. The rise in ferritin typically occurs gradually over weeks to months of supplementation. However, if you don't have iron deficiency but continue taking supplements, your ferritin levels could potentially rise above the normal range.
According to the guidelines for anemia of chronic kidney disease, the goal of iron therapy is to improve erythropoiesis, not to attain specific levels of TSAT and/or serum ferritin 1. The levels of TSAT or serum ferritin above which patients will have iron overload are not known, but serum ferritin levels between 300 and 800 ng/mL have been common in dialysis patients, and there has been no evidence that such levels are associated with adverse, iron-mediated effects 1.
Other factors that can cause high ferritin include inflammation, liver disease, certain genetic conditions like hemochromatosis, and some types of cancer. In the management of hemochromatosis, serum ferritin levels are used to monitor the effectiveness of treatment, with the goal of keeping serum ferritin between 50 and 100 lg/L 1. If you're taking iron supplements and concerned about high ferritin levels, it's essential to consult with your healthcare provider, who may recommend adjusting your dosage or discontinuing supplements if your iron stores have become sufficient or excessive.
Some key points to consider when taking iron supplements include:
- Monitoring ferritin levels regularly to avoid iron overload
- Adjusting the dosage of iron supplements based on ferritin levels and clinical response
- Being aware of the potential for iron overload, especially in patients with certain medical conditions
- Consulting with a healthcare provider to determine the best course of treatment for individual cases.
From the Research
Iron Supplements and Ferritin Levels
- Iron supplements can affect ferritin levels, as ferritin is a protein that stores iron in the body 2.
- High ferritin levels can be an indication of iron overload, which can lead to various health problems, including insulin resistance and β-cell injury 2.
- Iron overload can occur due to various factors, including genetic disorders, increased intestinal iron absorption, and chronic transfusional regimens 3, 4, 5.
- Serum ferritin is commonly used as a diagnostic tool to assess body iron stores, although it may not be a specific method 3.
Relationship Between Iron Supplements and Ferritin
- Excessive ferritin levels have been linked to an increased risk of gestational diabetes mellitus (GDM) due to iron overload 2.
- Insufficient ferritin levels, on the other hand, can cause obstetric complications such as anemia and gestational hypertension 2.
- The decision to start iron supplementation and the choice of chelator should be made jointly by the clinician and patient, taking into account the individual's specific needs and health status 3, 4, 5, 6.
Monitoring and Treatment of Iron Overload
- Phlebotomy and chelation are the two main treatment options for iron overload, with phlebotomy being the initial treatment of choice in hereditary hemochromatosis and chelation being a mainstay in the treatment of transfusional siderosis 4, 5.
- Serum ferritin levels and liver iron concentration are used to monitor iron overload, and MRI is a valuable tool for assessing cardiac iron load 4, 6.
- Various chelation regimens have been shown to be effective in controlling iron overloading in thalassaemia major, with some regimens demonstrating Level A Evidence in controlling serum ferritin levels and liver iron concentration 6.