From the Guidelines
A ferritin level of 514 is significantly elevated and indicates potential iron overload, which requires prompt medical evaluation to determine the underlying cause and prevent long-term organ damage. This elevation suggests excess iron storage in the body, which can be due to various causes such as hemochromatosis, liver disease, inflammation, or certain anemias 1. The normal range for ferritin typically falls between 20-250 ng/mL for men and 10-120 ng/mL for women.
To determine the cause of the elevated ferritin level, additional tests such as transferrin saturation, complete blood count, and liver function tests may be recommended by a healthcare provider. MRI can also be a helpful tool for non-invasive quantification of iron and to study the distribution of iron in the liver, spleen, pancreas, heart, and brain in patients with suspicion or diagnosis of iron overload disorder 1.
Some key points to consider in the management of elevated ferritin levels include:
- Reducing iron intake by limiting red meat, iron supplements, and vitamin C with meals (which enhances iron absorption)
- Regular blood donation may be suggested as a treatment if appropriate
- Lifestyle modifications including limiting alcohol consumption and maintaining a healthy weight are also important
- Elevated ferritin levels can be associated with increased risk of organ damage, such as liver, heart, and pancreas damage, if left untreated 1.
It is essential to consult with a healthcare provider for proper evaluation and management of elevated ferritin levels to prevent long-term complications.
From the Research
Ferritin Levels and Their Implications
A ferritin level of 514 can be considered elevated, as normal ranges typically vary between 15-150 μg/L for women and 30-400 μg/L for men 2.
Possible Causes and Associations
- Elevated ferritin levels can be associated with various conditions, including iron overload, inflammation, infection, and hemophagocytic lymphohistiocytosis (HLH) 3, 4.
- A ferritin level of 514 is significantly lower than the cut-off of 6000 μg/L, which is associated with HLH diagnosis 3.
- However, it is still higher than the normal range and may indicate iron overload or other conditions such as hemochromatosis, which can lead to end-organ damage if left untreated 5, 2.
Management and Treatment
- Therapeutic phlebotomy is used to remove excess iron and maintain low normal body iron stores in patients with hemochromatosis, typically initiated in men with serum ferritin levels of 300 μg/L or more and in women with serum ferritin levels of 200 μg/L or more 2.
- The goal of phlebotomy therapy is to reduce serum ferritin levels to 50 μg/L or less, and maintenance therapy is targeted to prevent iron reaccumulation 2, 6.
Prognosis and Mortality
- Elevated ferritin levels, including a level of 514, may be associated with increased in-hospital mortality, particularly in critically ill patients 4.
- However, the prognosis and mortality risk depend on the underlying diagnosis and other factors, such as the presence of HLH or other critical conditions 3, 4.