From the Guidelines
Elevated ferritin levels in the blood indicate excess iron storage in the body, and if you have elevated ferritin, you should consult with a healthcare provider for proper evaluation and treatment. The approach typically involves identifying and treating the underlying cause, which could include hemochromatosis (a genetic disorder), inflammation, liver disease, or certain cancers. For hereditary hemochromatosis, treatment often includes therapeutic phlebotomy (blood removal) performed regularly until iron levels normalize, then maintenance sessions as needed, as recommended by the American College of Physicians 1.
Some key points to consider:
- Dietary modifications are also important, such as reducing alcohol consumption, avoiding iron supplements, limiting vitamin C with meals (as it enhances iron absorption), and reducing consumption of red meat and iron-fortified foods.
- For severe cases, iron chelation therapy with medications like deferoxamine (Desferal), deferasirox (Exjade, Jadenu), or deferiprone (Ferriprox) may be prescribed to help remove excess iron, as suggested by the European Association for the Study of the Liver 1.
- Regular monitoring of ferritin levels is essential to track progress and adjust treatment, with a goal of maintaining serum ferritin levels between 50-100 ng/mL, as recommended by the National Kidney Foundation 1.
- Elevated ferritin requires attention because excessive iron can damage organs including the liver, heart, and pancreas, potentially leading to cirrhosis, heart failure, diabetes, and other serious complications if left untreated, as highlighted by the American Association for the Study of Liver Diseases 1.
It is crucial to work with a healthcare provider to determine the best course of action, as the optimal treatment approach may vary depending on the underlying cause and severity of the condition.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Elevated Ferritin Levels
Elevated ferritin levels can be caused by various conditions, including:
- Inflammatory conditions such as adult-onset Still's disease, systemic juvenile idiopathic arthritis, and hemophagocytic lymphohistiocytosis/macrophage activation syndrome 2
- Malignancy, which was the most frequent condition in a study of 627 patients with markedly elevated serum ferritin levels 2
- Iron-overload syndromes, which were the second most common condition in the same study 2
- Infection, which was a common cause of hyperferritinemia in a study of 77 patients with serum ferritin levels above 2000 μg/L 3
- Hematological malignancy, which was the most prevalent diagnosis in a study of 77 patients with extreme hyperferritinemia 3
- Liver dysfunction, renal failure, and solid tumors, which were also common causes of hyperferritinemia in a study of 1394 patients 4
Diagnostic Significance
- Elevated ferritin levels can be a diagnostic marker for iron deficiency and overload, but its accuracy can be affected by inflammation and infection 5
- A study found that ferritin concentration is reasonably sensitive and specific for iron deficiency in people presenting for medical care, but its performance in screening asymptomatic people is uncertain 5
- The diagnostic odds ratio for ferritin concentration in detecting iron deficiency was estimated to be 140, indicating a relatively highly informative test 5
- However, the diagnostic odds ratio for ferritin concentration in detecting iron overload was estimated to be 8, indicating a less informative test 5
Clinical Relevance
- Extremely elevated ferritin levels can be associated with poor prognosis and critical clinical situations, such as hemophagocytic lymphohistiocytosis/macrophage activation syndrome 3
- A study found that patients with marked hyperferritinemia (ferritin levels above 10,000 μg/L) had a higher mortality rate at 3 months compared to those without marked hyperferritinemia 3
- Elevated ferritin levels can also be a marker of underlying inflammation and infection, and its monitoring can be useful in clinical practice 2, 3, 4