Is Lactoferrin of 11.5 Very High?
Yes, a fecal lactoferrin level of 11.5 μg/g (or mg/g) is elevated and strongly suggests active intestinal mucosal inflammation, most likely from inflammatory bowel disease, requiring endoscopic evaluation.
Understanding Your Result
The diagnostic threshold for fecal lactoferrin is 7.25 μg/g - values above this indicate intestinal inflammation with 83% sensitivity and 75% specificity for moderate to severe endoscopic inflammation in IBD 1, 2.
Your level of 11.5 is approximately 1.6 times the diagnostic cutoff, placing you clearly in the elevated range that warrants further investigation 1.
In patients with moderate to severe symptoms and elevated lactoferrin above 7.25 μg/g, only 3.7% are false positives - meaning 96.3% truly have moderate to severe endoscopic inflammation 1.
What This Means Clinically
This is not a borderline result - it represents definite elevation that requires action:
Fecal lactoferrin detects neutrophil-derived inflammation at the molecular level, indicating active mucosal disease rather than simple bleeding from non-inflammatory sources like hemorrhoids 3.
Studies show mean fecal lactoferrin levels in active IBD range from 440-1125 μg/g, while healthy controls have levels around 1.27-1.45 μg/g 4, 5.
Your level of 11.5 falls between normal and the typical active disease range, but is still significantly elevated above the diagnostic threshold 4, 5.
Immediate Next Steps
The American Gastroenterological Association recommends endoscopic assessment rather than empiric treatment when biomarkers are elevated 6:
Colonoscopy with ileoscopy and biopsy is the gold standard for establishing diagnosis and assessing disease extent 6.
Perform this within 7-14 days, as early endoscopy is associated with shorter symptom duration and shorter steroid treatment duration 6.
Before Endoscopy, Rule Out Infections:
Stool culture for bacterial pathogens (Salmonella, Shigella, Campylobacter, E. coli O157:H7) 6.
C. difficile toxin testing to exclude infectious colitis 6.
Fecal calprotectin measurement provides quantitative assessment and helps establish which biomarker correlates better with your disease pattern 6.
Serum CRP - if elevated >5 mg/L, this provides additional evidence for moderate to severe endoscopic inflammation 6.
Important Clinical Context
Do not delay endoscopy based on symptom severity alone:
The National Comprehensive Cancer Network specifically recommends early endoscopy for all patients with positive lactoferrin results, even those with only mild symptoms 6.
Elevated lactoferrin can detect inflammation before it becomes visually apparent on endoscopy, and capsule endoscopy or standard colonoscopy can miss subtle mucosal inflammation 2.
Common Pitfall to Avoid
Do not attribute this elevation to hemorrhoids or other non-inflammatory bleeding sources:
Hemorrhoids cause bleeding without mucosal inflammation and do not trigger neutrophil infiltration or lactoferrin release 3.
If you have both hemorrhoids and elevated lactoferrin, the elevated lactoferrin indicates concurrent intestinal mucosal inflammation requiring investigation 3.