From the Guidelines
High ferritin levels in the blood indicate excess iron storage in your body, and if your ferritin is elevated, you should consult with a healthcare provider for proper evaluation and treatment. The normal range for ferritin varies by gender, with levels typically between 20-250 ng/mL for men and 10-120 ng/mL for women 1. Your doctor may recommend additional tests like transferrin saturation, complete blood count, and liver function tests to determine the cause. Common causes include:
- Hemochromatosis (a genetic disorder causing iron overload)
- Inflammation
- Liver disease
- Alcohol consumption
- Metabolic syndrome
- Certain anemias
Treatment depends on the underlying cause but may include phlebotomy (blood removal) for iron overload conditions, with 500mL of blood removed every 1-2 weeks until ferritin normalizes 1. Dietary modifications to reduce iron intake may also help, such as limiting red meat, iron-fortified foods, vitamin C with meals, and alcohol. Ferritin is elevated because it's an acute phase reactant that increases during inflammation, and it also serves as the body's primary iron storage protein, rising when iron accumulates excessively in tissues. It is essential to interpret ferritin levels in the context of patient-specific conditions, such as chronic kidney disease and underlying inflammatory states 1.
From the Research
Causes of High Ferritin Levels
- High ferritin levels can be caused by various conditions, including malignancy, iron-overload syndromes, inflammatory conditions, and infections 2, 3
- Markedly elevated serum ferritin levels are often associated with severe underlying conditions, such as adult-onset Still's disease, systemic juvenile idiopathic arthritis, and hemophagocytic lymphohistiocytosis/macrophage activation syndrome 2, 4
- Hyperferritinemia can also be caused by liver dysfunction, renal failure, and hematological malignancy 3
Diagnosis and Management
- Ferritin levels should not be overlooked as merely an indicator of iron status or inflammation, and marked hyperferritinemia requires thorough investigation to differentiate between potential underlying conditions 4
- Dual chelation therapy with deferasirox and deferoxamine may be effective in reducing serum ferritin levels and improving liver iron loading in patients with beta thalassaemia major 5
- Clinical monitoring and management of complications related to chelation therapy are crucial in patients with β-thalassemia to reduce morbidity and mortality related to siderosis 6
Key Findings
- The most frequent cause of hyperferritinemia was non-human immunodeficiency virus infection, followed by solid tumor, liver dysfunction, renal failure, and hematological malignancy 3
- Patients with hyperferritinemia frequently had multiple conditions, and the level of serum ferritin was determined by the underlying conditions to a certain extent 3
- Marked hyperferritinemia can indicate severe underlying conditions, including infections, cardiovascular disease, endocrinological, autoimmune, and malignancies 4