Ferritin Reveals Our Iron Stocks

What is ferritin?

Ferritin is a protein that is present in all our cells. The dose in the blood (serum ferritin) reflects the state of the body’s iron reserves. In a 2011 report, the Haute Autorité de Santé estimates that “usually 1 microgram per liter of serum ferritin (the one circulating in the blood, editor’s note) corresponds to about 10 milligrams of iron in reserve.”

Iron is essential for health because the red blood cells ensure that the oxygen transport in the organism.

A lower percentage in women

Women generally have lower ferritin than men. In fact, they lose small amounts of iron each month during menstruation. In addition, during pregnancy, the female body consumes a lot of iron for proper development of the fetus. A situation that can lead some pregnant women to anemia, ie to iron deficiency, so regular monitoring of their ferritin.

Food: how do you get enough iron?

In principle, a balanced diet provides sufficient iron and makes it possible to compensate for small deficiencies. The National Health Security Agency (ANSES) estimates nutritional needs at 9 milligrams per day (mg/d) for a man, 8 mg/d for a postmenopausal woman and 20 mg/d for a non-menopausal woman. In comparison, the rules correspond to an iron loss between 0.4 and 0.5 mg/d.

In the diet, iron is mainly found in red meat, fish and seafood; but also in green lentils, chickpeas, tofu, eggs and green leafy vegetables. However, iron of plant origin is less well absorbed than iron of animal origin. This is why people who use a . follow vegetarian diet are sometimes required to take nutritional supplements or adjust their menu.

When should ferritin be measured?

The ferritin test is one of the biological tests often requested by general practitioners. “The main reason for this dosage is the search for iron deficiency anemia. This iron deficiency is suspected in the presence of certain symptoms: fatigue, paleness, brittle hair, etc. explains Dr. Lionel Barrand, president of the medical biologists’ union.

A classic blood test

A simple blood test can be used to measure ferritin, as part of a classic blood test. This test is usually accompanied by an NFS (blood count) which, among other things, can determine the level of hemoglobin, ie red blood cells, in the blood. A hemoglobin low combined with low ferritin is a sign of iron deficiency. It is then necessary to consult your doctor to consider treatment.

You don’t have to fast

This blood test does not require fasting. However, it is recommended that you come to the laboratory preferably in the morning.

The rules don’t change the result

A young woman can have her ferritin measured during her period without fear of distorting the result. “It takes a long time to build up and break down the stock of iron. Even if the period is heavy for several days, the ferritin will not decrease overnight,” explains Dr. Barrand.

Ferritin and Inflammation

An inflammatory condition temporarily increases the ferritin level, therefore it is recommended not to dose it during a cold or during a crisis in inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis, etc.).

At what level of ferritin should we be concerned?

“The standard is usually between 30 and 200 or 300 micrograms per litre. Below 30 is too low. Above 300 is too high. But these are global numbers; the exact thresholds depend on the lab provider, gender, and age of the person. For example, for a young woman, a ferritin between 15 and 30 micrograms per liter may be common.” the biologist recalls. To find out if its ferritin content is correct, simply check the lab reference values ​​listed on the analysis report.

Low Ferritin (Hypoferritinemia): Possible Causes

In general, ferritin is considered abnormally low below 30 micrograms per liter The threshold may be lower for a young woman.

A low ferritin is a sign of anemia, the most common form is iron deficiency anemia associated with iron deficiency. To confirm this diagnosis, the doctor conducts a clinical examination looking for characteristic symptoms (fatigue, paleness, brittle hair, etc.). It is also comparable to other blood results.

Ferritin supplemented with hemoglobin level

The hemoglobin level in the blood indicates the condition of the red blood cells. If it is too low (usually less than 110-120 grams per liter in women and less than 130 g/l in men), oxygen is no longer properly transported in the blood, which explains the fatigue of anemic patients.

This anemia can have various causes: insufficient food intake (for example in the context of a vegetarian diet), abnormal iron loss due to digestive bleeding (colon cancer, colon polyps, stomach ulcer…) or a lack of iron absorption (celiac disease, etc.).

Regular monitoring of ferritin is recommended in patients with heart failure. Iron deficiency (or iron deficiency) is common in these people. Again, iron supplementation may be necessary.

High Ferritin (Hyperferritinemia): When Should You Worry?

Abnormally high ferritin can have several causes.

Which ferritin level is alarming?

If the ferritin level is moderately elevated (usually less than 500/L), this may be a sign of inflammation. In this case, the doctor will complete his diagnosis by requesting a blood test for C-reactive protein (CRP).

If it is very high (greater than 600 or even 1000/l), it could be an iron overload due to a genetic disease: hemochromatosis.

In all cases, the doctor takes into account other symptoms and the patient’s health condition in order to interpret a ferritin level that is too high. For example, the result is often too high in chronic renal failure or in certain cancers.

A very high percentage is also observed in chronic alcoholism, where alcohol stimulates the synthesis of ferritin. In this case, other blood markers associated with liver damage (Asat, gamma-GT, etc.) can be looked for.

Is it dangerous to have too much ferritin?

Due to accumulation in organs such as the liver, excess iron (characterized by excessive ferritin levels) can have serious long-term consequences such as cirrhosis, with a possible evolution to liver cancer.

Hemochromatosis: a genetic disease linked to iron overload

To understand the origin of an iron overload, the doctor must analyze another blood parameter, transferritin. A transferritin saturation level greater than or equal to 45% confirms the suspicion of hemochromatosis. But since this disease is of genetic origin, other more specific tests are needed to confirm the diagnosis.

Once the diagnosis of hemochromatosis is made, treatment is initiated. Regular bloodletting can therefore lower the ferritin level in the blood. The High Health Authority recommends lowering it to less than 50 micrograms per liter. This disease that affects the liver may also be asked to test liver markers such as the AST level.

In a press release dated May 10, 2021, the Academy of Medicine highlights the frequency of hemochromatosis and calls for better screening for the disease “based on simple blood tests such as the combination of the transferrin saturation coefficient and the rate of ferritinemia.”

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