High or Low Ferritin Levels: What Your Results Mean

Updated in July 2022

Ferritin is a protein produced by the liver that is responsible for the storage of iron. Iron is essential for the formation of red blood cells. 

Ferritin tests are useful to determine whether there is an excess or deficiency of iron in the body. It is usually tested with blood iron levels and a complete blood count. It is also used to help with diagnosing the acute phase of an infection or inflammation.

Normally, in healthy people, normal iron levels are between 23 to 336 ng/mL for men and between 11 to 306 ng/mL in women. It is normal for ferritin levels to dip in pregnant women due to a higher volume of circulating blood and due to iron passage from the placenta to the baby. 

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When to check ferritin levels

Ferritin tests are usually ordered to evaluate iron levels. It is often ordered with iron, transferrin and a complete blood count. Because it is a protein that is produced by the blood, the doctor may also order liver enzyme tests, also known as ALT and AST tests

Ferritin is needed to store iron in the body, and it is also a marker for inflammation. If the doctor suspects infection or inflammation, ferritin testing may be ordered to assess the evolution of an illness or to monitor the efficacy of treatment if it has already been initiated. 

High ferritin level

Symptoms of high ferritin may be a sign of high iron levels, which may occur with inflammation or infections. This protein can become elevated in cases of acute inflammation or infection, such as: 

  • COVID-19
  • Hemolytic anemia 
  • Megaloblastic anemia
  • Alcoholic hepatitis
  • Hodgkin’s lymphoma
  • Myocardial infarct in men
  • Leukemia
  • Hemochromatosis 

Symptoms of high ferritin: Generally, people with high ferritin levels may feel joint pain, fatigue, shortness of breath or abdominal pain. Treatment for high ferritin varies according to the underlying cause, but blood dialysis may be recommended to level out excess amounts. Patients are advised to eat less foods that contain iron or vitamin C. 

Low ferritin level

Low ferritin levels usually indicate decreased iron levels. The liver stops producing iron as there is no iron available for storage. The main causes of low ferritin are: 

  • Iron deficient anemia
  • Hypothyroidism
  • Gastrointestinal bleed
  • Intense menstrual bleeding
  • Diet low in iron and vitamin C

Symptoms of low ferritin: Symptoms of low ferritin include fatigue, weakness, pallor, lack of appetite, hair loss, headaches and dizziness. Treatment can involve daily iron supplementation or iron rich diets with vitamin C sources, like meat, beans and oranges.