A high ferritin level may be a sign of cancer, rheumatoid arthritis, hemochromatosis, or infections. This condition, also known as hyperferritinemia, can cause symptoms such as fatigue, joint pain, shortness of breath, and weight loss, depending on the underlying cause.
Ferritin is a protein found in all cells and produced by the liver. It plays an important role in iron storage in the body and is essential for red blood cell production and oxygen transport.
Treatment for a high ferritin level should be guided by a hematologist or primary care provider and will depend on the underlying cause. It may involve the use of anti-inflammatory medications, antibiotics, pain relievers, blood removal (phlebotomy), or, in some cases, chemotherapy and surgery.
Common symptoms
The main symptoms of a high ferritin level include:
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Fatigue;
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Abdominal pain or discomfort;
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Joint pain;
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Shortness of breath;
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Unexplained weight loss;
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Low libido.
A high ferritin level alone doesn’t usually cause any symptoms. In most cases, these signs are linked to excess iron buildup in the body.
Confirming a diagnosis
To find out if your ferritin level is high, it’s important to see a hematologist or primary care provider, who will assess your symptoms as well as your personal and family medical history.
Blood tests such as a complete blood count, serum ferritin and iron levels, and the transferrin saturation index are used to confirm a diagnosis.
Reference values
Ferritin is considered high when levels are above 300 mcg/L in men or 200 mcg/L in women. However, reference values can vary slightly depending on the lab performing the test.
Possible causes
1. Cancer
A high ferritin level may be associated with several types of cancer, such as leukemia, prostate cancer, Hodgkin’s lymphoma, cervical cancer, T-cell lymphoma, and breast cancer.
This happens because immune system cells release ferritin as part of the body’s response to inflammation or to help fight cancer cells.
What to do: Treatment depends on the type and stage of the cancer as well as the person’s overall health. The doctor may recommend chemotherapy, radiation therapy, surgery, or a bone marrow transplant.
2. Rheumatoid arthritis
Rheumatoid arthritis can lead to a high ferritin level because ferritin is an acute-phase protein that increases during inflammation or infection.
What to do: Treatment is managed by a rheumatologist and may include anti-inflammatory drugs such as ibuprofen or meloxicam, corticosteroids like prednisone, physical therapy, exercise, and in some cases, surgery.
3. Hemochromatosis
Hemochromatosis can cause a high ferritin level due to iron buildup in the body, leading to symptoms such as abdominal pain, fatigue, weight loss, and joint pain.
What to do: Treatment usually involves phlebotomy, which removes about 450–500 mL of blood at a time to reduce iron levels. A doctor may also prescribe iron-chelating medications such as deferoxamine (Desferal), deferasirox (Exjade, Jadenu), or deferiprone (Ferriprox), which bind to excess iron so it can be eliminated through the urine.
4. Liver disease
Liver conditions such as cirrhosis, fatty liver disease, and hepatitis can be linked to a high ferritin level. This occurs due to inflammation and the accumulation of iron in the liver.
What to do: Treatment depends on the specific condition but may include lifestyle changes like avoiding alcohol, losing weight, exercising regularly, following a balanced diet, taking prescribed medications, and in some cases, undergoing surgery.
Also recommended: Fatty Liver Diet: What to Eat, What to Avoid & Meal Plan tuasaude.com/en/fatty-liver-diet5. Infections
Ferritin levels can rise during infections such as COVID-19, pneumonia, urinary tract infections, tuberculosis, and dental abscesses. This increase occurs because ferritin production rises as part of the body’s immune response.
What to do: Treatment depends on the type of infection and may include antibiotics, anti-inflammatory medications, fever reducers (acetaminophen or ibuprofen), and in some cases, a nebulizer.
6. Hyperthyroidism
Hyperthyroidism can cause a high ferritin level because thyroid hormones increase the production and release of ferritin in the body.
What to do: Treatment typically includes medications such as propylthiouracil or methimazole (Tapazole), radioactive iodine therapy, or thyroid surgery, depending on the case and the doctor’s recommendation.
7. Metabolic syndrome
A high ferritin level may also occur in people with metabolic syndrome, a condition characterized by insulin resistance, inflammation, and a higher risk of diabetes, high blood pressure, and obesity.
What to do: Treatment involves losing weight, engaging in regular physical activity, and sometimes using medications such as losartan, metformin, or simvastatin. A registered dietitian may also recommend a balanced diet that limits foods high in sugar and fat, such as fried foods, sodas, ice cream, cakes, and fast food.
High ferritin in children
A high ferritin level in children can result from respiratory infections such as COVID-19 and pneumonia, pediatric multisystem inflammatory syndrome, or cancer.
It can also be caused by a rare genetic disorder known as hereditary hyperferritinemia-cataract syndrome, which is caused by mutations in the ferritin gene and leads to elevated ferritin levels in the blood and bilateral cataracts.
High ferritin in pregnancy
A high ferritin level during pregnancy may be linked to gestational diabetes, a type of diabetes that develops during pregnancy in women without a previous diagnosis, usually after the 24th week. This occurs due to insulin resistance caused by pregnancy hormones.
High ferritin with low iron
High ferritin with low iron levels may occur in chronic conditions such as kidney disease, obesity, fatty liver disease, diabetes, rheumatoid arthritis, and lupus.
High ferritin with normal iron
A high ferritin level with normal iron levels can occur in cases of obesity, metabolic syndrome, excessive alcohol consumption, COVID-19, or cancer.