Also Known As
Serum Ferritin
Formal Name
Ferritin, serum
This article was last reviewed on
This article waslast modified on
January 15, 2018.
At a Glance
Why Get Tested?

To determine your body's total iron storage capacity

When To Get Tested?

When your doctor suspects that you may have too little or too much iron in your system

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

You may be instructed to fast for 12 hours before the test; in this case, only water is permitted.

You may be able to find your test results on your laboratory's website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab's website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab's website or portal, or contact your healthcare practitioner in order to obtain your test results.

Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called "normal" values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

For more information, please read the article Reference Ranges and What They Mean.

What is being tested?

Ferritin is an iron-containing protein and is the primary form of iron stored inside of cells. The small quantity of ferritin that is released into the blood is a reflection of the amount of total iron stored in the body. This test measures the amount of ferritin in the blood.

In healthy people, about 70% of the iron absorbed by the body is incorporated into the hemoglobin of red blood cells. Most of the remaining 30% is stored as ferritin or as hemosiderin, a complex of iron, proteins, and other materials. Ferritin and hemosiderin are present primarily in the liver but also in the bone marrow, spleen, and skeletal muscles.

When available iron is insufficient to meet the body's needs, iron stores are depleted and ferritin levels decrease. This may occur because of insufficient iron intake, inadequate absorption, or increased need for iron such as during pregnancy or due to a condition that causes chronic blood loss. Significant depletion of iron stores may occur before any signs of iron deficiency develop.

Iron storage and ferritin levels increase when more iron is absorbed than the body needs. Chronic absorption of excess iron will lead to the progressive buildup of iron compounds in organs and may eventually cause their dysfunction and failure. This happens in hemochromatosis, a genetic disease in which the body absorbs too much iron, even on a normal diet.

How is the sample collected for testing?

A blood sample is drawn by needle from a vein in the arm.

Is any test preparation needed to ensure the quality of the sample?

A 12-hour fast may be required. In this case, only water is permitted. Morning specimens are preferred.

Accordion Title
Common Questions
  • How is it used?

    The ferritin test is ordered to assess a person's iron stores in the body. The test is sometimes ordered along with an iron test and a TIBC to detect the presence and severity of iron deficiency or iron overload.

  • When is it ordered?

    The ferritin test may be ordered, along with other iron tests, when a routine CBC shows that a person's hemoglobin and hematocrit are low and their red blood cells are smaller and paler than normal (microcytic and hypochromic), suggesting iron deficiency anemia even though other clinical symptoms may not have developed yet.

    In the early stage of iron deficiency, no physical effects are usually seen. If a person is otherwise healthy, symptoms seldom appear before the hemoglobin in the blood drops below a certain level (10 g per deciliter). However, as the iron-deficiency progresses, symptoms eventually begin to develop and a doctor may order ferritin as well as other iron-related tests. The most common symptoms of iron deficiency anemia include:

    • Chronic fatigue/tiredness
    • Weakness
    • Dizziness
    • Headaches
    • Pale skin (pallor)

    As iron stores continue to be depleted, there may be shortness of breath, ringing in the ears (tinnitus), drowsiness, and irritability. If the anemia progresses in severity, chest pain, headaches, leg pains, shock, and even heart failure may occur. Children may develop learning (cognitive) disabilities. Besides the general symptoms of anemia, there are certain symptoms that are characteristic of iron deficiency. These include pica (cravings for specific substances, such as licorice, chalk, dirt, or clay), a burning sensation in the tongue or a smooth tongue, sores at the corners of the mouth, and spoon-shaped finger- and toe-nails.

    A ferritin level may also be ordered when iron overload is suspected. Symptoms of iron overload will vary from person to person and tend to worsen over time. They are due to iron accumulation in the blood and tissues. Symptoms may include:

    To confirm the presence of iron overload, other iron tests (iron, TIBC) and a genetic test for hereditary hemochromatosis may be ordered as well.

  • What does the test result mean?

    Ferritin levels are often evaluated in conjunction with other iron tests. A summary of the changes in iron tests seen in various diseases of iron status is shown in the table below.

     

    Disease Iron TIBC/Transferrin UIBC

    %Transferrin

    Saturation

    Ferritin
    Iron Deficiency Low High High Low Low
    Hemochromatosis High Low Low High High
    Chronic Illness Low Low Low/Normal Low Normal/High
    Hemolytic Anemia High Normal/Low Low/Normal High High
    Sideroblastic Anemia Normal/High Normal/Low Low/Normal High High
    Iron Poisoning High Normal Low High Normal

    Ferritin levels are low in people who are iron deficient and are elevated in those with hemochromatosis or who have had multiple blood transfusions.

    Ferritin is an acute phase reactant and can be increased in people with inflammation, liver disease, chronic infection, autoimmune disorders, and some types of cancer. Ferritin is not typically used to detect or monitor these conditions.

  • Is there anything else I should know?

    Normally, most ferritin is found inside of cells with only a small amount in the blood. When there is damage to organs that contain ferritin, such as the liver, spleen, and bone marrow, ferritin levels can become elevated even though the total amount of iron in the body is normal.

  • My iron level is normal, but my ferritin level is low. Why is that?

    The development of iron deficiency anemia is a gradual process. If your body is not taking in enough iron, your body first uses the iron that is stored in tissues (i.e., ferritin) and blood levels of ferritin will begin to decrease. If not corrected, the stored iron begins to be depleted as it is used in the production of red blood cells. In the early stages of iron-deficiency, blood levels of iron can be normal while stored iron, and therefore ferritin levels, will begin to decrease.

  • I know eating foods high in iron or taking iron supplements will increase my iron level, but will it also increase my ferritin level?

    Yes. Taking in more iron will increase the level of iron in your body. If the level of iron in your body increases and is more than your body requires, then your body will begin to store more iron in the form of ferritin.

  • What other conditions may alter ferritin levels?

    Increased levels may be seen in alcohol abuse, acute hepatitis, and infections.

  • Who should take iron supplements?

    The people who typically need iron supplements are pregnant women and those with documented iron deficiency. Young women who become anemic due to poor dietary intake and have chronic and/or excessive loss of blood during their menstrual cycle may require iron supplements. People should not take iron supplements before talking to their doctor as excess iron can cause chronic iron overload. An overdose of iron pills can be toxic, especially to children.

  • Is there any way to cure iron overload?
    If it is due to a temporary condition or ingestion of iron supplements, then it will likely resolve on its own once the condition or supplement ingestion is resolved. If it is due to hemochromatosis or to a chronic disease, then it cannot be cured; careful management by your physician is required. In severe cases, periodic removal of a prescribed amount of blood, also known as therapeutic phlebotomy, may be necessary.
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