The ferritin test may be ordered, along with other iron tests, when a routine CBC shows that a person's hemoglobin andhematocrit are low and their red blood cells are smaller and paler than normal ( and ), suggestingiron 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:
- 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 hemochromatosismay 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.
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 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 , ferritin levels can become elevated even though the total amount of iron in the body is normal.