Ferritin: What It Is, Symptoms of High and Low Levels, and Treatment

Ferritin is a protein complex that controls the storage and release of iron, a mineral with vital functions in the body. Since iron can be stored, its deficiency or excess reflects the amount of iron in the body. Ferritin levels are among the first things checked, in addition to a complete blood count, as iron levels in the blood play a significant role in transporting oxygen to cells and carrying waste carbon dioxide from cells to the lungs. Iron is essential for maintaining cell vitality and carrying out cellular functions. A deficiency in ferritin can lead to serious health problems, starting with fatigue and progressing to the formation of anemia.

What is Ferritin?

Red blood cells, known as erythrocytes, need to be bound to iron in order to transport oxygen to cells. The protein responsible for carrying oxygen and carbon dioxide bound to iron is called hemoglobin. Ferritin is the protein that ensures adequate binding of iron. Ferritin is produced by cells in the immune system called reticuloendothelial cells and hepatocyte cells in the liver. Ferritin helps dissolve, store, and release the necessary amount of iron into the body. Ferritin combines with a protein called transferrin to deliver the required iron to the relevant parts of the body. Therefore, ferritin levels are used to determine the amount of iron in the body. A low ferritin level means that the body is unable to obtain the necessary amount of iron. When the body’s iron needs are not met, cells begin to lose function due to a lack of oxygen. This condition causes significant symptoms in the body. Just like low ferritin levels, high ferritin levels can also result in important symptoms in the body. Therefore, periodic blood tests should be performed to detect any deficiencies and address them with appropriate treatment.

What is Low Ferritin?

Low ferritin levels are one of the key indicators of iron deficiency. When iron is lacking, cells are unable to receive the oxygen they need, causing them to malfunction. Low ferritin levels can lead to cell dysfunction and cell death, resulting in damage to the skin, hair, and nails. It is normal for ferritin levels to be slightly lower in women than in men. For men, the normal ferritin range is between 20 to 500 nanograms per milliliter, while for women, the acceptable range is 20 to 200 nanograms per milliliter.

Symptoms of Low Ferritin

Low ferritin, and consequently iron deficiency, can cause discomforts that affect the entire body, starting with fatigue. Ferritin deficiency leads to negative effects on many tissues in the body, especially the skin, hair, and nails. The most common symptoms of low ferritin include:

Fatigue and tiredness
Dizziness
Loss of appetite
Shortness of breath
Pale skin color
Hair damage and hair loss
Weakening and damage to nails
Numbness and coldness in hands and feet
Forgetfulness
Difficulty concentrating
Irritability
Headaches
Tinnitus (ringing in the ears)

Causes of Low Ferritin Levels

The low levels of ferritin, which is crucial for the body, can be attributed to genetic, personal, and environmental factors. Some genetic factors that can cause low ferritin levels include celiac disease, gastrointestinal disorders that affect iron absorption, and certain chronic diseases of genetic origin. A person's lifestyle and eating habits also play a significant role in ferritin deficiency. Unhealthy and irregular eating, excessive consumption of coffee and tea, processed foods, and frequent pregnancies are personal factors that contribute to low ferritin levels. Furthermore, prolonged menstrual periods and bleeding caused by accidents or injuries can also lower ferritin levels. The causes of low ferritin levels can be classified as follows:

Eating habits
Lifestyle
Conditions causing bleeding
Genetic diseases
Absorption disorders
Pregnancy

Treatment for Low Ferritin Levels

When symptoms of low ferritin are present, the doctor will request a blood test. If the blood test shows low ferritin levels, the first thing to consider is whether there has been recent bleeding. After an accident, injury, or a difficult menstrual period, ferritin levels may decrease. If no bleeding has occurred, other potential causes of low ferritin are investigated. Once the cause is identified, treatment is provided to raise ferritin levels. Iron supplements, increasing the intake of iron-rich foods such as red meat, and avoiding habits that reduce iron absorption, such as excessive tea, coffee, and smoking, are essential in treating low ferritin. When taking iron supplements prescribed by doctors, it is advised to avoid consuming dairy products for a few hours because minerals like calcium and magnesium can reduce iron absorption.

What is High Ferritin?

Ferritin, which shows the amount of iron storage in the body, is considered elevated when its level exceeds 500 nanograms per milliliter. High ferritin levels often indicate the presence of an infection, inflammation, type 2 diabetes, metabolic syndrome, or malignant (cancerous) diseases. When ferritin levels rise, the iron storage is usually higher than it should be, leading to significant issues such as chest tightness and heart palpitations. If the high ferritin level is due to increased iron storage, measures should be taken to avoid iron intake and reduce iron absorption. Certain cancers, diseases that increase iron absorption like hemochromatosis, and disorders that reduce the utilization of iron, such as porphyria, can cause elevated ferritin levels.

Symptoms of High Ferritin

Just as low ferritin levels cause many health problems, high ferritin levels can also lead to life-threatening symptoms. While low ferritin levels result in damage to tissues due to cell death, high ferritin levels can cause issues related to excess oxygen. The main symptoms of high ferritin due to excessive iron storage can include:

Chest pain
Palpitations
Joint pain
Weight loss
Abdominal pain
A flushed skin tone
Decreased libido

What Causes High Ferritin?

Since the liver is one of the main places where iron is stored, many liver diseases and alcoholism are among the primary causes of high ferritin levels. Diseases that increase iron absorption, genetic disorders that disrupt iron metabolism, and conditions that prevent iron from being utilized properly can also lead to high ferritin. The conditions that cause high ferritin levels can be listed as follows:

Hemochromatosis
Rheumatoid arthritis
Chronic inflammatory disorders
Liver disease
Hyperthyroidism
Type 2 diabetes
Porphyria
Leukemia
Hepatitis C
Hodgkin’s lymphoma
Multiple blood transfusions
Excessive iron supplementation

How is High Ferritin Treated?

The treatment of high ferritin begins with the correct identification of the underlying cause. If a disease is responsible for the high ferritin, the disease is treated first, after which ferritin levels will normalize. If the cause is a non-disease-related factor, measures can be taken to reduce iron absorption. Increasing the intake of minerals like calcium, magnesium, and zinc, engaging in prolonged physical exercises, and increasing coffee and tea consumption can all reduce iron absorption. When experiencing high ferritin levels, iron supplements, if taken, should be temporarily stopped, and blood donations can be made. If these measures are insufficient in lowering ferritin levels, medications prescribed by a doctor may be used to reduce ferritin. Once ferritin levels return to normal through regular monitoring, the medication can be discontinued.

If you experience symptoms related to either low or high ferritin levels, it is important to visit a healthcare facility for a blood test. This will allow you to learn your ferritin levels and begin appropriate treatment under medical supervision.