Serum Ferritin

The serum ferritin test is ordered to see how much iron your body has stored for future use. Reduced serum ferritin concentration is the most useful test for diagnosis of iron deficiency.[1] As the body iron stores decrease so does the serum ferritin. A serum ferritin concentration below 12 ug/L is virtually diagnostic of absent iron stores.

On the other hand, a normal serum ferritin concentration does not confirm the presence of storage iron, because serum ferritin concentration may be increased independently of body iron by infection, inflammation, liver disease, malignancy, and other conditions.[2]

The goal of therapy in individuals with iron deficiency Anemia is not only to repair the Anemia, but also to replenish the iron stores. Sustained treatment for a period of 6 to 12 months after correction of the Anemia will be necessary.

The Hemoglobin concentration begins to increase after the first week and is usually normal within 6 weeks. Microcytosis may take as long as 4 months to resolve completely. The serum ferritin concentration remains below 12 ug/L until the Anemia is corrected and then gradually rises as storage iron is replenished.

References:
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1. Goddard AF, McIntyre AS, Scott BB: Guidelines for the management of iron deficiency anaemia. British Society of Gastroenterology. Gut 46(suppl 3-4):IV1, 2000.
2. Cook J: The nutritional assessment of iron status. Arch Latinoam Nutr 49:11S, 1999


normal serum ferritin concentration does not confirm the presence of storage iron, because serum ferritin concentration may be increased independently of body iron by infection, inflammation, liver disease, malignancy, and other conditions.[1]

An increased ferritin (>400 ng/ml) occurs in iron excess and in the following: iron overload from hemochromatosis or hemosiderosis; oral or parenteral iron administration; inflammatory diseases; acute or chronic liver disease involving alcoholism; acute myoblastic or lymphoblastic leukemia; other malignancies (Hodgkin’s disease, breast carcinoma, malignant Lymphoma); Hyperthyroidism; hemolytic Anemia, megaloblastic Anemia; thalassemia (normal or sometimes higher).

Ferritin is normally found mainly inside of cells, with only a small amount in the blood. When there is damage to organs that contain ferritin (especially the liver, spleen, and bone marrow), ferritin levels can become elevated even though the total amount of iron in the body is normal.

References:
==========
1. Cook J: The nutritional assessment of iron status. Arch Latinoam Nutr 49:11S, 1999.

Category: Pathology Notes