Type of test Blood

Normal findings

Male: 12-300 ng/mL or 12-300 mcg/L (SI units)

 Female: 10-150 ng/mL or 10-150 mcg/L (SI units)

Children

Newborn: 25-200 ng/mL

 ≤ 1 month: 200-600 ng/mL

2-5 months: 50-200 ng/mL

 6 months-15 years: 7-142 ng/mL

Test explanation and related physiology

The serum ferritin study is a good indicator of available iron stores in the body. Ferritin, the major iron storage protein, is normally present in the serum in concentrations directly related to iron storage. In normal patients, 1 ng/mL of serum ferritin corresponds to approximately 8 mg of stored iron.

Decreases in ferritin levels indicate a decrease in iron storage associated with iron deficiency anemia. A ferritin level less than 10 ng/100 mL is diagnostic of iron deficiency anemia. Increased levels are a sign of iron excess, as seen in hemochromatosis, hemosiderosis, iron poisoning, or recent blood transfusions. Increased ferritin is also noted in patients with megaloblastic anemia, hemolytic anemia, and chronic hepatitis. Furthermore, ferritin is factitiously elevated in patients with chronic disease states, such as neoplasm, alcoholism, uremia, collagen diseases, or chronic liver diseases.

A limitation of this study is that ferritin levels also can act as an acute-phase reactant protein and may be elevated in conditions not reflecting iron stores (e.g., acute inflammatory diseases, infections, metastatic cancer, lymphomas). Elevations in ferritin occur 1 to 2 days after onset of the acute illness and peak at 3 to 5 days.

interfering factors

 • Recent transfusions and recent ingestion of a meal with high iron content may cause elevated ferritin levels.

• Recent administration of a radionuclide can cause abnormal levels if testing is performed by radioimmunoassay.

 • Hemolytic diseases may be associated with an artificially high iron content.

• Disorders of excessive iron storage (e.g., hemochromatosis, hemosiderosis) are associated with high ferritin levels.

 •Iron-deficient menstruating women may have decreased ferritin levels.

• Acute and chronic inflammatory conditions and Gaucher dis ease can falsely increase ferritin levels.

* Iron preparations may increase ferritin levels.

Procedure and patient care

 • See inside front cover for Routine Blood Testing.

• Fasting: no

 • Blood tube commonly used: red

Abnormal findings

 Increased levels

 -Hemochromatosis

-  Hemosiderosis

 -Megaloblastic anemia

 -Hemolytic anemia

-  Alcoholic or inflammatory hepatocellular disease

 -Inflammatory disease

 -Advanced cancers

 -Chronic illnesses (e.g., leukemias, cirrhosis, chronic hepatitis)

 - Collagen vascular diseases

- Hemophagocytic syndromes

 -Congenital and acquired  sideroblastic anemias

Decreased levels

- Severe protein deficiency

- Iron-deficiency anemia

- Hemodialysis