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In recent years, discussions about ferritin have surged across social media, making this indicator of the body's iron reserves one of the most popular tests. But who should take it, how should it be done, and how should results be interpreted? Hematologist Anton Klodzinsky sheds light on these crucial questions.

What Exactly is Ferritin?

Ferritin is a protein that stores iron in the body. Iron is a vital micronutrient essential for the formation of hemoglobin and the transport of oxygen. Simply put, ferritin acts as the body's iron storage facility, located in the liver, spleen, bone marrow, and muscles. The iron circulating in the blood is known as serum iron.

When Iron Reserves Begin to Deplete

When the body's iron reserves start to decrease, ferritin levels are the first to drop. A low ferritin level indicates a 100% deficiency in iron. However, even if ferritin levels appear normal, it doesn't necessarily mean there's no iron deficiency. This is because ferritin is not only an iron store but also an indicator of inflammatory processes in the body, which can sometimes lead to misinterpretation.

In cases of iron deficiency, serum iron and transferrin, which transports iron, decrease first. Only in the later stages does hemoglobin level drop, leading to iron deficiency anemia.

Tests for Suspected Anemia

If anemia is suspected, the following tests are recommended:

This minimal set of tests can help confirm iron deficiency anemia. If necessary, additional tests for transferrin and C-reactive protein may be conducted.

Understanding Normal Ferritin Levels

Laboratory reference ranges for ferritin often show 15–150 mcg/L. However, a ferritin level below 30 mcg/L is considered a criterion for latent iron deficiency (even without anemia) or manifest deficiency (with anemia). If this indicator is below 30, iron deficiency is presumed. The goal of treatment is to raise ferritin levels above 50 mcg/L.

This is an average indicator and can vary based on inflammation, patient age, and other factors. Nevertheless, it is a generally accepted indicator for both men and women, aligning with international recommendations.

Causes and Symptoms of Low Ferritin

The causes of iron deficiency can be diverse, including:

Symptoms of low ferritin can include:

It's important to note that these symptoms can also be indicative of other illnesses, making a medical consultation essential.

Which Doctor Treats Iron Deficiency?

Typically, a general practitioner or therapist manages iron deficiency treatment. However, in cases of chronic diseases (kidney, heart, or intestinal conditions), a hematologist's consultation may be necessary.

Preparing for the Test

Dr. Anton Klodzinsky recommends the following guidelines when undergoing the test:

Iron Supplements: From Pills to Infusions

The main difference between oral iron supplements and intravenous (IV) infusions is that IV therapy allows for the calculation and administration of the exact required amount of iron. While oral treatments take additional time to raise ferritin levels to 50 mcg/L, IV infusions can be more rapid.

Indications for intravenous iron include:

The "rapid treatment" method may only be effective in severe anemia cases; otherwise, oral treatment is generally considered safer.

When Will Ferritin Levels Rise After Treatment?

Within the first 3-7 days of starting treatment, the number of reticulocytes (new red blood cells) increases, signaling the treatment's effectiveness. Hemoglobin levels begin to rise between the second and fourth weeks, typically over 1.5-2 months. It can take 1-3 months, or sometimes up to six months, to significantly increase ferritin levels.

Important: Iron supplements should not be taken without medical supervision or for extended periods, as this can lead to iron overload in the body.

Why Might Ferritin Not Increase Despite Supplementation?

Several reasons can explain this:

How Often Should Healthy Individuals Be Tested?

Anton Klodzinsky recommends having a general blood test at least once a year. If there are no specific symptoms, checking ferritin levels may not be mandatory annually.

This information is reported by the Infohub.kz news agency.