Not medically reviewed
Iron and vitamins
Ferritin
Not medically reviewed · Content last updated · 1 min read ·
This is the date the draft was written, not a medical review date.
The intracellular iron-storage protein, a small amount of which circulates in proportion to body iron stores. It is the most sensitive and specific test for iron deficiency, but it is also an acute-phase reactant.
Reference interval
| Conventional (ng/mL) | SI (µg/L) | |
|---|---|---|
| Men | 24–336 ng/mL | 24–336 µg/L |
| Women | 11–307 ng/mL | 11–307 µg/L |
Specimen: Serum or heparinised plasma · Conventional × 1 = SI
Causes of high values
Iron overload (haemochromatosis, transfusion), inflammation and infection, liver disease, malignancy, adult-onset Still disease, hyperthyroidism, metabolic syndrome, alcohol, renal failure, haemophagocytic syndromes (very high).
Causes of low values
Absent iron stores (iron deficiency) from chronic blood loss, poor dietary intake, malabsorption (coeliac disease), pregnancy. A level below about 15 ng/mL is highly specific, and under 30 ng/mL is commonly used as a cut-off for deficiency.
Pre-analytical and method notes
Premenopausal women have lower values than men, and children and the elderly have different ranges. In inflammation, ferritin can be normal despite iron deficiency, so a higher cut-off (for example up to 100 ng/mL in chronic kidney disease or heart failure) is used by some guidelines, and results are method-dependent. Reference intervals vary by laboratory, method and population; use the interval printed on the report.
References
- Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity (WHO/NMH/NHD/MNM/11.1). World Health Organization (2011) — Tier 1 (standards / international bodies)
- Rifai N, Horvath AR, Wittwer CT. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier, 6th edition (2018) — Tier 3 (textbook)
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. Elsevier — Tier 3 (textbook)
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