Lexicon
Ferritin
Definition
Ferritin is a major iron storage protein that is essential to iron homeostasis and is involved in a wide range of physiologic and pathologic processes. [1] In clinical medicine, ferritin is predominantly utilized as a serum marker of total body iron stores, playing a critical role in the diagnosis and management of both iron deficiency and iron overload. [1]
How it works
The major role of ferritin is to bind iron, oxidize it, sequester it in a safe form in the cell, and release it according to cellular needs. [2] Serum ferritin provides a useful and convenient method of assessing iron storage status, but inflammation, infection, metabolic abnormalities, and malignancy can all elevate it and complicate interpretation. [2] As an acute-phase reactant, ferritin may be nonspecifically elevated in a wide range of inflammatory conditions, so a low value is a specific marker of iron deficiency while a normal or high value does not exclude it during inflammation. [3]
Connected concepts
How it's measured
Serum ferritin measurement has become a routine laboratory test and is one of the most commonly requested investigations in both primary and secondary care. [2] [4] Serum ferritin is the most powerful test for iron deficiency, and low serum ferritin levels invariably indicate reduced iron stores. [5] [4] A key test in the further investigation of an unexpectedly raised serum ferritin is the serum transferrin saturation. [4]
What levels mean
A serum ferritin concentration of less than 30 microg/L has high specificity and sensitivity for diagnosing iron deficiency in adults. [6] In adults without inflammation, a ferritin level of less than 45 ng/mL, or 46 to 99 ng/mL together with a transferrin saturation below 20%, is diagnostic of iron deficiency, while in patients with inflammation a ferritin below 100 ng/mL is diagnostic.
Community knowledge
## Sleep And Iron Status
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- 1.Knovich MA, Storey JA, Coffman LG, Torti SV, Torti FM. Ferritin for the clinician. Blood Rev · 2009
- 2.Piperno A, Pelucchi S, Mariani R. Hereditary Hyperferritinemia. Int J Mol Sci · 2023
- 3.Zhang D, LaSenna C, Shields BE. Serum Ferritin Levels: A Clinical Guide in Patients With Hair Loss. Cutis · 2023
- 4.Cullis JO, Fitzsimons EJ, Griffiths WJ, Tsochatzis E, Thomas DW, British Society for Haematology. Investigation and management of a raised serum ferritin. Br J Haematol · 2018
- 5.Goddard AF, James MW, McIntyre AS, Scott BB, British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut · 2011
- 6.Truong J, Naveed K, Beriault D, Lightfoot D, Fralick M, Sholzberg M. The origin of ferritin reference intervals: a systematic review.
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