Ferritin vs. Iron – Understanding Your Blood Results

What Is Iron?

Iron is a mineral that your body needs to form hemoglobin. Hemoglobin, the iron-rich protein in your red blood cells, is responsible for transporting oxygen from your lungs to the rest of your body. But Hemoglobin, with its crucial component iron, encompasses many more vital functions for the body, like strengthening the immune system and producing new erythrocytes (red blood cells). [1]

Consequently, adequate iron levels ensure your body’s optimal hemoglobin function, facilitating oxygen transport to tissues, including those of the immune system, thus enhancing your body’s ability to fight infections and potential health problems.

Without sufficient iron, your body can't produce enough healthy red blood cells, leading to a condition known as iron deficiency anemia. [2]

Iron is primarily stored in your body in hemoglobin. About one-third of iron is also stored as ferritin and hemosiderin in the bone marrow, spleen, and liver. [2]

Did you know that the average man has around 1000 mg of stored iron, which lasts for about three years, while a woman’s body only stores about 300 mg, enough for about six months? Therefore, especially women should keep track of their iron storage.

But what can you take away from the iron levels in your blood test results?

Understanding Iron in Blood Test Results

When you undergo blood testing, your iron levels are a key indicator of your general health status and an important criterion of your nutritional supply.

• Serum Iron: Your serum iron refers to the amount of iron circulating in your bloodstream.

• Low Serum Iron: Too low concentrations of iron in your blood can be due to diets low in iron or indicate iron deficiency (anemia). Anemia affects the body's ability to produce adequate hemoglobin for red blood cells, reducing oxygen transport to tissues. Low serum iron can also result from blood loss, body changes or Gastrointestinal tract abnormalities. [2]

• High Serum Iron: Suggests iron overload. Iron overload can be genetic due to the inherited condition hemochromatosis, where iron in the body slowly builds up over many years. It can also result from blood transfusions or excessive intake of iron supplements. [3]

If you have received your blood test results or are investigating low or high iron levels, ferritin is another blood level that will pop up in your blood analysis.

What Is Ferritin?

Ferritin is a blood protein that stores iron within your cells. This blood protein plays a crucial role in regulating your body's iron levels, ensuring that there is a sufficient supply available for vital body functions, such as the formation of your red blood cells. A ferritin blood test can give you insight into your iron stores. [4]

Understanding ferritin levels can help diagnose and manage conditions related to iron imbalance, such as anemia (iron deficiency) or hemochromatosis (iron overload).

Understanding Ferritin in Blood Test Results

• Serum Ferritin Levels: Ferritin acts as an iron storage protein, reflecting the total iron reserves in your body.

• Low Ferritin: Low ferritin levels are often the first sign of iron deficiency, even before other symptoms become apparent.

• High Ferritin: Conversely, a high amount of ferritin might indicate an excess of iron or an inflammatory condition.

• Transferrin and Total Iron-Binding Capacity (TIBC): Transferrin is a protein that transports iron through the blood, and TIBC measures all proteins available for binding iron, including transferrin. The TIBC helps assess how well your body can transport and store iron.

• High TIBC and low transferrin saturation suggest iron deficiency

• Low TIBC could indicate iron overload or chronic illness.

What’s the Difference Between Ferritin and Iron?

Ferritin is a protein that stores iron inside your cells, acting as a regulator to maintain iron at safe levels and ensure its availability for essential bodily functions. Iron, on the other hand, is a mineral vital for your health, particularly for the formation of hemoglobin, which carries oxygen through your blood. Even though one is a protein and the other a mineral, they are closely connected and work together.  [1] [2] [3]

What Are Typical Ferritin Levels?

Normal ferritin levels in your blood depend on several factors, including your age, gender, and overall health status. Results are given in nanograms per millilitre (ng/mL).

• Ferritin Levels for Men: 24 to 336 ng/mL for adult males. [4]

• Ferritin Levels for Women: Healthy levels are often a little lower than for men, ranging from 24 to 307 ng/mL for adult females. [4]

How High Should My Iron Levels Be?

The optimal iron levels in your blood depend on various factors, including your age, gender, and overall health status. Results are given in millilitres (ng/mL) or micromoles per litre (mcmol/L).

However, as a general reference, we provide you with what is considered the normal range for serum iron levels, TIBC and transferrin saturation below:

• Iron levels: 60 to 170 micrograms per deciliter (mcg/dL), or 10.74 to 30.43 micromoles per litre (micromol/L) [3]

• Total iron binding capacity (TIBC): 240 to 450 mcg/dL, or 42.96 to 80.55 micromol/L [3]

• Transferrin saturation: 20% to 50% [3]

What Are the Symptoms of Low Ferritin Levels and Iron Levels?

Low ferritin and iron levels typically indicate iron deficiency, which can lead to anemia. Here's an overview of the common symptoms associated with low ferritin and iron levels or anemia: [2] [4]

• Fatigue and Weakness: These symptoms can occur because iron is essential for producing haemoglobin, the protein in red blood cells that carries oxygen. With less iron, your body makes fewer and less effective red blood cells, reducing oxygen supply to tissues and causing fatigue and weakness.
• Pale Skin and Mucous Membranes: Hemoglobin gives blood its red colour, so low levels due to iron deficiency can make the blood less red. This results in paler skin and mucous membranes.
• Shortness of Breath: With lower hemoglobin levels, your body can't transport oxygen efficiently. This inefficiency means your muscles and organs receive less oxygen, which can lead to shortness of breath during activities as your body tries to increase oxygen intake.
• Dizziness or Light-headedness: Insufficient oxygen supply to the brain, a result of reduced hemoglobin, can cause feelings of dizziness or light-headedness, especially when standing up quickly or exerting yourself.
• Headaches: The brain's oxygen supply is compromised when hemoglobin levels are low, potentially leading to headaches as the blood vessels in the brain dilate to try to increase oxygen delivery.
• Cold Hands and Feet: Iron deficiency can lead to poor circulation because of the reduced oxygen-carrying capacity of your blood, making your hands and feet feel colder than usual.
• Brittle Nails: Iron is vital for many bodily functions, including nail growth. Low iron levels can disrupt the growth of nails, making them brittle, spoon-shaped, or ridged.
• Hair Loss: Hair follicle cells can go into a resting phase and fall out more quickly when they don't receive enough iron, leading to hair loss.
• Restless Legs Syndrome: Iron is necessary for dopamine function, a neurotransmitter that affects movement. Low iron levels can lead to uncomfortable sensations in the legs and an irresistible urge to move them, characteristic of restless legs syndrome.

What Are the Symptoms of High Ferritin and Iron Levels?

High ferritin and iron levels can indicate conditions such as hemochromatosis (iron overload) or chronic inflammation.

Symptoms related to high iron levels can be nonspecific and may affect various organs. We have summarized some more common symptoms that are associated with high iron and ferritin levels: [3] [4]

• Joint Pain: Excess iron can be deposited in joints, leading to pain and arthritis-like symptoms, particularly in the hands and knees, as the iron accumulation causes inflammation and damage to the joint tissues.
• Fatigue: Despite being associated with low iron levels, fatigue is also common in iron overload due to the body's toxic response to excessive iron, which can affect energy metabolism and organ function.
• Abdominal Pain: High iron levels can lead to liver enlargement and damage, manifesting as abdominal pain, especially in the upper right quadrant. The pancreas may also be affected, potentially causing pain and digestive issues.
• Skin Color Changes: Hemochromatosis has been called “bronze diabetes.” Iron overload can cause the skin to appear bronze or gray due to iron deposition in skin tissues, affecting the skin colour.
• Heart Problems: Excessive iron can lead to cardiomyopathy, characterized by irregular heartbeats, shortness of breath, and weakness due to iron deposits in the heart muscle, impairing its function.
• Diabetes: High ferritin and iron levels can damage the pancreas and affect its ability to produce insulin, potentially leading to diabetes or worsening existing diabetes symptoms due to the toxic effect of iron on insulin-producing cells.
• Liver Problems: Symptoms such as liver enlargement, cirrhosis, or liver failure can occur because the liver is a primary site of iron storage, and excessive iron can cause liver damage and affect its function. Therefore, liver disease and high iron and ferritin levels can be related.
• Sexual Dysfunction: In men, high iron levels can lead to impotence or loss of libido, and in women, it may additionally cause an absence of the menstrual cycle, as iron overload can affect hormone production and regulation.
• Mood Disorders: Excessive iron can affect the brain, potentially leading to mood swings, depression, or cognitive changes due to the toxic effects of iron on brain tissue and neurotransmitter pathways.