Maybe you’ve seen it on the results of a blood test, discussed it with your doctor, or read about it after donating blood: ferritin. But what exactly is it and what can you do about a low ferritin level? Metro talks to Karina Meijer, a professor at the University of Groningen and a hematologist.
“Ferritin is a value in the blood that is used to assess iron stores,” explains Prof. Dr. Meijer. “There are a few caveats: ferritin is a protein in the blood that increases during inflammation, infection, or illness. If ferritin is low, it always means there is too little iron in the body. But a high ferritin level can also occur when you are sick.”
Low ferritin level
According to Meijer, you can only reliably measure the ferritin level when someone is healthy. If someone is sick, their ferritin level is likely elevated due to the illness. There is no one answer to what a good ferritin level is. Meijer says, “It depends on the lab where you have it tested. It depends on the standard they compare it to and their research method. This can vary from lab to lab.”
“You don’t suffer from a low ferritin level, you suffer from too little iron. You need iron to make red blood cells, and if your iron level is low for a long time, it can lead to anemia. A low ferritin level is actually the first step towards an iron deficiency. It is a typical form of anemia, where red blood cells are smaller than usual.”
Why is ferritin low and what do you do about it?
There are two reasons why there is too little iron in your blood: you either don’t get enough or you lose it, meaning blood loss. “Sometimes the cause is very clear, for example, if your ferritin is low and you also menstruate, then you lose blood. In that case, it may be wise to take iron supplements,” explains the hematologist. But if the cause of a low iron level is not clear, it’s important to determine why. “That question is more important than what to do about it.”
“If I see an older person with a low ferritin level, they are losing blood. This can only happen in the gastrointestinal tract, if another cause of blood loss is not clear. This is also the basis of the population screening for colon cancer, where they check for blood in the stool. This can indicate colon cancer, polyps, or gastritis. If you are not a menstruating woman and you have an iron deficiency, the doctor will often decide to do further tests.”
High ferritin level
In addition to a low ferritin level, there are also situations where the ferritin level is too high. Meijer says, “This can happen when you are sick, but it can also be due to a hereditary condition that makes it easy for you to absorb iron. There are certain genetic mutations where iron accumulates in the organs, known as hemochromatosis. There are also hereditary red blood cell disorders, such as thalassemia, which can be harmful. In these cases, people can undergo ‘iron reduction’ therapy with medications.”
When should you take iron supplements?
For some people, it may be a good idea to supplement their iron deficiency with iron supplements, “but never on your own,” emphasizes Meijer. “If the cause of your low ferritin or iron is clear – for example, during menstruation – you often need to take iron supplements. The balance is often off: someone is menstruating and not getting enough iron through their diet. Easily absorbable iron is found in meat, so if a woman menstruates and is a vegetarian, she may be low in iron. This is the only group where you might consider iron supplements, but not on your own.”
According to the hematologist, men “actually never” need to take iron supplements. “I can’t think of a situation where a man has an iron deficiency that isn’t indicative of an illness. Men with an iron deficiency need to see a doctor because that is not good. They shouldn’t be losing blood. Iron supplements are only okay for menstruating and pregnant women, but only under medical supervision.”