Low Ferritin Levels

Ferritin is the main protein that stores iron and regulates its controlled release.  Basically, it stores iron as ferric hydroxide phosphate complex.Low ferritin levels simply mean iron deficiency and higher levels than normal, refer to iron overload. Either of this condition is dangerous as they lead to serious diseases.

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Ferritin blood test

A ferritin blood test is done to check the levels of ferritin, the protein that binds to iron in the blood. Ferritin is present in liver, skeletal muscles, spleen, bone marrow and blood. The levels present in the blood indicate the amount of iron is stored in the body.  The blood test is carried out to find out the cause of anemia, check for  inflammation, find out if too much iron is present and to evaluate whether the treatment to increase or reduce the levels of iron is working.

The ferritin blood test is conducted with the venous blood as extracted in a normal blood test. Mostly this test is conducted in conjunction with other tests so as to evaluate the iron stored in the body.

If high levels of ferritin are reported, it indicates iron storage disorder like chronic disease or hemochromatosis. Lower levels of ferritin may indicate deficiency of iron which leads to disease called anemia.

The normal ferritin levels are 18 to 270 ng/mL of blood among males and it is 18 to 160 ng/mL range among females. People having levels below 18 to 50 nanogram are said to have low ferritin levels or anemic. Children of age group ½ to 15 years have normal ferritin levels of 7 to 140 ng/mL and for infants it is 50 to 200 ng/mL.

What does a low ferritin level indicate?

Low levels of ferritin are the clear indication of iron deficiency. If the body is deficit of iron, then it fails to produce sufficient amount of hemoglobin, a component in RBCs responsible to carry oxygen. This result into a condition called anemia.

Low ferritin levels may also lead to other conditions such as Vitamin C deficiency, celiac disease and hypothyroidism. Teenagers and adolescents who have ferritin levels low but above the range of anemic condition are most likely to develop Restless Leg Syndrome.

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Mild anemia is not a serious condition and does not produce any symptoms. However severe cases of anemia produce following symptoms:

  • Breathlessness or shortness of breath
  • Dizziness or laziness
  • Pale skin
  • Heartbeat increases
  • Fatigue


In order to find out the underlying cause of low ferritin levels or anemia, your physician may ask questions related to living style and medical history. The physician is most likely to ask about the following:

  • Diet that you take to check whether it contains iron-rich foods
  • If you are a women, your doctor may ask if you have menorrhagia i.e. if you have been experiencing heavy periods
  • Any medicine that you might have been taking regularly that causes gastrointestinal bleeding
  • About your family history so as to ensure that you do not have a family history of blood disorders or gastrointestinal bleeding
  • If you donate blood regularly or in any case where you had excessive blood loss
  • About any other medical condition that you are currently having or had in the recent past

Physical examination of low ferritin levels or anemia

Physical examination will usually be conducted only if your cause of iron deficiency is not known. Physical examination may include examining the abdomen to find out if there is gastrointestinal bleeding which is the most common cause of low ferritin levels. The physician may also check for the symptoms of heart failure or condition if heart is not pumping the blood efficiently.

Two important physical examinations used to detect low ferritin levels are rectal examination and pelvic examination. Rectal examination is done only if patient is found to have rectal bleeding. Perhaps this is the most common method of knowing the cause of bleeding in gastrointestinal tract. In this exam, the physician will insert a lubricated and gloved finger into the rectum to check for any abnormalities. Generally the person does not feel pain but has a feeling of his bowels moving around.

If the physician detects heavy menstrual bleeding i.e. menorrhagia among women, then he may take up pelvic examination as it may be a cause of low ferritin levels. This examination is done to check external sex organs namely vulva and labia for bleeding of any infection. Alternatively the physician may also take the examination internally by inserting his lubricated and gloved finger inside the vagina to check if ovaries and uterus is enlarged.

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