Examination
17723
Purpose of test
Ferritin
Iron deficiency occurs when the body's iron demand is not
met by iron absorption from the diet. Iron deficiency
anaemia (IDA) occurs in the more severe stages of iron
deficiency when the body is iron deficient to the degree
that red blood cell production is reduced
* WHO Classification of anaemia
Haemoglobin: < 130 g/L in adult male
< 120 g/L in adult female
< 110 g/L in pregnancy
Sample
Blood
Sample Tube/Container
Adult- Yellow top or Green top Lithium Heparin Gel
Paediatric- Green top Lithium Heparin Gel
Sample Volume
4ml
Minimum (see calculation of minimum volume)
Special Precautions
No specific requirements
Request Form:
Clinical Chemistry & Haematology Requests
Laboratory
Biochemistry
Biological reference range
Male 30-400 ug/L
Female to 55yrs 13-150 ug/L
Female >55yrs 13-300 ug/L
Clinical decision values
Please note that ferritin is an acute phase marker and
should be interpreted in the context of the CRP. The
following iron deficiency anaemia cut-offs are quoted in
Investigation and Management of the Adult Patient with
Anaemia, published by GAIN 2015;
Se ferritin < 30 µg/L when CRP < 30 mg/L
Se ferritin < 100 µg/L when CRP > 30 mg/L
For patients with a ferritin above the reference range and
a fasting transferrin saturation >55% genetic testing is
recommended - see Guidelines for HFE Gene Screening
in General Practice in clinical guideline section of the trust
website
Factors affecting performance In sample where icterus (bilirubin), haemolysis or lipemia
is indicated by the manufacturer to cause inaccuracy of
>10%, the result will be dashed out or reported with a
disclaimer
Samples should not be taken from patients receiving
therapy with high biotin doses until at least 8 hours
following the last biotin administration
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In rare cases, interference due to extremely high titres of
antibodies to analyte-specific antibodies, streptavidin or
ruthenium can occur
Turnaround times:
The Laboratory aims to report 90% of requests within the
stated time from receipt
Urgent - 1 hour
Ward - 4 hours
GP and OPD – 1 working day
Patient preparation
No specific requirements
Instructions for patient
collected sample
Not applicable
Sample transportation
No specific requirements
Special handling needs
No specific requirements
Patient consent required
Implied consent
Specific rejection criteria
Generic rejection applies
Additional information
Stability: Whole blood – no data available
Serum/Plasma – 5 days at 2-8˚C
Samples are kept in the laboratory for a maximum of 5
days post analysis
Minimum Retest IntervalsFerritin monitoring for haemochromatosis- initially 3
months but test more frequently as ferritin approaches
normal range
Iron profile/ferritin in patients on parenteral nutrition- 3‐6
months
Iron status in chronic kidney disease- Monitor iron status
no earlier than 1 week after receiving IV iron and at
intervals of 4 weeks to 3 months routinely
Iron profile/ferritin in a normal patient- 1 year
Serum ferritin level is the biochemical test which most
reliably correlates with relative total body iron stores. Low
levels indicate low iron stores. However,
- Serum ferritin levels are difficult to interpret in presence
of the following co existing conditions, known to cause
elevated levels. Levels can be high even in the presence
of iron deficiency
- inflammatory/ rheumatoid disease
- alcoholic/inflammatory hepatocellular disease
- haemochromatosis
-megaloblastic anaemia
- haemolytic anaemia
- haemosiderosis
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- advanced cancers (leukaemia, Hodgkin’s disease and
carcinoma of lung, liver, colon, pancreas)
- collagen vascular disease
- chronic illness (leukaemia, cirrhosis, chronic hepatitis)
- autoimmune disease (Macrophage activation syndrome,
Still’s disease)
- liver disease, malignancy, hyperthyroidism, kidney
disease, or heavy alcohol
Serum ferritin levels fall in the second and third trimesters
of pregnancy independent of iron stores
References
Lab Tests Online
Roche insert 2016-11 V15 English
WHO use of anticoagulants in diagnostic laboratory
investigations
Investigation and Management of the Adult Patient with
Anaemia guidelines published by GAIN
https://rqia.org.uk/RQIA/files/1e/1e2a9adc-7517-4a47858a-5192b0746456.pdf
CKS anaemia guidelines
NI audit group recommendations
Tim Lang ACB Minimum retesting recommendations 2013
Rosário et al. The Hyperferritinemic Syndrome:
macrophage activation syndrome, Still’s disease, septic
shock and catastrophic antiphospholipid syndrome BMC
Medicine 2013, 11:185
Note: Printed documents are not controlled
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