Ferritin is a protein that iron binds to in the body. High ferritin is a sign of high levels of iron. As such, the protein itself is not toxic. However, high levels of iron are toxic, and the diseases associated with high levels of iron also cause problems.
Functions of Ferritin
According to "Harrison's Principles of Internal Medicine," by Anthony S Fauci M.D., ferritin functions to store iron in the body. In iron deficiency, ferritin can release the iron for use in the body, such as helping red blood cells to carry oxygen. Alternatively, ferritin can sequester iron if levels rise too high in the body. Therefore, the level of ferritin parallels the level of iron. If there is too little iron, ferritin levels will drop, and if there is too much iron, the level will rise.
Causes
High ferritin iron is associated with a number of conditions. Iron overload can occur in the contex of ongoing multiple blood transfusions. Certain diseases can cause red blood cell counts to be low. For example, in myelodysplastic syndromes the bone marrow does not produce enough red cells; this may require blood transfusions. The repeated doses of iron in the blood build up and ferritin rises. Hereditary hemochromatosis is a condition of iron overload from a genetic mutation in a gene called HFE that causes the body to store excess iron.
Symptoms
The excessive iron damages several organs as noted by "Current Medical Diagnosis and Treatment" by Drs. Stephen McPhee and Maxine Papadakis. The liver may become cirrhotic, meaning the normal functioning liver tissues are replaced by scar tissue. This can cause fluid buildup, bleeding, increased risk of infections, confusion and other symptoms. Damage to the heart muscle interferes with the pumping of blood and can cause fatigue and shortness of breath. The pancreas can fail, leading to diabetes. Joint pain, or arthritis, occurs from iron depositing in the joints. The skin may become darker and the ovaries and testicles may become non-functional, causing fertility and sexual problems.
Diagnosis and Prognosis
The diagnosis of ferritin and iron overload can be made directly from a blood test that measures the concentration of ferritin and compares it to a standard concentration. MRI, magnetic resonance imaging, is a technique that uses magnets to make a picture of the body. It can be calibrated to scan for iron, and can be useful in the liver. Tests for gene mutations are also available.
Treatment
Treatment is often the regular removal of blood, called phlebotomy, because blood contains much of the iron. Another treatment is with the drug deferoxamine, which binds to iron in the blood and helps the body to expel it. Other treatments involve addressing the organ dysfunction. For example, the damage to the pancreas causes it to not be able to release insulin. The treatment for this would be insulin shots.
References
- "Harrison's Principles of Internal Medicine" Anthony S. Fauci; 17th Ed 2008
- "Current Medical Diagnosis and Treatment"; Stephen J. McPhee and Maxine Papadakis; 49th Ed 2009
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