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Test ID FERR1 Ferritin, Serum

Specimen Required

Patient Preparation: For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container Tube: Plastic vial

Specimen Volume: 0.6 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.

Useful For

Aiding in the diagnosis of iron deficiency and iron overload conditions


Differentiating iron deficiency anemia and anemia of chronic disease

Method Name

Electrochemiluminescence Immunoassay

Reporting Name

Ferritin, S

Specimen Type


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  365 days
  Ambient  24 hours

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus Reject

Clinical Information

Ferritin is a large spherical protein consisting of 24 non-covalently linked subunits with a molecular weight of approximately 450,000 Da. The subunits form a shell surrounding a central core containing variable amounts of ferric hydroxyphosphate. One molecule of ferritin is capable of binding between 4000 and 5000 atoms of iron, making ferritin the major iron storage protein for the body.


Ferritin is found mainly in the cytoplasm of cells of the reticuloendothelial system and is a constituent of normal human serum. The concentration of ferritin is directly proportional to the total iron stores in the body, resulting in serum ferritin concentrations becoming a common diagnostic tool in the evaluation of iron status.


In most normal adults, serum ferritin concentrations vary with age and sex. There is a sharp rise in serum ferritin concentrations in the first month of life, coinciding with the depression of bone marrow erythropoiesis. Within 2 or 3 months, erythropoiesis becomes reactivated and there is a drop in the concentration of serum ferritin. By 6 months, the concentration is reduced to fairly low levels, where they remain throughout childhood. There is no sex difference until the onset of puberty, at which time ferritin concentrations rise, particularly in male patients. There is a significant positive correlation between age and serum ferritin concentrations in female patients, but not in male patients.


Patients with iron deficiency anemia have serum ferritin concentrations approximately one-tenth of normal subjects, while patients with iron overload conditions (hemochromatosis, hemosiderosis) have serum ferritin concentrations much higher than normal. Studies also suggest that serum ferritin provides a sensitive means of detecting iron deficiency at an early stage. Serum ferritin concentrations may serve as a tool to monitor the effects of iron therapy, but results should be interpreted with caution as these cases may not always reflect the true state of iron stores. Ferritin is a positive acute phase reactant in both adults and children, whereby chronic inflammation results in a disproportionate increase in ferritin in relation to iron reserves. Elevated ferritin is also observed in acute and chronic liver disease, chronic kidney failure, and in some types of neoplastic disease.


Evaluating body iron stores may include serum iron determination, total iron binding capacity (TIBC), and percent saturation of transferrin, however, these are subject to diurnal variations and may be less precise. Additionally, they do not discriminate between depleted iron stores (iron deficiency) and conditions associated with defective iron release (eg, anemia of chronic disease).

Reference Values


0 days-4 weeks: 150-973 mcg/L

5 weeks-5 months: 9-580 mcg/L

6 months-9 years: 6-111 mcg/L

10-17 years: 15-201 mcg/L

≥18 years: 31-409 mcg/L



0 days-4 weeks: 150-973 mcg/L

5 weeks-5 months: 9-580 mcg/L

6 months-17 years: 8-115 mcg/L

18-50 years: 6-175 mcg/L

≥51 years: 11-328 mcg/L


Hypoferritinemia is associated with increased risk for developing iron deficiency where iron deficiency is sufficient to reduce erythropoiesis causing hemoglobin concentrations to fall. Latent iron deficiency occurs when serum ferritin is low without low hemoglobin.


Hyperferritinemia is associated with iron overload conditions including hereditary hemochromatosis where concentrations may exceed 1000 mcg/L. Non-iron overload hyperferritinemia may be caused by common liver disorders, neoplasms, acute or chronic inflammation, and hereditary hyperferritinemia-cataract syndrome.


For more information about hereditary hemochromatosis testing, see Hereditary Hemochromatosis Algorithm.


Ferritin is an acute phase reactant and may be elevated in patients with inflammation, liver disease, chronic infection, autoimmune disorders, and malignancy.


Ferritin may be elevated in excess iron storage disorders besides hemochromatosis including hemolytic anemia, sideroblastic anemia, and in those with multiple blood transfusions.


Race and ethnicity factors (especially in Africans, African Americans, and Asians) are also associated with higher mean concentrations of serum ferritin than are typical of the White population, the basis of which is incompletely understood.

Clinical Reference

1. McPherson RA, Pincus MR: Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Elsevier Saunders; 2007:506

2. Burtis CA, Ashwood ER, Bruns DE: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier Saunders; 2012:985-1030

3. Cappellinin MD, Lo SF, Swickels DW: Hemoglobin, iron, bilirubin. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier Saunders; 2018:719-775

Method Description

The Roche ferritin method employs monoclonal antibodies specifically directed against ferritin. A biotinylated monoclonal antibody and a second monoclonal antibody labeled with a ruthenium complex react to form a sandwich complex. After the addition of streptavidin-coated microparticles, the complex becomes bound to the solid phase via interaction of biotin and streptavidin. The reaction mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Application of a voltage to the electrode then induces chemiluminescent emission, which is measured by a photo multiplier.(Package insert: Elecsys Ferritin. Roche Diagnostics; V2 10/2022)

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 2 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
FERR1 Ferritin, S 20567-4


Result ID Test Result Name Result LOINC Value
FERR1 Ferritin, S 20567-4