Are you looking at your blood tests and seeing you have really high ferritin and low iron saturation and wondering why this could be happening? My name is Dr. Teranella, and in this video, we're going to break down this question on high ferritin, low iron saturation, what could be going on in your body and what it might mean.
In this video, we're looking at actual reasons for high ferritin and low iron saturation. High ferritin can happen for several reasons, and the same thing with low iron saturation, but these two things usually increase together. That is, as iron goes up in the body, so does the iron saturation and so does the ferritin.

So the way that it works is iron is carried throughout the body on a carrier protein called transferrin. As the amount of iron goes up, the transferrin molecule is said to be more saturated, and this is what we mean by iron saturation. So if you have low iron saturation, it typically means you have low amounts of circulating iron in the blood as well. Now onto the high ferritin results, this usually reflects high iron reserves.

The ferritin molecule is a way for the body to store iron and to put it away so it has access to it at another time. It's also a way to protect the body from the iron when levels are high circulating in the blood. Now typically when you have high iron consumption in your diet, your iron saturation will be normal to high, and the ferritin will be similarly normal to high.

The main reason for high ferritin and low iron saturation is going to be from an inflammatory process occurring in the body. When infections are present, it causes the body to sequester iron so that the iron is no longer available for those bugs to grow and proliferate. Iron, in particular, helps bacteria and other bugs to grow, and so it's a defense mechanism by the body. As a compensatory mechanism, the body will start to scavenge up all the iron and put it into that storage form called ferritin. This process happens through mechanisms driven by mainly the immune system.

Chemical messengers made by the immune system called cytokines cause the body to scavenge up the iron, and those same cytokines are produced during autoimmune diseases and other causes of inflammation. So the reason for high ferritin and low saturation is directly related to this in most instances. You can verify this by running some other tests, like inflammatory tests like C-reactive protein and sed rate.

And this is really important to actually do this and not assume that something is going on because you can actually become anemic in situations like this. You can have low hemoglobin as well as low red blood cells. But if you also have really high inflammation, you really wouldn't want to dump a bunch of extra iron into your body or start taking an iron supplement. And the reason is twofold. For one, it's not really going to help increase your hemoglobin and red blood cells.

Because it's just going to get scavenged up again into the ferritin molecule and two, it's potentially going to enhance or further inflame the body even more. And if there's an infection present, it's certainly going to help promote that infection and make it harder for your immune system and body to kill off that bug. So in cases like this, first, you want to check for inflammation and check for autoimmune conditions.

If those are not going on, it could just be a temporary thing going on. For instance, during severe infections like those seen with COVID-19, ferritin levels were reaching somewhere around 700 to 800, and sometimes even higher in some patients. All the while, they were also anemic with low hemoglobin, low red blood cells. The iron saturation was also low in these cases.

And the levels quickly resolved once the infection was cleared. In some cases, infections lingered longer than others, but the point is sometimes these are just temporary things. If it's lingering on multiple blood tests, for sure you want to find and clear the infection or autoimmune thing that's going on.