Optimal Ferritin Levels May Surprise You

Optimal Ferritin Levels Blog Image

Often patients express worry that their ferritin levels are too low, when, in fact, I am concerned about the opposite.

Ferritin is a large protein molecule, and while its role is complex and still unclear, ferritin is generally considered a surrogate marker for total iron storage in the body and often acts as a biomarker of health. Optimal ferritin levels and reference ranges are not currently well defined, but what are considered “normal levels” may actually be too high, and some researchers are advocating for a change in what is considered normal. While we still don’t know the “optimal” numbers, aiming for below the 50 percentile is most likely healthier (20-40 for women, 50-70 for men). Ferritin specialist William R. Ware, PhD, suggests that we should aim even lower for some patient populations (those with cardiometabolic disease, non-alcoholic fatty liver, etc.).

Elevated ferritin has been linked with a number of physiologic processes, the most notable inflammation. Clinical studies that aim to reduce ferritin levels have documented improvement in outcomes. This reinforces the idea that iron may be a causal factor in various disease processes, based on the following:

  • Iron is highly reactive and can produce oxidative stress, damaging DNA, organs, and vasculature.
  • High levels of iron are associated with chronic diseases, such as diabetes, cardiovascular disease, metabolic syndrome, chronic kidney disease, aging and neurologic disease, and even some cancers.
  • Iron levels gradually increase if in dietary (or supplemental) excess, as humans do not have regulatory mechanisms – other than blood loss – to rid of excess iron.

Elevated Ferritin and Iron are Linked to a Number of Brain, Heart, and Gut Diseases

BRAINdementia, neurodegenerative disorders
CARDIOMETABOLICdiabetes, hypertension, high cholesterol, heart disease, kidney disease, obesity, non-alcoholic fatty liver disease
GUT liver and colon cancer

While iron deficiency anemia is a concern worldwide, it is most common in children, premenopausal women, and those who are pregnant and lactating. I urge patients to be cautious with iron supplements, especially men and post-menopausal women. For those with low ferritin levels, ask your physician to check iron levels, as only those with documented iron deficiency and anemia should take iron, and then just to sufficient, but not high, levels of iron. For those with high ferritin levels look for an underlying cause, have your iron levels checked, and consider blood donation and a low iron diet.

Worth Reading

Adams MD, Paul, Management of Elevated Serum Ferritin Levels, NCBI/2008

Bregy, A., Trueb, R.M., No Association between Serum Ferritin Levels >10 μg/l and Hair Loss Activity in Women, Karger/2008

Fan, Yong-Gang, Guo, Chuang, Liu, Jun-Lin, et al., Iron and Alzheimer’s Disease: From Pathogenesis to Therapeutic Implications, NCBI/2018

Ware, William R., PhD, The Risk of Too Much Iron: Normal Serum Ferritin Levels May Represent Significant Health Issues, International Society of Orthomolecular Medicine/2013

Integrative Medicine is Not Alternative Medicine

Integrative Medicine is Not Alternative Medicine

Over the years I have been approached by patients who seek my care in an effort to bypass conventional medicine. It’s understandable, as many are dissatisfied by the tendency of conventional medicine to focus on high-tech interventions and pharmaceutical management of established disease. There are beneficial aspects of conventional care, most notably acute and surgical care, but I am concerned about those forgoing the preventive aspects of conventional medicine, such as cancer screenings, immunizations and medications that can prevent complications or progression of disease. In addition, I have also seen those declining curative cancer therapy.

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Surgical Success: How “Prehab” Exercise Affected My Recovery

Studies show that a contributor to successful rehabilitation is prehabilitation or prehab, an exercise program started prior to surgery. Formerly affiliated with orthopedic operations such as knee and hip replacements, prehab has become more mainstream in the treatment of cancer patients, as early research reveals that becoming fit prior to cancer surgery may reduce the risk of cancer recurrence and progression, improve the effectiveness of treatment, reduce the side effects of chemotherapy and improve energy, self-image, confidence, and quality of life.

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Colonoscopy Screening Saves Another Life

Make An Appointment Colonoscopy

Make An Appointment Colonoscopy

For me, January is a time to organize, to donate household items that my family has outgrown, and to schedule health-related screenings​,​ most notably my colonoscopy.

Colorectal cancer is the fourth most common cancer diagnosed in men and women in the United States

Yes, I am aware that March is National Colorectal Cancer Awareness Month, but I am relaying this information early because, with the exception of skin cancer, colorectal cancer is the fourth most common cancer diagnosed in men and women in the United States and the second leading cause of death from cancer. The American Cancer Society estimates that some 140,000 new cases will be diagnosed this year, but the good news is, colorectal cancer, if found early, is one of the most preventable and treatable cancers.

Affecting both men and women of all races and ethnicities, colorectal cancer occurs in the colon or rectum and typically develops as polyps, which are abnormal growths inside the colon or rectum that, if not removed, may become cancerous. While the cancer is found mostly in those 50 years old and above, the incidence in those younger than age 50 is on the rise. So, the American Cancer Society recently changed their screening recommendations for average-risk adults to begin at age 45.

How to reduce your risks of colorectal cancer

The best way to reduce your risk of colorectal cancer is by screening for the disease via a colonoscopy, an outpatient procedure which examines the full colon and allows a physician to identify and remove polyps during the process. There are several additional screening options, including at-home tests that can detect blood in the stool, but they are not definitive in identifying polyps, which are usually the precursor for this cancer.

Warning signs of precancerous polyps and colorectal cancers

There are no clear-cut symptoms associated with precancerous polyps and colorectal cancers, which is why screening is of the utmost importance, but warning signs might include blood in or on the stool, a change in bowel habits, such as diarrhea or constipation, persistent stomach pain, gas or cramps, unexplained weight loss, nausea and/or vomiting. However, many who are diagnosed with colorectal cancer never experience any symptoms.

I realize that people avoid colonoscopies because they are inconvenient, considered invasive, may disrupt the microbiome or merely due to procrastination, but the bottom line is this: Your risk of adverse events from a colonoscopy is lower than your risk of colorectal cancer, and many who receive the diagnosis have little or no risk factors.

Kick off the new year with an early colorectal screening

So, why am I suggesting kicking off the new year with an early colorectal screening? Because this procedure saved my life. At the age of 50, when I had my first colonoscopy, I was, against all odds, diagnosed with colorectal cancer. My surgeon believes the cancer began when I was in my mid 40s, and if I had put off the test for just a couple of years, my cancer most likely would have been inoperable. I hope you will take my experience into consideration and, please, don’t put off scheduling your colonoscopy another week, month or year. The time is now to be proactive and take the lead in anticipating a healthy 2019!

References: https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21457