Ferritin plays a crucial role in the body as it serves as the primary storage protein for iron. Iron, an essential mineral, carries oxygen throughout the body and is necessary for various physiological processes.

Low ferritin levels can lead to iron deficiency and cause a range of symptoms, including fatigue, weakness, shortness of breath, and impaired immune function. Identifying the underlying causes of low ferritin is essential for effective treatment. Here, we explore ten potential factors that can contribute to low ferritin levels.

1. Inadequate Dietary Intake of Iron

One of the primary causes of low ferritin levels is inadequate dietary intake of iron. Consuming foods rich in iron is crucial to maintain optimal ferritin levels.

Iron-rich foods include red meat, poultry, fish, legumes, dark leafy greens, and fortified grains. Consuming inadequate amounts of these foods can lead to iron deficiency, which manifests as low ferritin levels.

2. Gastrointestinal Disorders

Gastrointestinal disorders can interfere with the absorption of iron and contribute to low ferritin levels.

Conditions like celiac disease, inflammatory bowel disease, and Crohn’s disease can damage the lining of the intestines, impeding the body’s ability to absorb nutrients, including iron. Individuals with these conditions often have poor iron absorption, leading to low ferritin levels and iron deficiency anemia.

3. Menstrual Blood Loss

Women of reproductive age commonly experience low ferritin levels due to menstrual blood loss. The monthly shedding of the endometrium results in blood loss containing iron.

Excessive or prolonged menstrual bleeding can lead to significant iron loss, eventually depleting ferritin stores. Women with heavy menstrual periods are particularly susceptible to iron deficiency and may require iron supplementation to replenish ferritin levels.

4. Pregnancy

Pregnancy places a significant demand on the body’s iron stores. The developing fetus relies on a steady supply of iron from the mother to support its growth and development.

If a pregnant woman’s dietary iron intake is insufficient to meet the increased demands, the body’s ferritin levels can drop, leading to iron deficiency. Pregnant women often require iron supplementation to prevent or correct low ferritin levels and ensure healthy pregnancy outcomes.

5. Blood Loss

Chronic or acute blood loss from various sources such as gastrointestinal ulcers, gastritis, hemorrhoids, or heavy injury can contribute to low ferritin levels.

Blood contains iron, so significant blood loss can deplete the body’s iron stores and subsequently lower ferritin levels. Treating the underlying source of blood loss is crucial to restore ferritin levels and prevent iron deficiency.

6. Chronic Inflammation

Chronic inflammation, such as that seen in autoimmune diseases like rheumatoid arthritis or lupus, can disrupt iron metabolism and lead to low ferritin levels.

The immune system’s response during chronic inflammation increases levels of hepcidin, a hormone that reduces iron absorption from the intestines and sequesters iron within cells. This sequestered iron is unavailable for ferritin synthesis, resulting in low ferritin levels.

7. Hypothyroidism

Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones, can contribute to low ferritin levels. Thyroid hormones play a role in regulating iron metabolism, and low levels can disrupt this process.

Hypothyroidism leads to decreased absorption of iron in the intestines, reduced utilization of iron by cells, and impaired ferritin synthesis, all of which contribute to low ferritin levels.

8. Chronic Kidney Disease

Chronic kidney disease (CKD) can disrupt iron homeostasis and cause low ferritin levels. The kidneys are responsible for producing erythropoietin, a hormone that stimulates red blood cell production.

In CKD, the kidneys cannot produce sufficient erythropoietin, leading to anemia. Anemia of CKD is often accompanied by low ferritin levels due to impaired iron utilization and decreased production of red blood cells.

9. Increased Iron Requirements

There are certain conditions where the body’s iron requirements increase, leading to low ferritin levels if these demands are not met.

For example, individuals who engage in regular intense physical exercise or endurance training have higher iron requirements due to increased red blood cell production and oxygen-carrying capacity. Inadequate iron intake to meet these increased demands can result in low ferritin levels.

10. Genetic Disorders

Some genetic disorders can affect iron absorption, utilization, or storage, leading to low ferritin levels.

Examples include hereditary hemochromatosis, a condition where the body absorbs too much iron, and atransferrinemia, a rare genetic disorder characterized by the absence of transferrin, a protein involved in iron transport. These disorders can disrupt iron homeostasis and cause low ferritin levels.