Ferritin is a protein that serves as the primary storage unit for iron within the body. This article clarifies the role of ferritin and blood donation guidelines for individuals with elevated ferritin levels.
Ferritin’s Role in the Body
Ferritin is the body’s main iron-storage protein, found inside cells and circulating in the blood. Its primary function is to store iron in a soluble, non-toxic form, making it available when needed and preventing harmful accumulation. This protein maintains iron balance, buffering against both deficiency and overload. Measuring ferritin levels indicates the body’s overall iron stores.
Blood Donation Eligibility and High Ferritin
Blood donation centers screen potential donors by checking hemoglobin levels, rather than directly measuring ferritin. Hemoglobin is the iron-containing protein in red blood cells. To ensure donor safety and blood quality, specific hemoglobin thresholds are in place: female donors need a minimum of 12.5 g/dL, and male donors require at least 13.0 g/dL, with an upper limit of 20.0 g/dL for both. While a high ferritin level indicates elevated iron stores, it is not always a direct cause for deferral in voluntary blood donation, unless linked to underlying medical conditions. Some blood services may notify donors of high ferritin results and suggest consulting a healthcare provider.
Concerns about high iron in donated blood relate to potential iron overload in recipients. However, blood from donors with conditions like hemochromatosis is generally considered safe for transfusion if all standard eligibility criteria are met. The U.S. Food and Drug Administration (FDA) has issued guidance allowing individuals with hemochromatosis to donate blood under the same circumstances as other volunteer donors, provided they meet safety regulations. Despite this, some organizations, such as the American Red Cross, have maintained policies that traditionally did not permit hemochromatosis patients to donate, though some blood centers now accept these donations.
High Ferritin: Donation vs. Therapeutic Treatment
It is important to differentiate between voluntary blood donation and therapeutic phlebotomy, a medical procedure. Therapeutic phlebotomy, or blood removal, treats conditions characterized by iron overload, most notably hemochromatosis. Hemochromatosis is an inherited disorder where the body absorbs and stores too much iron, which can accumulate in organs and cause damage over time. The purpose of therapeutic phlebotomy is to reduce iron levels and prevent or mitigate organ damage.
Historically, blood collected via therapeutic phlebotomy was often discarded. However, current FDA guidance permits its use for transfusion if the donor meets standard eligibility requirements. Many blood centers allow individuals with hemochromatosis to donate blood as part of their treatment, often permitting more frequent donations than typically allowed for standard donors. This arrangement offers a dual benefit: it helps patients manage their iron levels while also contributing to the blood supply.
Next Steps After a High Ferritin Diagnosis
Upon receiving a diagnosis of high ferritin levels, consulting a healthcare professional is the recommended next step. Elevated ferritin can signal iron overload, but it may also be indicative of other underlying conditions such as inflammation, liver disease, metabolic syndrome, or certain malignancies. To determine the cause, further diagnostic tests may be ordered, including transferrin saturation, additional liver function tests, and potentially genetic testing for hemochromatosis.
Management strategies will vary depending on the identified cause. These may include specific dietary adjustments, such as reducing intake of iron-rich foods or avoiding vitamin C consumption alongside iron, or therapeutic phlebotomy if iron overload is confirmed. The diagnosis of high ferritin and its underlying cause will influence future eligibility for blood donation, and this should be discussed with both a medical professional and the blood donation center.