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Q. Can ferritin levels increase from an injured elbow or osteoarthritis?

Answered by
Dr. Nidhin Mohan
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 03, 2018

Hello doctor,

Last October, on a routine physical, I received a ferritin reading of 535 with all other CBC/ metabolic panel tests and Iron panel completely normal. A follow up six weeks later, still showed a raised ferritin of 448 and yet another showed two weeks after that at 575 (at time of the 575 value, my CRP was normal, less than .4, and my ESR was 2 mm/hr) I was referred to a hematologist who one week later did a ferritin test (different lab) and my result came back at 341 and one month later at 368.

My TIBC averages around 269 and iron around 108. TS % usually 39 %. The hematologist also tested me for the HFE gene and this was negative. ANA negative, various viruses like hepatitis, and did another ESR which came back at 4 mm/hr. I had an abdominal u/s that was unremarkable with the exception of some renal cysts and repeated metabolic panels and CBCs with normal results.

I am a 42 year old very fit male with a BMI of around 24. I am involved in boxing and other contact sports so not sure if this could be a factor. Can ferritin increase from an injured swollen elbow or osteoarthritis? Is there much variation amongst lab results measuring ferritin (575 down to 341 in six days seems like a lot?

I am trying to get to the bottom of these results. I have no real symptoms of other diseases. I notice some labs quote a high of 300 as normal for a man, others 400 and a website indicates even a value of 500 is normal. Could this level just be normal for me? If not, what is the most likely underlying issue? I can provide more info as needed.

Could my levels be a result of something serious considering the normal CRP, ESR, ANA and other blood work? Any other workup to be done other than follow up to check levels? One other thing, I do consume four to five meals per day and do eat iron-rich foods. Could this be a factor considering the data I presented? Any other info you need? Thank you.

#

Hello,

Welcome to icliniq.com.

Ferritin levels can vary from lab to lab. It also has a variation based on fasting status and time of the day when the sample is taken. Your ferritin levels are not alarmingly high. All the major workup are done and negative.

Avoid alcohol intake if any.

Your BMI is slightly above normal. Your USG does not suggest fatty liver, but I would suggest a fibroscan or USG elastography as it can pick up early fatty liver which can also cause a slight increase in ferritin. Red meat intake regularly can also cause a slight increase in ferritin.

Osteoarthritis and old injury over elbow have no relation to high ferritin.

Your condition is not serious, as a part of finishing your workup you can get a fibroscan of liver and follow up ferritin levels from the same lab every six months. Preferably give the samples at the same time of the day.

For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

Would an active injury (swollen elbow) or a mild virus affect levels? I do not drink any alcohol. I eat chicken two to three times per day, have four to five meals per day and have a diet probably 20 to 40 % over the norm in terms of iron intake and vitamin C. Could this be a factor? Could a stabilized ferritin of around 341/368 with a 269 TIBC and 108 Inc be suggestive of malignancy with the other test results I provided? Just want to know if there is any follow up I should be doing or have not done and what to worry about.

#

Hello,

Welcome back to icliniq.com.

An increased ferritin above baseline (this itself can have variation from person to person, diurnal variations, etc.), indicates some inflammation going on in the body. Yes, a viral infection or acute injury can increase your ferritin level.

Unless your elbow is chronically infected, chronic arthritis, it is unlikely to cause high ferritin.

Do not worry about malignancy. Ferritin is never used as a marker for malignancy, associations with malignancy are extremely rare. I would not worry about it.

If you have any chronic joint pains or if your elbow is constantly paining since a long time, the only other possibility to consider would be some form of chronic arthritis which can be evaluated by a rheumatologist close to you.

Since hemochromatosis is ruled out, you can have a normal diet with adequate iron intake.

For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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