Falsely elevated ferritin, also known as non-transferrin-bound iron (NTBI), can occur due to various causes. NTBI is a type of iron that is not bound to the transferrin protein and can cause falsely elevated ferritin. This can be caused by inflammation or other medical conditions such as liver disease, hemolysis, or rapid cell breakdown. Inflammation can occur due to a variety of conditions like infection, autoimmunity, and injury, which can cause an increase in ferritin. Liver disease can increase the amount of ferritin produced in the liver, leading to a false elevation in ferritin. Hemolysis is the breakdown of red blood cells and can lead to an increase in iron in the bloodstream, which can cause a falsely elevated ferritin. Rapid cell breakdown can also lead to an increase of iron in the bloodstream, which can lead to elevated ferritin. In addition, certain medications such as statins and iron supplements can increase the amount of iron in the bloodstream, causing a falsely elevated ferritin. Lastly, certain genetic disorders can also cause an increase in ferritin, leading to a false elevation.
It is important to distinguish between a true elevation and a false elevation of ferritin. A false elevation can lead to inappropriate treatments and can mask underlying conditions. If there is suspicion of a false elevation, further testing should be done to determine the cause of the elevation. This may include a full blood count, liver function tests, and a genetic test. Treatment for a false elevation in ferritin varies depending on the underlying cause. For example, if the cause is inflammation, treatment would involve addressing the underlying inflammation. If the cause is liver disease, treatment would involve addressing the underlying liver disease. If the cause is hemolysis, treatment would involve addressing the hemolysis. In addition, if the cause is due to medication, the medication should be stopped to see if the ferritin level drops.
In conclusion, a false elevation in ferritin can occur due to a variety of causes including inflammation, liver disease, hemolysis, rapid cell breakdown, and medications. It is important to distinguish between a true and false elevation of ferritin to ensure appropriate treatment. If there is suspicion of a false elevation, further testing should be done to determine the cause of the elevation and treatment should be targeted to the underlying cause.