An iron-deficient anemia is suggested by the lab in a 38-year-old woman. Which ferritin pattern is characteristic?

• A. High ferritin
• B. Normal ferritin
• C. Low ferritin
• D. Low TIBC

Answer: (C)

Ferritin is the storage form of iron, and its level in the blood reflects how much iron the body stores has. In iron-deficiency anemia, those iron stores are depleted, so ferritin levels fall. This makes low ferritin the characteristic pattern. Ferritin can be normal or high in inflammation or liver disease because it acts as an acute-phase reactant, but in straightforward iron deficiency, ferritin is low. So in a patient with suspected iron deficiency, the ferritin pattern you’d expect is low ferritin.