Myths vs facts: Eisen-Ferritin Selbsttest and Stress

Myth: A high ferritin level in a self-test always means iron overload. Fact: Ferritin is an acute-phase reactant; its synthesis is upregulated by inflammatory cytokines (e.g., IL‑6, TNF‑α) triggered by stress, infection, or chronic disease – independent of iron stores. Without concurrent measurement of CRP or other inflammatory markers, a self-test cannot distinguish iron overload from inflammation. Myth: Low ferritin always indicates iron deficiency. Fact: In chronic inflammation, ferritin can be falsely low due to impaired release. Stress (physical or psychological) modulates ferritin via cytokine pathways. Thus, interpreting a single ferritin value without clinical context is misleading. Evidence is based on established clinical guidelines (WHO, AACE, ASH). For accurate assessment, CRP, transferrin saturation, and soluble transferrin receptor should be included.