Evidence Based

What is Transferrin + High & Low Levels

Written by Helen Quach, BS (Biochemistry) | Reviewed by Biljana Novkovic, PhD | Last updated:
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology) | Written by Helen Quach, BS (Biochemistry) | Reviewed by Biljana Novkovic, PhD | Last updated:

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Transferrin is a protein that binds iron and transports it to where it’s needed. When there is enough transferrin, your body can effectively use the iron you get from the diet. Iron availability dictates transferrin production, but transferrin levels are also influenced by inflammation, liver, and kidney disease. Keep reading to learn more about high and low transferrin levels and ways to improve them.

What is Transferrin?

Transferrin is a protein that binds iron and transports it throughout the body. It is the main iron carrier in the blood. When you have enough transferrin, your body can effectively use the iron you get from your diet [1, 2].

Transferrin levels increase with iron deficiency. When iron is low, your body will try to compensate by making more transferrin to increase the availability of iron [3]. On the other hand, transferrin will decrease with iron overload [4, 5].

This protein is produced in the liver, so its levels are also associated with your liver health and inflammation in general. Transferrin is a negative acute phase protein. This means that with inflammation and as liver increases the production of inflammation-associated proteins (e.g. CRP, ferritin) it decreases the production of transferrin [6, 7].

Transferrin levels can be measured directly with a blood test. Alternatively, they can also be measured indirectly using total iron binding capacity (TIBC).

Normal Range

In healthy people, transferrin levels will normally be between 200 – 370 mg/dL (milligrams per deciliter).

High Transferrin Levels

Causes of High Transferrin Levels

1) Iron Deficiency

The most common cause of high transferrin levels is iron deficiency [8, 9, 10].

2) Birth Control Pills

In a study of 117 women, the women who took birth control pills (oral contraceptives) for at least 2 years had higher transferrin levels than the women who never took them [11].

Ways to Decrease Transferrin Levels

Increase Iron In Your Diet

Eating a diet high in iron can help prevent iron deficiency. Foods that contain a lot of iron include red meat, poultry, and fish [12].

Iron supplements will help increase iron levels but should be taken only if there’s an iron deficiency that cannot be corrected by diet [13, 14, 15].

Reduce the consumption of drinks such as coffee, cocoa, green and herbal tea, as these decrease iron absorption from food [16, 17, 18, 19, 20, 21].

Vitamin C helps increase iron absorption. It’s a good idea to include vitamin C sources with your iron-rich meals (lemon juice, sauerkraut) [22].

Low Transferrin Levels

Causes of Low Transferrin Levels

1) Iron Overload

The most common cause of low transferrin levels is iron overload (excess iron) [23, 10].

2) Malnutrition

To produce protein, the liver needs resources. It needs amino acids that you obtain as dietary protein. When there’s a lack of protein in the diet, your liver can’t produce transferrin effectively [24].

In studies with over 80 children, the ones that were malnourished had significantly lower transferrin levels [25, 26].

3) Inflammation

As mentioned above, transferrin is a negative acute phase protein. When the liver increases the production of inflammation-associated proteins (e.g. CRP, ferritin) it decreases the production of transferrin. A number of conditions such as infection and cancer can decrease transferrin levels [6, 7, 27].

In an observational study of 297 people, patients with active inflammatory bowel disease (IBD: both Crohn’s disease and ulcerative colitis) had significantly lower transferrin levels. Increased IBD activity and inflammation severity were associated with lower transferrin levels [28].

Similarly, a study compared 20 patients with chronic periodontitis (gum inflammation) and 20 healthy people. It found that those with chronic gum inflammation had lower transferrin levels. Three months after the inflammation was treated blood transferrin levels increased back to the levels seen in healthy subjects [29].

Preeclampsia, a condition that causes high blood pressure during pregnancy, is associated with inflammation. Women with preeclampsia can have decreased transferrin levels [30, 31].

4) Liver Disease

In liver disease, the liver can’t produce transferrin effectively [32].

This can be caused by impaired liver function, inflammation, or alcohol consumption [33].

Liver disease patients have significantly lower transferrin levels than healthy people [34, 35].

5) Kidney Disorders

Nephrotic syndrome is a kidney disorder that causes the body to excrete too much protein in the urine. Transferrin is one of the proteins that gets excreted. That’s why nephrotic syndrome patients may have significant transferrin loss [36, 37].

6) Genetics

Transferrin can be low due to genetic causes [38, 39].

Ways to Increase Transferrin Levels

Address Potential Iron Overload

To increase transferrin, you should make sure that you do not have high iron levels.

If your transferrin is low due to iron overload:

  • Avoid foods that are high in iron, such as red meat, fish, and poultry [12]
  • Eat more foods that reduce iron absorption such as fiber and phytic acid (from whole grains) and chili [40, 41, 42]
  • Drink more coffee, cocoa, green tea and herbal teas, such as chamomile, lime flower, pennyflower, mint, and vervain – all of these decrease iron absorption [16, 17, 18, 19, 20, 21]

Get more exercise. Regularly exercising will help prevent your iron levels from becoming too high [43, 44].

The following supplements may also help reduce iron absorption:

Eat a Well Balanced Diet

Make sure that you are getting enough protein and nutrients in your diet. Proteins are needed to produce transferrin effectively [35, 24].

Address Any Potential Inflammation

If inflammation is the underlying cause of your low transferrin, it’s important that you work with your doctor on resolving the cause.

Irregular Transferrin Levels?

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About the Author

Helen Quach

BS (Biochemistry)

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