Ferritin stores iron and transports it to where it is required. In blood, it is an important indicator of the total iron stores. However, ferritin also participates in infections, inflammation, and malignancies. Elevated ferritin is often found in disorders with chronic inflammatory states such as obesity, metabolic syndrome, and diabetes. Find out why it is important to keep this protein in balance, and which factors increase or decrease ferritin levels.

What is Ferritin? Ferritin Definition

Ferritin is a spherical protein complex. It is the primary iron-storage protein within the cell, that stores iron in a soluble, non-toxic form, and can transport it to areas where it is required (R).

Iron can be toxic to cells because of its capacity to generate reactive species which can directly damage DNA and proteins. Ferritin captures and buffers the iron within cells, and is very important for our survival (R).

Mice deficient in ferritin die in the embryo stage (R).

Ferritin is found in most tissues where it is located inside the cells. Within the cells, ferritin is mostly found in the cellular fluid (cytosol), nucleus or mitochondria (R).

Mitochondrial ferritin (FtMt) is produced by specific tissues such as the testis and the brain (R).

Small amounts of ferritin are also secreted into the blood where it functions as an iron carrier. Apart from the blood, ferritin is also secreted into joint (synovial) and spinal fluids (R).

The liver’s stores of ferritin are the primary source of reserve iron in the body (R).




Ferritin Roles/Functions

As previously mentioned, ferritin plays an important role in the storage of cellular iron (R). It functions in cell detoxification, limiting the formation of reactive oxygen species, and mitigating their damaging effect on cellular structures (R).

By capturing toxic metal ions, ferritin is involved in the antioxidant system of cell defense. Apart from iron, ferritin also regulates the cellular concentration of other transition metals, including beryllium, aluminum, zinc, cadmium and lead (R).

On the other hand, ferritin outside the cell can function as a highly efficient iron delivery mechanism. Compared to another iron carrier – transferrin, which carries a maximum of 2 iron atoms, a single ferritin molecule can sequester up to 4500 iron atoms (R).

Blood ferritin, which is believed to be iron-poor, carries much less iron than this, but could nevertheless make a significant impact on iron delivery (R).

Ferritin acts as a buffer against iron deficiency and iron overload (R).

Additionally, it was shown that circulating ferritin may assume roles entirely independent of its classic role as an iron binding protein (R).

Ferritin is may play an important role in the skin defence. Ferritin in the skin is increased by UVA and infrared-A radiation. Increased ferritin following acute UV/IR radiation could afford increased protection against subsequent oxidative stress (R,R).

Ferritin is an acute phase reactant and a marker of acute and chronic inflammation and is nonspecifically elevated in a wide range of inflammatory conditions (R).

One study suggests that blood ferritin actually originates from damaged cells and thus reflects cellular damage (R).

Ferritin can behave as a real pro-inflammatory cytokine, activating the NFκB cascade and inducing liver damage (R).

Ferritin can modulate immune function by inhibiting lymphocyte function. Ferritin decreased the number of granulocyte-macrophages, and red blood cell precursors in mice (R).

Ferritin has also been shown to suppress immune activity in humans (R).

Ferritin can stimulate blood vessel growth in inflammation, desirable in wound healing, but undesirable in tumors (R).

Unless indicated otherwise, the statements in the text below refer to the circulating ferritin found in blood.

Joe’s Experience With Ferritin

Most of my client population have lower ferritin and this is usually because of some kind of intestinal inflammation that is not allowing the person to absorb iron well, as well as hypothyroidism.

Indeed, research shows that people with IBD, fatigue, hypothyroidism and fibromyalgia have lower ferritin, which are common groups among my clients.

When iron (indicated by ferritin) is lower, it can contribute to and exacerbate existing health problems, so you want to get that fixed.

I myself had ferritin on the lower end of the range when I wasn’t as healthy (about 40-50).

Some people are trying to get ferritin to 20 ng/ml for “anti-aging purposes”, but given the research cited here, that’s a big mistake.

I personally try to get my ferritin levels over 90 ng/ml, especially because I’m Th1 dominant and more iron is better for me.

Recommended Ferritin Supplements for Increasing Ferritin/Iron Status Without Gut Problems

  • Ferric iron polymaltose complex + heme iron polypeptide (R)
  • Lactoferrin
  • Vitamin C
  • Lysine – Addition of L-lysine to iron supplementation resulted in a significant increase in serum ferritin concentration in some women with chronic hair loss (telogen effluvium) who failed to respond to iron supplementation alone (R).

Optimal and Normal Reference Ranges for Ferritin (serum)


Blood ferritin is an indirect indicator of the total amount of iron stored in the body. Therefore, blood ferritin is used as a diagnostic test for iron-deficiency anemia (R).

Ferritin is normally high at birth. Ferritin levels rise during the first two months of age and then fall until the end of the first year of life, i.e. later infancy. At about one year of age, ferritin levels begin to rise again (R).

Normal ferritin blood levels:

  • Men: 18-270 or 30-300 nanograms per milliliter (ng/mL)*
  • Women: 18-160 or 10-200 ng/mL*
  • Children (6 months to 15 years): 7-140 ng/mL
  • Infants (1-5 months): 50-200 ng/mL
  • Newborns: 25-200 ng/mL

Reference ranges for blood ferritin vary across laboratories, but generally levels of 30 to 300 ng/ml are considered normal for men, and 10–200 ng/ml for women (R).

However, ferritin ranges for optimal health are between 60-200 ng/ml.

Note that ferritin has been shown to increase in response to stressors, such as inflammation or infection. These conditions may change what would otherwise be low ferritin indicating a lack of iron, into a value in the normal range.

Ferritin Deficiency

Blood ferritin anywhere below 12 to 30 ng/ml indicates depletion of iron stores and is a diagnostic criterion for iron deficiency (R,R).

Because it also behaves as an acute phase protein, the levels of ferritin can go up several-fold in response to stress and infections or inflammatory states (R). In these cases, ferritin stops being an accurate indicator of iron deficiency.

Some studies state that the traditional cutoff point of 12 and 30 ng/ml is too low to detect iron deficiency anemia in the general population, but especially for those with inflammatory or liver diseases. A level higher than approximately 40 ng/ml was suggested to exclude iron deficiency in most patients, and a level higher than 70 ng/ml was suggested to exclude iron deficiency in patients with inflammation or liver diseases (R).

Other than anemia, low ferritin may also indicate hypothyroidism, vitamin C deficiency or celiac disease (R,R).

Vegetarians can have significantly lower blood ferritin levels, resulting from iron deficiency. One study found iron deficiency in 19% of vegetarians (R).

Ferritin Excess

If ferritin is high, there is iron in excess or else there is an acute inflammatory reaction in which ferritin is mobilized without iron excess.

Ferritin is increased under oxidative stress. It is increased by the antioxidant-responsive element (ARE) (R).  Ferritin, in turn, can increase liver proinflammatory mediators IL-1b, iNOS, RANTES, IkappaBα, and ICAM1 (R).

Ferritin is used as an indicator for iron overload disorders, such as hemochromatosis or hemosiderosis.

As ferritin is also an acute-phase reactant (a part of body’s response to inflammation), it is often elevated in various diseases. A normal C-reactive protein (CRP) can be used to exclude elevated ferritin caused by acute phase reactions.

Ferritin levels of greater than 1000 ng/ml are a nonspecific marker of illness, including infections and cancer (R).

However, ferritin over 300 can indicate some inflammation.

Symptoms of Low Ferritin (serum)

Your doctor may order a ferritin test if you have some of the following symptoms associated with low ferritin levels:

  • Anemia
  • Unexplained fatigue
  • Hairloss
  • IBD and Celiac’s
  • Fibromyalgia
  • Depression
  • Anxiety
  • Hypothyroidism
  • Attention issues/ADHD
  • Parkinson’s and Restless Leg Syndrome
  • Dizziness
  • Chronic headaches
  • Unexplained weakness
  • Ringing in your ears
  • Irritability
  • Leg pains
  • Shortness of breath

Summary of Diseases Associated With Higher Ferritin

We have an in depth post dedicated to diseases associated with conditions that have higher or lower ferritin.

Circulating ferritin is widely recognized as an acute phase reactant and a marker of acute and chronic inflammation. It is  elevated in a wide range of inflammatory conditions, including chronic kidney disease, rheumatoid arthritis and other autoimmune disorders, acute infections, and malignancy (R).

Common causes of elevated ferritin levels also include obesity, diabetes, metabolic syndrome and daily alcohol consumption (R,R).

The elevated ferritin in these states reflects increased total body iron storage, but paradoxically, these stores are sequestered and not available for red blood cell production.  This contributes to the widely recognized anemia of chronic disease (ACD) (R).

Note that although ferritin levels generally increase in infection, some infections can also result in decreased ferritin (R).

  • Inflammatory conditions (R)
  • Chronic kidney disease (R)
  • Rheumatoid arthritis (R)
  • Autoimmune disorders (R)
  • Acute infections (R)
  • Cancer (R,R,R)
  • Anemia of Chronic Disease (R)
  • Type 2 diabetes (R)
  • Metabolic syndrome (R)
  • Atherosclerosis (R)
  • Fatty liver disease patients (R)
  • Anorexia (R)
  • Graves’ disease (R)
  • Arrhythmias (R)
  • Chronic Hepatitis C infection (R)
  • Hemochromatosis (R)
  • Hemophagocytic syndrome (R)
  • Still’s disease (R)
  • Sideroblastic anemia (R)

Potential Causes of Higher Ferritin

1) Alcohol

Alcohol enhances the absorption of iron.

Alcohol consumption is significantly associated with levels of ferritin (R).

There was a positive relationship between wine intake and concentrations of both ferritin and iron in the blood (R).

In alcohol abuse, ferritin levels are elevated and rapidly decrease with alcohol abstinence (R).

2) Smoking

Women who smoke have higher ferritin and higher body iron compared to nonsmoking women. However, when women smoke during pregnancy, their newborn infants have lower iron stores than those of non-smoking mothers (R).

Tobacco smoking was associated with elevated ferritin concentrations in Parkinson’s disease patients (in this setting smoking had a beneficial effect) (R).

3) Inflammation

Pro-inflammatory cytokines stimulate the production of ferritin, which in inflammation/infection acts as an acute phase reactant (R).

Circulating ferritin production is increased by the cytokines interleukin-1-β (IL-1) and tumor necrosis factor-α (TNF-α) (R).

Summary of Diseases Associated With Lower Ferritin

Patients with iron deficiency, as measured by ferritin, have an increased risk of unipolar depressive disorder (OR = 2.34), bipolar disorder (OR = 5.78), anxiety disorder (OR = 2.17), autism spectrum disorder (OR = 3.08), attention deficit hyperactivity disorder (OR = 1.67), tic disorder (OR = 1.70), developmental delay (OR = 2.45), and mental retardation (OR = 2.70) (R).

  • Anemia (R)
  • Fatigue (R)
  • Hair loss (RR, R, R)
  • Fibromyalgia (R)
  • IBD (R)
  • Hypothyroidism (R)
  • Depression (R)
  • Anxiety (R)
  • ADHD (R)
  • Celiac disease (RR)
  • Parkinson’s (R)
  • Restless leg syndrome (R)

Low Ferritin Causes Fatigue and Fibromyalgia


Ferritin and iron depletion can be found in some fatigue patients.

Intravenous administration of iron improved fatigue in iron-deficient, nonanemic women (R). Over 80 percent had reduced fatigue after receiving iron.

A couple of studies recommend iron supplementation for women with unexplained fatigue who have ferritin levels below 50 μg/L (R).

Iron is a necessary for serotonin and dopamine production and may have a role in causing fibromyalgia.

The average serum ferritin levels in the fibromyalgia 27.3 and 43.8 ng/ml in a healthy group.

Statistical analyses show that ferritin levels below 50 ng/ml caused a 6.5-fold increased risk for Fibromyalgia.

Low Iron Can Contribute to IBD

Chronic intestinal bleeding in inflammatory bowel disease (IBD) may exceed the amount of iron that can be absorbed from the diet, resulting in a negative iron balance (R).

In fact, anemia is a common complication associated with inflammatory bowel disease (IBD). The World Health Organization estimates that more than 30% of the population have iron deficiency anemia yet it remains an under-managed feature of many gastrointestinal conditions. Also, one-third of inflammatory bowel disease (IBD) patients suffer from recurrent anemia (R).

Almost every anemic patient with IBD demonstrates some degree of iron deficiency as a consequence of dietary restrictions, malabsorption, or intestinal bleeding (R).

When anemic Crohn’s disease patients were treated with iron sucrose and EPO, the feeling of well-being, mood, physical ability, and social activities improved. Also, individual patients reported relief of disturbed sleep and increased appetite or libido (R).

Iron deficiency may enhance the inflammatory IFNgamma response in Th1 driven inflammatory disorders such as Crohn’s disease (R).

High iron load lowers inflammation by decreasing inflammatory cytokines such as TNF-a and lowering Th1 and increasing Th2 function (R).

Ferritin is Lower in Hypothyroidism

Alterations in thyroid status and activity result in changes in blood ferritin levels (R).

Subclinical hypothyroidism is associated with iron-deficiency anemia (R) and lower ferritin levels (R).

Blood ferritin levels increased in hypothyroid patients with Hashimoto’s disease when normal thyroid function was achieved with L-Thyroxine therapy (R).

In patients with Graves’ disease (higher thyroid hormones), ferritin is higher and decreases back to normal when normal thyroid function is achieved by antithyroid drug therapy (R).

Low Ferritin Causes Depression and Anxiety

The average ferritin level in students with depression was significantly lower than the healthy ones.  Low ferritin increases the odds of depression by 1.92X (R).

The study implies a possible association between depression and decreased ferritin level before the occurrence of anemia (R).

In another study, patients with iron deficiency, as measured by ferritin, have an increased risk of unipolar depressive disorder (OR = 2.34), bipolar disorder (OR = 5.78) and anxiety disorder (OR = 2.17) (R).

The mechanism could be related to lower dopamine and serotonin in iron deficiency.

Low Ferritin Causes ADHD


Iron is associated with dopamine metabolism and low iron levels might be associated with more significant impairment in dopamine function in subjects with ADHD (R).

Iron deficiency has been associated with attention and behavioral problems and ADHD.

Kids with lower ferritin (average of 18.4 ng/mL) had worse inattention, hyperactivity/impulsivity, and ADHD symptoms (R, R, R).

Children who were on ADHD meds showed a stronger association between ferritin and ADHD symptom severity (R).

These findings add to the growing literature implicating iron deficiency in ADHD (R).

Iron supplementation should be investigated as a potential intervention in individuals with low iron stores and ADHD (R).

Low Ferritin Causes Hair Loss

Multiple studies have found low ferritin correlating with hair loss (RR, R, R).

In women without systemic inflammation or other underlying disorders, ferritin levels below or equal to 30 ng/mL are strongly associated with hair loss (R).

A total 210 patients with male and female pattern hairloss were compared to 210 healthy controls. Ferritin concentration was lower in patients with female pattern hairloss (49.27 ng/ml), compared with normal healthy women (77.89 ng/ml).

Among male patients, 22.7% of them showed lower ferritin than 70 ng/ml, while none of the men without hairloss had lower than 70 ng/mL (R).

The average ferritin level in patients with male pattern baldness (37.3 ng/ml) and an autoimmune hair loss disease called alopecia areata (24.9) were statistically significantly lower than in people without hair loss (59.5) (R).

How to Increase Ferritin Levels

In normal subjects, daily iron loss amounts to 1–2 mg and this requires a similar amount of iron to be taken up from the diet (R).

Menstruating women lose more blood than their male counterparts and are therefore at higher risk of iron deficiency (R).

1) Iron Supplements

Supplementing with 30 mg/d of iron for 90 days increased ferritin concentration in schoolchildren with low iron stores, and this effect persisted 6 months after supplementation (R).

Oral iron supplements commonly contain iron in the form of ferrous salts (ferrous sulphate, ferrous gluconate, and ferrous fumarate). All ferrous compounds are oxidized in the gut, releasing reactive radicals as byproducts. These will attack the gut wall and produce a range of gastrointestinal symptoms and discomfort (R). This problem is especially pronounced in IBD patients where oral iron may enhance gut inflammation (R).

Ferric iron polymaltose complex or heme iron polypeptide are also available, and may present safer and better tolerated alternatives (R).

Another good alternative is intravenous iron supplementation (R).


  • Ferric iron polymaltose complex + heme iron polypeptide (R)
  • Lactoferrin (R) – formulas with infants fed lactoferrin had higher ferritin levels (R)

2) Iron-rich Foods


  • Dietary iron occurs in two forms: heme (from meat, poultry, and fish) and non-heme (mostly from plants) (R).
  • Non-heme iron absorption depends on many factors, including the presence of stomach acid and Vitamin C.  Inhibitors such as phytic acid and polyphenols (in vegetables) reduce non-heme absorption (R).
  • Heme iron is released after mechanical and enzymatic digestion of myoglobin found in meat and fish (R).

Consuming iron-rich foods improves iron stores and ferritin levels. These include green leafy vegetables, cocoa powder and dark chocolate, oatmeal, cereals, wheat germ, beans and tofu, lamb and beef, nuts, pumpkin and squash seeds, liver and mollusks, etc.

Red meat consumption correlates significantly with ferritin in the blood (R).

Meat is not only a source of iron itself, but it can help you absorb non-heme iron from plant based foods 57% better from a 75g portion (R).

In one experiment, beef protein enhanced iron absorption 80% better than did chicken protein.

The increased absoprtion of iron come from the protein and fat in meat (RR).

Chicken, salmon and pork also increase iron absorption.

3) Vitamin C

Vitamin C (ascorbic acid) increases the bioavailability of iron and its absorption from dietary sources (R).

Ascorbic acid uptake induces both iron-independent and iron-dependent ferritin production (R).

4) Vitamin A and Beta Carotene

In multiple human studies, simultaneous use of iron and vitamin A supplements seemed to be more effective to prevent iron deficiency anemia than the use of these nutrients alone (R).  There are some confounding variable in some of the studies, however.

Beta-carotene significantly increases absorption of iron. In the presence of phytates, polyphenols or tannins, beta-carotene generally overcame the inhibitory effects in humarns (R, R).

5) Sugar/Fructose

Evidence that simple sugars such as glucose and fructose affect iron bioavailability first arose in the 1960s from work showing that sugars were able to form stable, soluble complexes (R).

Studies show that sugar, especially Fructose, increases iron bioavailability (R).

So consuming iron wit fruit can be a good idea.


1g Citric acid to a meal containing 3 or more mg of iron could help iron absorption (R).

L-alanine increases ferritin (R).

A copper deficiency can reduce iron absorption in rats (R).

How to Decrease Ferritin

Because there is no excretory route, iron level is regulated by iron uptake. If iron absorption is not tightly regulated, iron overload and associated toxicity occur (R).

1) Coffee

Coffee interferes with the utilization of supplemental iron (R).

Pregnant women with a high frequency of coffee consumption had lower values of body iron (R,R).

2) Green Tea

Tea contains tannins and polyphenols which inhibit the absorption of iron. However, tea does not seem to impact ferritin levels in healthy adults. It may only lower ferritin in those with iron deficiency or iron overload.

Ferritin concentrations were not related to black, green or herbal tea consumption in healthy adults (R).

However, ferritin displayed a negative correlation with the consumption of tea in elderly (R).

In groups with high prevalence of iron deficiency, tea consumption was associated with lower ferritin (R).

In those at risk for iron overload, tea consumption may lower ferritin concentrations (R).

EGCG, found in tea, markedly inhibits intestinal heme iron absorption (by reducing iron export in Caco-2 cells) (R).

3) Fiber

Fiber impairs the absorption of iron.

Intake of fiber-poor fruits, vegetables, and juices were associated with higher ferritin concentrations in premenopausal women (R).

4) Whole Grains (Phytic Acid)

Phytic acid is common in pretty much all plant based foods, including whole grains, beans, nuts and seeds.

Phytic acid is a potent inhibitor of native and fortification iron absorption (R).

In people, there is a dose-dependent inhibitory effect of phytate on iron absorption (R).

Iron absorption increased four- to fivefold in humans when phytic acid was reduced from its normal amount in soy (R).

5) Exercise


Ferritin increases acutely immediately after exercise but returns to baseline a few hours later (R).

On the other hand, long term, routine exercise lowers ferritin along with other acute phase reactants (R).

Regular physical activity, especially extensive running, increases iron loss. Mild iron deficiency (abnormal blood ferritin and normal hemoglobin concentration) and sometimes true iron deficiency anemia can occur especially when nutritional iron intake is insufficient and iron demand is increased because of growth (children, adolescents) or additional iron loss (by menstruation) (R).

Iron deficiency is common in athletes involved in endurance sports. In female marathon runners, the prevalence is as high as 28%, compared to 11% in the general female population (R).

Endurance athletes need more iron because their training causes an expansion in the amount of red blood cells. This means that their hemoglobin levels may seem normal but their ferritin levels (a marker of the iron reserves stored in the body) may be low.

Low ferritin with hemoglobin in the mid- to upper normal range, and low ferritin with hemoglobin in the low normal range are relative indications for iron supplementation in athletes (R).

6) Calcium


Calcium-rich foods, such as dairy products, may decrease the absorption of iron.

Ferritin levels were negatively associated with the amount of cows’ milk consumed and calcium intake in 18-month old children (R).

Pregnant women who had consumed cow’s milk at least 3 times a week had lower levels of ferritin and body iron (R).

A diet rich in milk and yogurt increased the risk of low iron status by 50 percent in women in New Zealand (R).

However, although some short-term effects have been observed, long-term calcium supplementation was not observed to negatively impact iron status and ferritin concentration (R).

7) Zinc

Zinc is an essential minerals commonly found in multi-mineral supplements. Zinc is important for immune function.

Zinc may interfere with iron absorption because of similar chemical properties and shared absorption pathways.

In human trials, zinc supplementation alone does not appear to have a clinically important negative effect on iron status. However, when zinc is given with iron, iron indicators do not improve as greatly as when iron is given alone (R).

8) Manganese

Manganese is an essential minerals commonly found in multi-mineral supplements.

Manganese may interfere with iron absorption because of similar chemical properties and shared absorption pathways.

In humans, manganese inhibited iron absorption dose dependently both in solutions and in a hamburger meal. Manganese has a strong direct competitive inhibition of iron absorption (R).

9) Magnesium

Some types of common magnesium supplements, such as magnesium oxide, can impair iron absorption in cellular studies (R).

10) Curcumin

Curcumin, a polyphenol found in turmeric, binds to iron and can cause iron deficiency in rats (R).  It can also help rats with iron overload (R).

In a model of borderline iron deficiency, rats fed curcumin induced a full blown deficiency (R).

11-13) Peppermint, Cocoa, and Chamomile

Compared with humans who just drank water (R):

  • Beverages containing 20-50 mg total polyphenols/serving reduced iron absorption from the bread meal by 50-70%
  • Beverages containing 100-400 mg total polyphenols/serving reduced iron absorption by 60-90%

Inhibition of iron by teas (same concentration of polyphenols) (R):

  • Black tea = 79-94%
  • Peppermint tea = 84%
  • Pennyroyal = 73%
  • Cocoa = 71%
  • Vervain = 59%
  • Lime flower = 52%
  • Chamomile = 47%

14) Eggs

Egg yolks decrease the absorption of iron (R).

15) Grapeseed Extract (and Anthocyanins)

Grape seed extract (GSE) markedly inhibits intestinal heme iron absorption (by reducing iron export in Caco-2 cells) (R).

Regular consumption of dietary vitamin C can easily counteract the inhibitory effects of low concentrations of dietary polyphenols on heme iron absorption but cannot counteract the inhibitory actions of high concentrations of polyphenols (R).

16) Chili

Chili is capable of inhibiting iron absorption in a study done on young women (R).

17) Aspirin

Subjects who took >7 aspirins/week had significantly lower ferritin than nonusers, who took <1 aspirin/week (R).

This effect of aspirin on ferritin was more marked in diseased subjects with inflammation, infection or liver disease (R).

18) Blood Donation


Ferritin levels are lowered after donating blood.

Decrease in ferritin is dependent both on the number of blood donations as well as the periodicity between them (R).

19) Estrogen and Progestin Hormone Therapy

Estrogen may lower ferritin.

Current users of oral conjugated estrogen plus progestin had significantly lower ferritin concentrations than did current users of estrogen only (R).

Longer times since menopause and longer times since the last hormone use were associated with higher ferritin concentrations (R).


Risedronate treatment is associated with significantly decreased ferritin levels in postmenopausal women with osteoporosis and cardiovascular risk factors (R).

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  • Suzanne Grabber

    This is a very interesting article. Must wanted to say thanks. My ferritin is of course, low, and you have helped me understand a lot.

  • Kim Johnson

    My Ferratin level went from 3 to 256 (after 3 rounds of IV therapy) 3 week span
    I HONESTLY do not feel any different!
    My doctor has done a ultrasound of my stomach and that test came back unremarkable.
    Has this happened to anyone else?
    I do not understand how it can fluctuate so much, yet my body feels the same:(

  • AaH

    Any reader of Joe’s (awesome) blog have experience to comment: Been on cholestyramine for 18 months for shortened bowel syndrome. My resection (Crohn’s inactive for +25yrs) was back in 1989 and have coped pretty well but when a routine checkup put me in touch with my gastroenterologist after 20 years, he suggested the bile sequestrant and I sure did enjoy the relief. Two months ago came down with peripheral neuropathy (hands, feet) and extreme sensitivity to sun exposure. (Am an Irish redhead so cautious with sun anyway but as a commuter cyclist, had to cover up like a freakin’ deep sea diver.) Didn’t put the neuropathy together with a low ferritin reading (39) right away. All other hematology is high normal which, again, could be the athletics factor – no shortage of oxygen, etc.. Never had low ferritin until now and I realize it could be the wear of vigorous cycling but am just suspicious of cholestyramine’s capacity to bind with nutrients. My diet is textbook perfect for me: not vegetarian and I have to follow low fodmaps protocols. Any thoughts? Similar reality? Thx in advance.

  • Pisa

    An elevated Ferritin of 300 indicates an inflammatory condition, and it is not a healthy ferritin level.

  • Daniel

    I eat completely vegan, no heme iron from any animal products. I eat nothing fortified with iron, no enriched white flour or white rice, and no processed foods fortified with iron. My diet is super high in phytic acid from eating lots of whole grains and legumes. I eat more phytic acid than almost anyone else. Despite all that, my ferritin test just came back at 304. Anyone who says that veganism causes iron deficiency clearly doesn’t know what they’re talking about.

  • Dale

    Find another doctor. Your ferritin count should be no higher than 300 at any given time. Sounds like you may have hemacromatosis.

  • Cheri Beck

    Menopausal female. I have had low Ferritin for years. Ranges from 8 – 30. I have no stamina. I exercise and am wiped out for a day or two after. I understand the relationship between my hypothyroidism, gluten sensitivity etc. I have had 3 hematologists ( I used to work in the practice) tell me it was just a matter of time before I became full blown anemic. I never did. That was years ago. The rest of my iron panel is normal. They gave me iron infusions but nothing stuck and I was afraid to keep pumping iron into my body without dealing with the root cause of the Ferritin deficiency. I am wondering if I should take some iron glycinate to help with the fatigue/tinnitus/exercise intolerance? Great article by the way.
    Also, is magnesium deficiency related to Ferritin deficiency in any way do you know? Thank you!

  • ann

    Hi – my 17 yo daughter diagnosed with ulcerative colitis 8 months ago, Hospitalized 3X since then, blood transfusion and 2 iron infusions 5 months ago. Hemoglobin OK, barely, last month but ferritin level falling. Was 15 2 months ago, then 11 a month ago. She has been taking 2 iron sulfate pills a day for a couple months. I am wondering if a different supplement would be better – her Dr. does not want to give her another iron infusion. She also has frequent heavy periods – is starting progesterone only birth control pills. Gets Remicade infusion monthly and takes Uceris, a gut-focused steroid. Lots of hair loss, fatigue, Would appreciate your thoughts.

  • JD

    Hi there – I just recently had some blood work done as part of my 2 yr follow-up for my gastric bypass surgery (2015). For the first year all my numbers looked great. The latest results have me worried, based upon my ferritin level. Below are my numbers compared from 2016 to 2017. My Iron level looked ok, but my ferritin DROPPED in one year. Over the past 6-8 mos my energy level has dropped,, but I figured that was due to family issues (a couple of deaths) that we have had to go through. Thoughts… Thank you!!

    Iron Saturation: 2016 = 40% 2017 = 25%
    TIBC Iron Binding Capacity: 2016 = 279 ug/dL, 2017 = 381 ug/dl
    Ferritin: 2016 = 145ng/ml, 2017 = 11ng/ml

  • Lorene

    The curcumin doesn’t seem to be helping my ferritin level at all. I was 190 in late May. Today, July 28, I’m 273. I have an appointment with my MD on August 9 so I may have to ask him about a phlebotomy. In the meantime, I’ll reread your article. Maybe there’s a clue there.

  • Julie

    I’m thankful your Dr discovered this. I’m assuming your Thyroid and Vitamin D levels were checked as well. Low Vitamin D will also cause heart palpitations and arythmia. Often, these three go hand in hand.

  • KXA

    I’ve had low ferritin for many years – usually single digits to teens or twenties – I’ve started digging around on the internet and came across a blogs which may be helpful – I will be following a cocktail 2 -3 times daily and will advise how my ferritin does – Cocktail that did the trick for others – L-Lysine 500mg / 1000mg of Vitmin C / Ferrits Ferrous Fumarate (Ferrous Sulfate did not do the trick for others and it hasn’t worked too well for me either) – I will also supplement with Thornes Basic B-Complex and Ferasorb. I will also try taking Ruma Guayusa Teas as they contain caffeine but no tannins which inhibit iron absorption.

  • Lizz

    I’ve had some light headed sensationa but I thought it was from a newer pain medicine given to manage flare ups. I have a lot of the symptoms listed for low ferritin. I was the one who requested my doc to order the ferritin test after feeling extremely depleted and realizing how unusually heavy my flow was during my cycle. I’m 31 , 5″4 and 210 lbs roughly… I know I could lose weight to help things but it’s easier said. I do keep a 3-5 day of 20-40 min of light to moderate exercise weekly schedule .

  • Lizz

    My ferritin is at a 9. I have hashi’s, fibro, and some ibs -c with dysphagia from suspected eosiniphilic esophagitis. I just wonder if I had low ferritin all along… these are all likely Co existing conditions, however it’s good to find out another piece of information of this puzzle! I will hopefully hear back in a few more days from my doc and have her explain what she might recommend.

  • Julie

    Update: I decided to take 25mg of Ferrous Bisglycinate, L-Lysine, and Yellowdock in orange juice per day. I take this little cocktail first thing in the morning on an empty stomach. I also avoid dairy and gluten, to help the iron absorb, and have been eating more red meat. Within 5 weeks my ferritin went from 30 to 45 and hair shedding is slowing (not as much loss). Iron numbers stayed within range. So, to conclude, taking iron supplementation with co-factors is helping raide my ferritin without raising my other iron numbers.

  • Tina

    My ferritin level was 2600 a month ago and over 2000 a few months ago. My docs don’t seem concerned,. I am a 12 yesr survivor of AML(leukemia) had a non-related stem cell transplant in 2005. I did have a slight infection both times my level was tested. (One time respiratory & the other a root canal infection) could that have raised my ferritin level that much?? My liver blood tests are always
    Normal. Thank you.

  • Erin

    I was told to try chaste tree tincture and it has really helped my period to normalize. It doesn’t seem as heavy. And I have started my period on the new moon for a few months now.

  • Stacy

    Donate blood.

  • nancy ellis

    my ferritin level is a 7!!!!…..I ve been having symptoms of fatigue and headaches for years.. but most recently alarming heart arrythmia and palpitations and severe dizziness.. feeling totally out of my body. Actually for years ive felt light headed, but i thought it was my low blood pressure. Im super healthy, teach and do yoga 5x a week, active, hiking, im a massage therapist also and work in a restaurant. I only eat organic, but have a full well rounded diet, that includes meat and dairy. Im also an Ayurvedic practitioner, so follow those guidelines for my constitution and seasonal eating. My doctor lady, was shocked that i hadnt passed out before, with my severely low ferritin levels… anyhow, ive started taking a B12 sublingual spray, vegan, and taking dessicated liver. Ive read that liver is the best way to get the heme iron, and most easily absorbed by the body without intestional side effects. Ive cut out coffee (that was my 1 vice) and has made a huge difference.., Its been a month on these supplments and feel better but far from 100%… id appreciate any feedback on dessicated liver and iron supplments. Ive also got the Thorne brand B12, and hemagenics red blood cell builder, and will start these soon as well. Im also doing regular acupucture to help build the blood focusing on heart, liver and spleen…This is my first time to a doctor in 20 years! The root cause of the low iron, is believed to be my heavy menses, lasting 5-7 days and cycling every 22 days a month. Im 45, so im hoping i can find all naturals ways through diet and herbs and alternative medicine to help this. Any insight is helpful. Thank you, Nancy

    1. Nattha Wannissorn, PhD

      Yes you need more iron than you do B12.

  • Haisam

    My ferritin in serum was 814 and the hemoglobin is 16.5
    And i was a heavy smoker i went to z doc and he told me to quit smoking and i did and i wait for a month and its now 880 so i dont know what to do ?

  • Jackie Walsh

    Both my husband and myself were told today by our family Doctor that our iron was low but our iron reserves are high. No explanation given as what is the cause or the remedy. What is your opinion on this?

  • Lorene

    I contacted Canadian Blood Services and asked whether I could donate blood. They said absolutely not. Taking blood from me might put me at risk. So I’m trying the curcumin, which should also help with any inflammation. I know I’m sensitive to dairy, eggs and soy, so I’ll be avoiding those. I’ll let you know how it goes. I will know by early August.

  • Lorene

    My ferritin level recently tested at 190 (the high end of the reference range is 150) so it’s a little high. I understand that a blood donation may be the most efficient way to deal with this. However, I was diagnosed with Pernicious Anemia in 1996 and took B12 injections every month since then. A number of years ago, I asked about donating blood but was refused because I was on injections.

    Just over a year ago, my B12 level was high so my doctor agreed that I could stop the injections and go on supplements. We test the B12 level about every 6 months and it is falling so I may have to go back on injections soon. I could ask about donating blood before resuming B12 shots but if I am still refused, would taking a curcumin supplement reduce my ferritin?

    1. Nattha Wannissorn, PhD

      Depends on why it’s high, yea. Could be inflammation or a problem with your body using the iron.

  • Siddu patil

    I have ferritin level 1556ng/ml in blood test…And I have rhematoid arthritis..What will do plz suggest me

  • Marilyn Knox

    I have anemia and chronically low ferriton. My numbers yesterday were 8.0 hemoglobin and 6 ferriton. My hematologist has decided to infuse monthly with ferrilicit. I am convinced my low ferriton is the causal factor of my anemia. Comments? Recommendations?

    1. Nattha Wannissorn, PhD

      low ferritin is a symptom of low iron (not necessarily anemia). It’s not a cause of anemia.

  • Helen Knowles

    I think that you have done a lot of hard work to produce such an all embracing presentation of Ferritin and as somebody who had to do loads of fast moving research daily in order to back up one’s work I would like to say ‘thank you.’

  • Julie

    I have low ferritin but within range iron levels. My iron saturation is even at 43%. However, I have a great deal of hair loss. I think low ferritin is the culprit. I want to increase my ferritin but not the other iron numbers. Is this possible? I’m an otherwise healthy 35 y/o female with no other issues. I haven’t been able to find much information on this issue and doctor’s are of NO use!

    Iron, Total 143 mcg/dL
    Transferrin 263 mg/dL
    TIBC Calc 329 mcg/dL
    Iron Saturation 43 %
    Ferritin 30.6 ng/mL

  • Daniel

    Isn’t iron not truly a nutrient, but just a toxic metal?

    If I also eat anything fortified with supplemental iron like enriched white rice, it immediately feels toxic. Just the thought of eating red meat also feels toxic. Only iron from plants may be safe.

    1. Nattha Wannissorn

      Well, there is iron in your blood. Without iron, you die, so it is a nutrient.

  • inom

    I have low Ferritin with possible gut inflammation. Which supplement would be better? I have heard carbonyl form is safer and good for those with less stomach acid. I am chronically sick with sensitivity of most of the foods.

    1. Nattha Wannissorn

      My advice is to fix the gut inflammation by testing for what could be causing the gut to be inflamed (i.e. stool screening for pathogens and organic acids). Otherwise, what you are doing is just controlling the symptoms (which includes avoiding the foods you are sensitive to), and you will not absorb much of the supplements and foods that you ingest. We can reasonably expect that all your other symptoms (if any) will improve once you kill the gut pathogens, re-balance the gut flora, and fix the leaky gut. If you would like help on this, you can book an appointment with me at https://selfhacked.com/consult-specialists/#Nattha_bio. We’ll chat about what’s going on, decide what tests are best for you, and help you on your way to health. ~Nattha @ Team SelfHacked

  • Cindi

    Great post, but it’s still not clear to me whether someone with high inflammation/metabolic syndrome should intentionally lower ferritin levels. Are they rising as a protective mechanism, or is the high ferritin contributing to the problem?

    1. Nattha Wannissorn

      More like the body is trying to conserve iron because it’s preparing to lose blood in the presence of inflammation (said one of the doctors I learned this stuff from).

  • Ted Hu

    how about Thalassemia minor, Taiwanese male, presumably Portuguese/Mediterranean descent.

  • Radek Pilich

    Highly recommended listening:

  • Kyle

    Are there any good supplements for lowering iron?

    1. Natcha M

      Things that prevent absorption like tannins and phytates. I think you better get those in foods rather than supplementing them. Also gotta eat less iron in the first place.

  • Shelley Goforth

    This is wonderful information! I appreciate you and your contribution to our understanding of our bodies so much.

    1. Natcha M

      Thank you!

  • Remy

    Ferritin can be normal or high in the Anemia of Chronic Disease. A better way to differentiate is transferrin/TIBC. If it is low, it’s more likely ACD. If it’s high, iron deficiency anemia.

    1. Natcha M

      Yes Remy, I agree. Unfortunately those things rarely get tested unless the doctor is following up on someone with a diagnosis. We definitely should have a comprehensive iron levels post.

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