What is ferritin?

Ferritin is the soluble, storage form of iron. As such, the ferritin measurement gives us an indirect measurement of your body’s iron stores. Low levels of ferritin may indicate depletion of iron stores (mild iron deficiency), iron-deficiency erythropoiesis (low red blood cell count), or iron deficiency anemia (low hemoglobin and hematocrit). Anemia is the most prevalent nutritional deficiency worldwide.

Why is it under both the Inflammation and Balance Axes?

Iron is an important indicator of physiological health as it is extensively used in energy production and oxygen transport in the blood. Ferritin levels that are out of range can point to a variety of complications such as fatigue, headaches, restless legs syndrome, heart problems, pregnancy complications, and developmental delays in children. In addition, people with iron deficiency anemia are more likely to have weaker immune responses, gastrointestinal upset, problems with concentration and memory, and are less able to work, exercise, and control body temperature. As women are especially susceptible to low levels of iron, this test is particularly important for women’s general health. Heme iron (found in meat) is more bioavailable than nonheme iron (found in plants and fortified foods), so vegetarians are more prone to having depleted iron stores as well.

How can I better understand my results?

Standard lab ranges for ferritin are currently quite broad. For example, the following are considered normal ranges according to:

  • Mayo Clinic: 24-336 ng/mL for males and 11-307 ng/mL for females
  • Cleveland Clinic: 30.4-565.7 ng/mL for males and 14.7-205.1 ng/mL for females
  • UCSF Health: 12-300 ng/mL for males and 12-150 ng/mL for females

Considering the link between ferritin and inflammation, as well as findings that levels under 50 ng/mL are associated with fatigue and above 150 ng/mL may indicate iron overload, SiPhox Health utilizes a more conservative optimal range between 50 ng/mL and 150 ng/mL.

As explained in Gastroenterology & Hepatology, while many laboratories consider serum ferritin levels > 200 ng/mL in females and > 300 ng/mL in males to be abnormal, these levels are common among the general population, likely due to the prevalence of obesity and fatty liver.

Abnormally low levels of ferritin may indicate iron deficiency at < 30 ng/mL and iron deficiency anemia at < 10 ng/mL.

It is important to note that serum ferritin levels may be elevated in the presence of the following conditions:

  • inflammation
  • significant tissue destruction
  • liver disease
  • malignancies such as acute leukemia and Hodgkin’s disease

Pregnant women, menstruating women, frequent blood donors, and people with cancer, gastrointestinal problems, and heart failure are most likely to have inadequate iron levels.

If you have low ferritin (< 50 ng/mL), a few lifestyle modifications to try include:

  • Supplement or consume more iron (fortified cereals, oysters, lentils, etc.)
  • Vitamin C enhances iron absorption (oranges, strawberries, tomatoes, etc.)
  • Limit foods containing phytates, polyphenols, and high calcium that inhibit iron absorption (tea, coffee, red wine, calcium supplements) when consuming iron
  • Cook with cast iron pans to increase the iron content of your meals

If you have high ferritin, a few ways to lower levels include:

If your ferritin levels are abnormally high, it may mean you have hyperthyroidism, hemochromatosis (iron overload), liver disease, inflammatory diseases, an infection, or cancer, which is why it is important to consult with your physician if you are concerned about any of your results.

Where can I learn more?

National Institutes of Health - Iron (fact sheet for consumers)

National Institutes of Health - Iron (fact sheet for healthcare providers)

National Heart, Blood, and Lung Institute - Iron-Deficiency Anemia

Cleveland Clinic - Ferritin Test