Ferritin: The Iron Marker Your Doctor Probably Isn't Checking

You're exhausted. Your hair is falling out in clumps. You can't focus at work, and you've started forgetting simple things. You finally get to the doctor, they run your iron labs, and... everything comes back "normal."

Sound familiar? If you're a woman dealing with unexplained fatigue, there's a good chance your doctor checked your hemoglobin and maybe your serum iron - but never looked at your ferritin.

What Is Ferritin and Why Does It Matter?

Ferritin is a protein that stores iron in your body. Think of it as your iron savings account, while serum iron is more like your checking account - the iron that's actively circulating in your blood at any given moment.

Here's the problem: your serum iron can look perfectly normal even when your ferritin (your iron stores) is severely depleted. Your body prioritizes keeping that circulating iron steady, even if it means draining your reserves. By the time your serum iron drops and anemia shows up on a standard blood test, you may have been running on empty for months or even years.

Symptoms of Low Ferritin

Low ferritin can cause symptoms long before you technically meet the criteria for iron deficiency anemia:

• Crushing fatigue that doesn't improve with sleep
• Hair loss - especially diffuse thinning across the scalp
• Brain fog and difficulty concentrating
• Shortness of breath during exercise
• Restless leg syndrome
• Frequent infections (iron is crucial for immune function)
• Brittle nails or spoon-shaped nails
• Cold hands and feet
• Headaches

The "Normal" Range Problem

Most labs list the "normal" ferritin range for women as 12-150 ng/mL. But here's what many doctors don't tell you: optimal ferritin for symptom relief is typically between 50-100 ng/mL - and some experts argue it should be even higher.

A ferritin of 15 ng/mL is technically "normal" by lab standards, but you can absolutely feel terrible at that level. Many women experience significant improvement in energy, hair growth, and cognitive function when their ferritin rises above 50 ng/mL.

Why the Standard Range Is Too Wide

Laboratory reference ranges are based on the statistical average of the population tested - not on what's optimal for health. Since so many women have low iron stores, the "normal" range reflects this widespread deficiency rather than ideal levels.

Who's at Risk for Low Ferritin?

• Women with heavy periods (changing pads/tampons every 1-2 hours, periods lasting more than 7 days)
• Vegetarians and vegans (plant-based iron is less bioavailable)
• Endurance athletes (running can cause iron loss)
• Pregnant women (iron needs increase significantly)
• Women with digestive issues (celiac, IBD, low stomach acid)
• Frequent blood donors
• Anyone taking PPIs or antacids (these reduce iron absorption)

Getting Your Ferritin Tested

If you've been told your iron is "fine" but you're still dealing with fatigue, hair loss, or brain fog, it's worth specifically asking for a ferritin test. Some things to know:

• Ferritin can be falsely elevated by inflammation - if you're fighting an infection or have an inflammatory condition, your ferritin may appear higher than it actually is
• Test when you're healthy - avoid testing during illness or your period if possible
• Track your levels over time - one test gives you a snapshot, but trending tells the real story

What to Do If Your Ferritin Is Low

Raising ferritin takes time - typically 3-6 months of consistent effort. Options include:

• Iron-rich foods: Red meat, organ meats (especially liver), oysters, spinach, legumes
• Iron supplementation: Various forms exist; some are gentler on digestion than others
• Vitamin C: Enhances iron absorption when taken together
• Avoid iron blockers: Coffee, tea, and calcium supplements can inhibit iron absorption

Take Control of Your Health Data

Ferritin is one of many biomarkers that can significantly impact how you feel day-to-day, yet it's often overlooked in standard testing. Understanding your levels - and what optimal looks like for you - is a crucial step in advocating for your own health.

You deserve answers, not dismissal. If your symptoms are real, the data should reflect that.

Tired of being told you're "fine"? Get your Ferritin tested along with a complete iron panel to finally understand your energy levels.