Ferritin level: normal values and what a low ferritin means

Your ferritin is the blood value that shows how large your iron stores are. A low ferritin level usually points to a shortage of iron, even before you have anaemia. A normal value for women lies roughly between 15 and 150 micrograms per litre, although the cut-off values differ per lab and per guideline.

I notice that ferritin is one of the most confusing values on a result. One time the reference starts at 10, another time at 30, and then you read online that you only feel good around 50. In this article I calmly explain what ferritin is, what a normal value is and what a too low or too high ferritin can mean. For the story about a low ferritin without anaemia I point to a separate article.

What is ferritin?

Ferritin is a protein that stores iron in your body. The amount of ferritin in your blood is an indirect measure of your iron stores. The more stored iron you have, the higher your ferritin usually is.

Your body uses iron among other things to make haemoglobin, the protein in your red blood cells that carries oxygen. Ferritin is like the reserve tank. As long as that tank is well filled, your body can draw on iron whenever it needs to.

That is why ferritin is often the first value to fall when your iron stores run out. Your haemoglobin may still be normal while your reserves are already low. If you want to know how ferritin relates to iron and transferrin, also read our iron values reference table with iron, ferritin and transferrin per reference.

What is a normal ferritin level?

A normal ferritin level for adult women lies roughly between 15 and 150 micrograms per litre. The exact lower and upper limits differ per laboratory and per guideline. Some labs use a lower limit of 10, others of 30.

That difference matters to understand. According to the Dutch NHG guideline on anaemia, a ferritin below about 15 micrograms per litre fits with iron deficiency, but many doctors already look critically at values between 15 and 30 when there are complaints. The table below gives an indicative overview, not a hard limit.

Please note: these are indicative figures. The cut-off values on your own result may differ, because labs use different methods and references. So always look at the reference value listed next to your own result.

What does a low ferritin mean?

A low ferritin almost always means your iron store is low or empty. Often that is the first step towards anaemia, but it can already be there while your haemoglobin is still normal. Complaints that can fit include tiredness, getting out of breath faster and sometimes hair loss.

A low ferritin is relatively common in women. Menstruation costs iron every month, and a heavier period can gradually deplete the store. Pregnancy, an iron-poor diet or problems with absorption in the gut can also play a role.

It is important that a low ferritin is something other than anaemia. You can have a low ferritin while your haemoglobin is still normal, which is often called iron deficiency without anaemia. What that means exactly you can read in our article on iron deficiency without anaemia and what a low ferritin means.

A single low value does not immediately tell you the cause.

What does a high ferritin mean?

A high ferritin does not automatically mean you have too much iron. Ferritin is also an inflammation protein, which rises with an infection, inflammation or liver strain. So your ferritin can be temporarily high without anything being wrong with your iron store.

If your ferritin is structurally high, your doctor may look further. Sometimes it points to iron overload, for example in the hereditary condition haemochromatosis. Being overweight, drinking a lot of alcohol and a liver condition can also raise the value.

Because a high value can have so many causes, it is rarely judged on its own. Your doctor looks at the whole picture, including your iron and sometimes the transferrin saturation, and at your complaints and history.

When do you test your ferritin?

Testing your ferritin is useful if you have complaints that fit iron deficiency, such as ongoing tiredness, paleness or getting out of breath faster. The value can also be useful with a heavy period, a vegetarian or vegan diet or while trying to conceive.

Ferritin is often looked at together with your haemoglobin. That way you see not only whether you have anaemia, but also whether your iron store is already shrinking. That distinction is handy, because a low ferritin warns you earlier than the haemoglobin.

According to Thuisarts.nl, tiredness often cannot be explained by anaemia, so a normal ferritin value can also be reassuring. If you want to know more about the link with anaemia, read our pillar on anaemia in women, causes, symptoms and which blood values to test.

Testing your own ferritin

You can have your ferritin drawn yourself at Lunara, without a referral. The Iron Status test looks at your ferritin together with your ferritin and related iron values, so you get a complete picture of your store.

Your blood is drawn at one of the more than 750 draw locations, preferably in the morning. Every result is assessed by a BIG-registered doctor, so you do not just get a number but also context.

Testing yourself is meant as an addition, not as a replacement for your GP. You always discuss an abnormal ferritin value with a doctor, who looks at your whole situation.

Frequently asked questions

What is a good ferritin value for women?

For adult women a value between roughly 15 and 150 micrograms per litre is generally considered normal. The exact limits differ per lab. With complaints, doctors sometimes already look critically at values below 30.

Is a ferritin of 15 too low?

A ferritin around 15 micrograms per litre lies on or just above the lower limit of many labs. With complaints it can fit an early iron deficiency. Whether that is the case for you is judged by a doctor together with your haemoglobin and your complaints.

What is the difference between ferritin and iron?

Iron in the blood shows the current amount circulating at that moment, while ferritin reflects your stored reserve. Ferritin is more stable and falls earlier with a shortage. That is why ferritin is often the first value to stand out.

Can my ferritin be high without an iron surplus?

Yes. Ferritin also rises with inflammation, infection or liver strain. So a high value does not automatically mean you have too much iron. Your doctor looks at additional values to find the cause.

Do I have to be fasting for a ferritin test?

For ferritin you usually do not have to be fasting. It can be handy to draw in the morning, because some values are more stable then. The draw location will let you know whether there is anything to take into account.

References

1. NHG. NHG guideline Anaemia. Dutch College of General Practitioners.
2. Thuisarts.nl. I have anaemia due to iron deficiency. Thuisarts.nl.
3. Voedingscentrum. Iron. Netherlands Nutrition Centre, The Hague.

Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. Blood testing through Lunara does not replace contact with your GP. For diagnosis or treatment, discuss your results with your GP.