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I was surprised to learn that iron deficiency doesn’t actually show up in your iron levels. At least, not right away.

It feels backwards. Shouldn’t a blood test for iron…measure how much iron you have?

But that’s not how our bodies—or lab reports—work. I’ve had friends told their labs looked “normal,” even while battling fatigue, brain fog, and all the classic signs of low iron. It wasn’t until a provider thought to check their ferritin that the real issue came into focus.

And that’s part of the problem: ferritin isn’t always tested unless your doctor suspects iron deficiency in the first place.

It shouldn’t be this complicated. But given the inconsistent guidelines we're working with, it often is.

In this issue, I’m looking at what ferritin actually tells you, why it’s the first marker to drop when iron runs low, and why it’s worth requesting specifically.

Storage: Do You Have Enough Iron in Reserve?

🩸 Ferritin: Your Iron Savings Account

Ferritin is how your body stores iron.

Think of it as your iron savings account, used to keep reserves ready for high-demand moments: pregnancy, menstruation, stress, recovery, or simply living in a female body.

When iron starts running low, your ferritin drops first, long before your hemoglobin or serum iron fall enough to flag as anemia.

That’s why you can feel tired, foggy, and weak, and have lab tests still looking fine.

🧪 What’s “Low” vs. “Optimal”?

• ⚠️ <30 ng/mL → Usually considered iron deficiency, even without anemia

• 🚨 <15 ng/mL → Often used as the official cutoff, but symptoms can show up much earlier

• 🏅 50–150 ng/mL → Generally seen as optimal for women’s energy and function

Many experts now recommend aiming for at least 50 ng/mL to feel and function your best.

🔥 One Big Caveat: Inflammation

Ferritin rises in response to inflammation.

So if you’re fighting an infection, dealing with autoimmune issues, or under chronic stress, your ferritin might look normal or even high—while your body is actually running low on iron.

In those cases, a falsely “normal” ferritin could mask a deficiency.

If you’re not feeling well but your ferritin looks fine, it’s worth asking your doctor to also check:

• C-reactive protein (CRP) → An inflammation marker

• Transferrin saturation → To see how well iron is circulating

• TIBC (Total Iron Binding Capacity) → To assess how much capacity your blood has to carry iron

💬 Has ferritin ever revealed what other labs missed for you? Or has it ever been overlooked entirely? Reply and let me know! I’d love to hear your story.