Question 1

What do the 2025 ASH draft guidelines say about ferritin?

Accepted Answer

The 2025 American Society of Hematology draft guidelines raise the ferritin threshold for diagnosing iron deficiency. In general adults, the suggested cutoff is now ≤30 ng/mL (up from ≤15). In people with symptoms or risk factors (heavy periods, upcoming surgery, planning pregnancy), ≤50 ng/mL is appropriate. In young children (9 months to 4 years), the cutoff is ≤20 ng/mL. In anemia of inflammation, ferritin alone is not enough: iron deficiency is diagnosed when TSAT ≤20% or ferritin ≤100 mcg/L.

Question 2

What causes high ferritin?

Accepted Answer

High ferritin does not always mean excess iron. Because ferritin is an acute-phase reactant, it rises with inflammation, infection, liver disease, and heavy alcohol use. These are far more common explanations than true iron overload. If ferritin is high without an obvious inflammatory cause, genetic testing for hemochromatosis (hereditary iron overload) is reasonable. Your doctor will look at ferritin alongside serum iron, TIBC, and iron saturation to distinguish inflammation from iron overload.

Question 3

What does low ferritin mean?

Accepted Answer

Low ferritin is the earliest marker of iron deficiency. It drops before hemoglobin or MCV change, making it useful for catching deficiency early. Common causes include blood loss (menstruation, GI bleeding), poor dietary iron intake, celiac disease, and vegetarian or vegan diets without supplementation. Treatment includes iron-rich foods, iron supplements (taken with vitamin C for better absorption), and addressing the underlying cause of iron loss.

Question 4

What is a normal ferritin level?

Accepted Answer

Normal ferritin ranges from about 20-250 ng/mL for men and 10-120 ng/mL for women. Some functional medicine practitioners consider optimal ferritin to be above 40-50 ng/mL, especially for women experiencing fatigue or hair loss. Ferritin below 30 ng/mL is strong evidence of iron depletion, even if hemoglobin is still normal. Levels above 300 ng/mL in men or 200 ng/mL in women should prompt further investigation.

Question 5

Is there a ferritin supplement?

Accepted Answer

There is no ferritin supplement directly. Ferritin is your iron storage protein, and its level rises when you replete iron. Oral iron (ferrous sulfate, ferrous bisglycinate) raises ferritin over weeks to months. Take iron with vitamin C, away from calcium, coffee, and tea, and recheck ferritin after 8 to 12 weeks.

Question 6

What is ferritin?

Accepted Answer

Ferritin is your body’s iron storage protein. Think of it as your iron savings account. It is the most reliable single marker of iron stores and often drops before any other sign of deficiency appears. The tricky part: ferritin is also an inflammation marker, so it can be misleadingly high when the body is fighting infection or dealing with chronic inflammation.

How does Ferritin change with age?

Ferritin stays relatively flat across adult ages (correlation with age, r = +0.05). Most of the spread in the chart below comes from differences between people rather than from age.

Ferritin is stable with age, chart with median and linear trend

Ferritin

How much does a Ferritin test cost?

How does Ferritin change with age?

What can cause low Ferritin?

Biomarkers related to Ferritin

Frequently asked questions about Ferritin

Where to get a Ferritin test near you

Know your Ferritin. Know your health.