What is a normal ferritin level?
Ferritin ≤30 ng/mL meets the 2026 ASH threshold for iron deficiency in most adults, even when hemoglobin is normal. A result above 30 does not always exclude deficiency: symptoms, blood loss, pregnancy, and inflammation change how the result is interpreted.
The table below summarizes the diagnostic thresholds. They are not treatment targets. Laboratory reference intervals vary, and a result marked “normal” can still warrant evaluation.
| Population or situation | ASH 2026 diagnostic guidance |
|---|---|
| Adults without inflammation, including menstruating and pregnant individuals | Ferritin ≤30 ng/mL |
| Adults with symptoms or ongoing risk factors; menstruating individuals with heavy bleeding, symptoms, additional risks, upcoming surgery, or plans for pregnancy | A threshold of ≤50 ng/mL is appropriate |
| Pregnancy with anemia | A threshold of ≤50 ng/mL may be appropriate |
| Adults with inflammation | Test both ferritin and transferrin saturation (TSAT). Consider deficiency if ferritin is <100 ng/mL or TSAT <20% |
| Children aged 9 months through 4 years | Ferritin ≤20 ng/mL |
Ferritin in ng/mL and µg/L has the same numeric value. Empirical’s app uses a general adult benchmark of 30–250 ng/mL; the lower boundary still meets the deficiency criterion. The upper boundary is not an ASH target, and higher ferritin is not always better.
What changed in the September 2026 ASH guidelines?
On September 16, 2026, the American Society of Hematology (ASH) announced its new guidelines for diagnosing iron deficiency. The guideline paper was published online August 24, 2026. These final recommendations replace the 2025 draft previously discussed here.
ASH favors higher ferritin thresholds to identify more people with iron deficiency before anemia develops. Earlier guidance varied: WHO used less than 15 ng/mL for otherwise healthy adults, while some specialties already used higher cutoffs. Empirical’s previous general adult benchmark started at 20 ng/mL.
View ASH’s visual summary of the 2026 recommendations
© 2026 American Society of Hematology. Select the image to open the full-size source PDF, including recommendation strength and evidence certainty. Guideline resources.
What does low ferritin mean?
Low ferritin points to depleted iron stores. Common reasons include heavy menstrual bleeding, other blood loss, insufficient dietary iron, and reduced absorption, such as with celiac disease. Pregnancy increases iron requirements. The next step is to identify why iron is low, alongside deciding whether iron replacement is needed. MedlinePlus: iron-deficiency anemia.
A clinician may review your diet, menstrual or other bleeding history, medications, and a complete blood count. Unexplained deficiency can require investigation for gastrointestinal blood loss. Iron supplements can replenish stores, but treating the cause matters too.
Speaking about women in their 20s and 30s, Dr. Soumya Rangarajan, a geriatrician in Ann Arbor, Michigan, told The New York Times:
“I think things like iron deficiency are written off as a normal part of life.”
Source: The New York Times, September 7, 2026.
What is “ferritin face”?
“Ferritin face” is a social-media label for a tired-looking complexion, paleness, or under-eye circles that people attribute to low iron stores. The New York Times covered the trend on September 7, 2026. It is not a medical diagnosis.
Iron-deficiency anemia can cause pale skin, but appearance alone cannot tell you whether ferritin is low. Dark circles and a tired-looking face have many possible explanations; they do not establish iron deficiency. NHLBI: iron-deficiency anemia; Bournemouth University: the evidence behind “ferritin face”.
If these changes come with persistent fatigue, heavy periods, or other risk factors, discuss ferritin and a complete blood count with your clinician. Testing can distinguish depleted iron stores from anemia. Iron supplements should address a confirmed need, rather than serve as a cosmetic treatment; unnecessary iron can be harmful.
What does high ferritin mean?
High ferritin does not automatically mean iron overload. Inflammation, liver disease, and alcohol use can raise ferritin; excess iron is another possible cause. Interpretation usually includes other iron studies and your medical history. MedlinePlus: ferritin testing.
Your clinician may repeat ferritin and check iron saturation, liver enzymes, and evidence of inflammation. Whether further testing for an iron-overload condition is appropriate depends on that combined picture.
Ferritin vs. iron: what is the difference in a blood test?
Ferritin reflects stored iron, serum iron measures iron circulating in the blood, total iron-binding capacity (TIBC) measures how much iron the blood’s transport proteins can carry, and iron saturation measures the percentage of that capacity being used.
A serum iron result is a snapshot: it varies through the day. Ferritin helps assess reserves, but inflammation can raise it. These tests answer different questions and are often interpreted together. MedlinePlus: iron tests.
Ferritin vs. iron deficiency: can you have normal hemoglobin?
Ferritin is a measurement; iron deficiency is the condition of having too little iron. You can have iron deficiency without anemia. Iron stores can fall before hemoglobin becomes low. Anemia describes low hemoglobin and can have causes other than iron deficiency. ASH’s diagnostic guidance explicitly covers deficiency with or without anemia.
Ferritin vs. iron saturation and TIBC
Transferrin is the main protein that transports iron. TIBC estimates its carrying capacity, while transferrin saturation (TSAT) tells you how much of that capacity is occupied. For example, serum iron of 60 µg/dL divided by TIBC of 300 µg/dL gives 20% saturation. The calculation requires matching units. MedlinePlus: TIBC.
When inflammation makes ferritin harder to interpret, ASH suggests checking both ferritin and TSAT. A ferritin result alone cannot reliably settle the question in that setting.
How does Ferritin change with age?
In Empirical’s pooled data, ferritin has little linear association with adult age (r = +0.05). This compares different people at different ages; it does not show how one person’s ferritin changes over time.
Does ferritin differ by sex?
In a 2025 analysis of 7,357 nonpregnant U.S. adults in NHANES, median ferritin was 145 ng/mL in men, 43 ng/mL in premenopausal women, and 98 ng/mL in postmenopausal women—about three times higher in men than in women before menopause. These are population medians, not treatment targets or an age-matched comparison.
Menstrual blood loss and pregnancy affect iron needs and can contribute to lower stores. The chart above combines people rather than separating them by sex or menstrual status, so its overall trend can hide subgroup differences. ASH’s general adult cutoff is ≤30 ng/mL, with the higher thresholds above based on clinical circumstances. A population average is not a diagnostic cutoff. MedlinePlus: iron needs and risk factors.