Ferritin
Ferritin is the protein your body stores iron in, and the value in your blood is the measure of how large that store is. It is the first value to know when you are tired, because the store runs empty long before you have anaemia.
Ferritin reference ranges
What does your value mean?
Normal: women 30 to 120, men 30 to 250 µg/L
Enter your value as it appears on your results. Range for adults.
Ferritin high or low: what it means
Ferritin too low
Belongs with: Iron deficiency, Anaemia
The store is empty, and the question is where the iron went.
| Cause | How often |
|---|---|
| The most common reason in women before the menopause; every month more iron goes out than comes in with food | Often |
| Especially with plant-based eating, because iron from plants is absorbed far less well than iron from meat and fish | Often |
| The baby and the placenta draw iron from the store; at the end of a pregnancy it is often empty | Often |
| Often goes unnoticed, from a stomach ulcer, haemorrhoids, a polyp or long-term painkillers; in men and after the menopause the first place to look | Sometimes |
| Sweat, the impact of every footstrike and a gut that loses a little blood after long efforts; runners and cyclists often sit at the low end | Sometimes |
| With coeliac disease, after stomach surgery or with long-term antacids the iron does not get across the gut wall | Rare |
Ferritin too high
Usually not iron overload, but ferritin rising with inflammation or a liver under strain.
| Cause | How often |
|---|---|
| Ferritin is an inflammation protein and rises with every infection or inflammation, independently of the store; CRP shows whether that is at play | Often |
| A liver full of fat leaks ferritin; it goes together with belly fat, a high ALT and insulin resistance, and falls with lifestyle | Often |
| Alcohol strains the liver and lifts ferritin; a few weeks without often lets the value fall already | Sometimes |
| Inherited; the gut absorbs too much iron and it builds up in liver, heart and joints; recognisable by a high transferrin saturation beside it | Rare |
What you do about it. With an empty store you eat iron you absorb well, red meat, fish and poultry, and from plant sources legumes, whole grains and green vegetables with vitamin C alongside, because that doubles absorption. Tea and coffee block absorption, so not with the meal. If the store is really empty, food alone does not refill it fast enough and an iron tablet is the way; which tablet suits you and how often you take it is something you can discuss with your GP. Haemoglobin recovers before the store does, which is why you carry on for another eight to twelve weeks once haemoglobin is normal again. With a high ferritin without overload, less alcohol, less belly fat and tackling the inflammation are the levers.
How does a ferritin blood test work?
- Which test. Ferritin is in the Iron & fatigue test (€99) and in .
- Fasting. Every draw is fasted: nothing to eat or drink from midnight, only water. Appointments are therefore in the morning, until 12:00.Skip an iron tablet on the day of the draw.
- Referral. Not needed. You can have ferritin measured yourself, and it is the most useful value for tiredness, for anyone who menstruates, eats plant-based or exercises a lot.
- When. Not during or just after a cold, infection or operation, because ferritin is temporarily high then and says little about your store. Wait a few weeks.
- The draw. One tube of blood from a vein in your arm. CRP, transferrin saturation and a blood count come from the same draw.
- Repeating. Three months after starting iron to see whether the store is filling, and for anyone who menstruates or exercises a lot once a year.
- Where to draw. You can draw at 400+ locations near you, no referral needed. See the locations
More about ferritin
Ferritin explained
Iron is the core of haemoglobin, the oxygen carrier in your red blood cells, and of the enzymes your muscles and brain use to make energy. What you do not need right away, your body puts away in ferritin, a protein that can hold thousands of iron atoms like a hollow ball. Most ferritin sits in your liver, spleen and bone marrow; a small part leaks into your blood, and that part moves with the size of the store. That is why the ferritin value is the measure of how much iron you have in stock, while your haemoglobin says how much you are using in your blood right now. Those two do not run in step. An iron deficiency starts with a store running empty, while haemoglobin stays up for months. In that phase you already have symptoms, tiredness, breathlessness on exertion, slower recovery, hair loss, while an ordinary blood count is still normal. Ferritin responds first, and that is why it is the value to know first when you are tired. The pitfall is that ferritin is also an inflammation protein. With an infection, an inflammation, liver damage or plenty of alcohol it rises independently of your store, and a normal value can then hide an empty warehouse. Your report shows ferritin in µg/L. Below 15 µg/L the store is empty, above 100 µg/L an iron deficiency is unlikely, and in between CRP and transferrin saturation decide.
Why is ferritin relevant?
Iron deficiency is one of the most common and most missed reasons for tiredness, especially in women who menstruate, in anyone who eats plant-based, in endurance athletes, pregnant women and blood donors. The symptoms are vague and creep in: less energy, out of breath sooner on the stairs, feeling cold, concentration slipping, hair thinning, restless legs at night. Because haemoglobin is still normal, it is often put down to being busy or sleeping badly. A ferritin value turns that suspicion into a number, and an empty store is cheap and easy to refill. For anyone who does sport, ferritin is even more interesting. Endurance sport uses iron: sweat, the impact of every footstrike that breaks red cells, and a gut that loses a little blood after a long effort. A ferritin that sits within the band but at the low end often goes together in athletes with less endurance, and many athletes feel better with a store above fifty. That is not a disease but a state of the store, and you adjust it with food and where needed a supplement. On the other side, a high ferritin is almost never iron overload. In practice it is more often inflammation, fatty liver, excess weight or alcohol: all reasons that lift the value without more iron being in stock, and that you bring down with lifestyle. The real iron overload, haemochromatosis, is an inherited condition in which the gut absorbs too much iron, and you recognise it by a high ferritin with a high transferrin saturation. That combination you do not want to miss, because it is very treatable as long as the organs have no damage yet.
How do you read ferritin?
A low ferritin means an empty store, and the question is why. The most common explanation first: heavy periods, too little iron from food, a pregnancy, blood loss in the gut, endurance sport, and rarely poor absorption as in coeliac disease. In a woman who menstruates the explanation is usually clear. In a man or a woman after the menopause an iron deficiency rarely comes from food alone; the gut is then the first place the blood can go, and that is looked into before you start topping up. A high ferritin usually means inflammation or a liver under strain, not too much iron. Look at CRP and at your liver values and your waist: a high ferritin with a high CRP is an inflammation, a high ferritin with a high ALT and excess weight is fatty liver, and both fall away once the cause does. A high ferritin with a transferrin saturation above 45% is the picture of iron overload, and then investigation for haemochromatosis belongs with it. Read ferritin beside CRP, because inflammation hides a deficiency, and beside transferrin saturation, which is low in a deficiency and high in overload. Haemoglobin and MCV tell whether the deficiency is already working through into your blood.
Frequently asked questions
The protein your body stores iron in, mainly in your liver, spleen and bone marrow. A small part sits in your blood and moves with the size of that store, so the ferritin value is the measure of how much iron you have in stock. It does not say how much iron is circulating right now, transferrin saturation reads that, and it also rises with inflammation without your store growing.
Related biomarkers
Sources 7
- 1.NHG guideline on anaemia (M76), Dutch College of General Practitioners. 2024. richtlijnen.nhg.org
- 2.WHO, Guideline on use of ferritin concentrations to assess iron status. 2020. who.int
- 3.Unilabs, test catalogue (Dutch): ferritin. 2026. bepalingenklapper.nl
- 4.Star-shl, test catalogue (Dutch): ferritin. 2026. star-shl.nl
- 5.Certe, test catalogue (Dutch): ferritin. 2026. bepalingenwijzer.certe.nl
- 6.Clinical Diagnostics, lab guide (Dutch): ferritin. 2026. clinicaldiagnostics.nl
- 7.LESA Laboratory diagnostics (Dutch primary-care laboratory agreement). 2026. richtlijnen.nhg.org
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