Lab result explainedVitamins and mineralsLast updated November 1, 2026

Ferritin: what low, high and dangerously high levels mean

Ferritin · Iron studies · reported in ng/mL (equivalent to µg/L)

Ferritin is the protein that stores iron inside your cells, and the small amount circulating in blood is the best single test of how much iron your body has in reserve. The normal range on most US reports is roughly 24 to 336 ng/mL for men and 11 to 307 ng/mL for women, though many clinicians treat anything under 30 ng/mL as iron deficiency. The two most common reasons it is off are iron deficiency from blood loss or low intake (low) and inflammation, fatty liver or alcohol (high).

Low ferritin is simple to interpret: it almost always means iron stores are depleted, even if hemoglobin is still normal. High ferritin is harder, because ferritin also rises with any inflammation, infection, liver injury, obesity, heavy drinking or cancer, and in most people with a raised level the iron stores are actually normal. Only about 1 in 10 raised ferritin results turns out to be iron overload (hemochromatosis or transfusion-related), which is why a high result is paired with transferrin saturation before anyone concludes you have too much iron.

This page gives the ranges, explains what counts as dangerously high and what symptoms go with it, lists the causes of low and high ferritin, and covers when iron supplements help, when they harm, and what tests come next.

Ferritin at a glance

Ferritin is the iron-storage protein; the blood level reflects total body iron stores (about 1 ng/mL ≈ 8–10 mg stored iron in a healthy adult).
Typical range: roughly 24–336 ng/mL in men, 11–307 ng/mL in women; under 30 ng/mL means iron deficiency in most adults, under 15 is definite.
Low ferritin: iron deficiency from menstrual or gut blood loss, pregnancy, low intake or poor absorption (celiac disease, bariatric surgery).
High ferritin: usually inflammation, fatty liver, alcohol, obesity or infection; iron overload (hemochromatosis) when transferrin saturation is also over 45%.
Dangerously high: over 1,000 ng/mL needs a cause found; over 10,000 points to rare conditions like adult Still's disease or hemophagocytic syndrome.
Next step: low ferritin needs a source of iron loss identified before or alongside iron tablets; high ferritin needs transferrin saturation, CRP and liver tests.

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What Ferritin measures

Ferritin is a hollow protein shell that holds up to 4,500 iron atoms in a safe, non-reactive form. Most of it sits inside liver cells, macrophages and marrow cells. A small fraction leaks into the blood in proportion to total stores, which is why serum ferritin tracks body iron: in a healthy adult each 1 ng/mL of serum ferritin corresponds to roughly 8 to 10 mg of stored iron, and a ferritin under 15 ng/mL means stores are essentially empty.

The complication is that ferritin is also an acute-phase reactant. The liver and immune cells release more of it in response to inflammation, infection, tissue damage and cancer, and damaged liver cells leak it directly. Fatty liver, alcohol and metabolic syndrome, which affect a large share of adults, all raise ferritin moderately. So a low ferritin is specific (iron deficiency is the only common cause) but a high ferritin is not, and it is interpreted together with transferrin saturation (how full the iron-transport protein is), which rises in true iron overload and stays normal or low in inflammation.

The test is a simple blood draw, ideally in the morning and fasting, since a large iron-rich meal or a recent iron tablet can raise transferrin saturation (though not ferritin much). Ferritin is not changed by hydration status.

Normal range for Ferritin

Reference ranges vary between labs and by age, sex and pregnancy. Use the range printed on your own report.

Group	Typical range (ng/mL (equivalent to µg/L))	Notes
Adult men	24–336 ng/mL	Some labs use 30–400. Levels rise through adult life.
Adult women (pre-menopause)	11–307 ng/mL	Some labs use 15–150. Lower because of menstrual iron loss.
Women after menopause	Similar to men over time
Iron deficiency	Under 30 ng/mL (definite under 15)	WHO uses under 15 ng/mL; in inflammation, up to 70–100 ng/mL can still hide deficiency.
Pregnancy	Falls in the second and third trimesters; under 30 ng/mL is treated
Children (1–15 years)	7–140 ng/mL	Newborns are much higher (up to 600) and fall over the first year.
Iron overload suspected	Over 300 (men) or 200 (women) with transferrin saturation over 45%
Needs urgent explanation	Over 1,000 ng/mL	Over 10,000: hemophagocytic syndrome, adult Still's disease, severe liver injury.

High ferritin

A high ferritin means either that you have too much iron stored (iron overload) or, much more often, that something is pushing ferritin out of cells regardless of iron: inflammation, infection, liver damage, alcohol, obesity and fatty liver, or a cancer. In primary care, iron overload explains only about 10 percent of raised results. The quickest way to separate the two is transferrin saturation: over 45 percent suggests overload; under 45 percent, with a normal or high CRP, suggests a reactive rise.

How high matters. Levels of 300 to 1,000 ng/mL are common with fatty liver, drinking, metabolic syndrome or a recent illness, and often drift down when the driver is addressed. Levels over 1,000 ng/mL always need an explanation; in hemochromatosis this is the threshold above which liver scarring becomes likely, and in anyone it raises the chance of an underlying liver disease, cancer or blood disorder. Levels over 10,000 ng/mL are rare and point to a small group of serious conditions: hemophagocytic lymphohistiocytosis, adult-onset Still's disease, severe liver injury or sepsis.

The symptoms people search for with high ferritin (joint pain, fatigue, abdominal pain, skin bronzing, loss of libido, diabetes, heart failure) are symptoms of true iron overload that has gone on for years, mainly hereditary hemochromatosis. A reactive high ferritin from fatty liver or inflammation has no iron-related symptoms of its own; the symptoms are those of the underlying condition.

Common causes

Inflammation and infection
Cytokines such as interleukin-6 increase ferritin synthesis and block iron release from stores. Any infection, autoimmune disease, recent surgery or chronic inflammatory condition can raise ferritin two- to five-fold while iron stores stay normal. CRP is usually raised too.
Fatty liver disease and metabolic syndrome
Insulin resistance increases iron uptake by the liver and leaky, inflamed liver cells release ferritin. 'Dysmetabolic hyperferritinemia', typically 300–800 ng/mL with normal transferrin saturation, is now the most common cause of a raised ferritin in US adults.
Alcohol
Alcohol increases iron absorption, damages liver cells so they leak ferritin, and suppresses hepcidin. Ferritin often falls by half within a few weeks of stopping drinking, which is itself a useful diagnostic test.
Liver disease (hepatitis B and C, cirrhosis, drug injury)
Damaged hepatocytes release stored ferritin directly into blood. Very high levels (several thousand) can follow acute liver injury. ALT and AST are usually abnormal.
Hereditary hemochromatosis
A mutation in the HFE gene (C282Y in most cases) reduces hepcidin, so the gut absorbs iron it does not need and stores pile up over decades in the liver, pancreas, heart and joints. Ferritin rises with transferrin saturation over 45–50%; about 1 in 200 people of northern European ancestry carry two copies.
Repeated blood transfusions or iron infusions
Each unit of blood delivers about 200–250 mg of iron with no way to excrete it; people with thalassemia, sickle cell disease or myelodysplasia who are transfused regularly accumulate iron and need chelation. Over-replacement with IV iron does the same.
Cancer
Lymphoma, leukemia, liver, kidney, lung and breast cancers raise ferritin through inflammation and tumor production. Ferritin is not a cancer screening test, but an unexplained persistent rise with weight loss, night sweats or fatigue is investigated.
Hyperthyroidism
Thyroid hormone stimulates ferritin synthesis; levels fall back with treatment. A mildly raised ferritin with a low TSH needs no separate iron workup.
Adult-onset Still's disease and hemophagocytic lymphohistiocytosis (HLH)
Extreme immune activation drives ferritin to 5,000–100,000 ng/mL alongside fever, rash, enlarged liver and spleen and low blood counts. Rare, but ferritin over 10,000 is a recognized alarm signal for them.
Ineffective red cell production
Thalassemia, sideroblastic anemia and myelodysplastic syndromes suppress hepcidin and raise iron absorption even without transfusion, producing high ferritin with anemia.

Symptoms that can go with it

Often none; most raised ferritins are found incidentally
Fatigue and weakness
Joint pain, classically the knuckles of the index and middle fingers (hemochromatosis)
Right upper abdominal pain or an enlarged liver
Bronze or grey skin tint
Loss of libido, erectile dysfunction or irregular periods
New diabetes or worsening blood sugar
Irregular heartbeat or shortness of breath (iron in the heart)
Fever, rash and swollen glands (Still's disease, HLH)

Low ferritin

A low ferritin means your iron stores are depleted. It is the earliest sign of iron deficiency and appears before hemoglobin falls: in the first stage, ferritin drops but the blood count is normal (iron deficiency without anemia); as stores run out, red cells become smaller and paler and hemoglobin falls (iron deficiency anemia). Fatigue, hair shedding, restless legs and poor exercise tolerance can occur in the first stage, before anemia, which is why a ferritin under 30 ng/mL is treated even with a normal hemoglobin.

The important question is not the number but why. Iron deficiency has a cause: blood loss (periods, pregnancy and delivery, gut bleeding from ulcers, polyps, cancer, NSAIDs or inflammatory bowel disease, blood donation), poor absorption (celiac disease, H. pylori, bariatric surgery, acid-suppressing drugs) or low intake (vegetarian and vegan diets, restrictive eating, growth spurts). In men and women past menopause, gut blood loss is assumed until excluded, and most guidelines recommend stool testing or endoscopy.

Replacing iron works well once the cause is handled: ferritin rises slowly, usually over 3 to 6 months of oral iron, and hemoglobin recovers within 2 to 3 months. Taking iron without finding the cause can mask a bleeding source and delay a diagnosis.

Common causes

Heavy or frequent menstrual bleeding
Losing more than about 80 mL per period removes more iron than diet can replace. Around a quarter of menstruating women have low ferritin; fibroids, adenomyosis and bleeding disorders make it worse.
Gastrointestinal blood loss
Ulcers, gastritis, polyps, colon cancer, hemorrhoids, inflammatory bowel disease, angiodysplasia and regular NSAID or aspirin use can bleed slowly and invisibly. This is the usual explanation in men and post-menopausal women and must be looked for.
Pregnancy and breastfeeding
A pregnancy costs about 1,000 mg of iron for the baby, placenta and expanded blood volume; short gaps between pregnancies and twins deplete stores further. Routine prenatal screening and supplementation exist for this reason.
Low dietary iron
Vegetarian and vegan diets supply only non-heme iron, which is absorbed at about 2–10% compared with 15–35% for meat iron. Restrictive eating, poverty and heavy tea or coffee intake with meals add to the risk.
Poor absorption
Celiac disease (undiagnosed in many adults with iron deficiency), H. pylori infection, gastric bypass or sleeve surgery, inflammatory bowel disease and long-term proton pump inhibitors or antacids all cut iron uptake. Celiac testing is routine in unexplained iron deficiency.
Endurance exercise
Runners lose iron through foot-strike hemolysis, sweat, gut bleeding and exercise-driven hepcidin surges. Low ferritin is common in female endurance athletes and affects performance before it affects hemoglobin.
Frequent blood donation
Each whole-blood donation removes about 200–250 mg of iron. Donating more than two or three times a year without supplementation often drives ferritin under 20 ng/mL, especially in women.
Hypothyroidism
Low thyroid hormone reduces gut iron absorption and red cell production; iron deficiency is more common in untreated hypothyroidism and the two should be corrected together.
Rare: inherited iron-refractory iron deficiency anemia
A TMPRSS6 mutation keeps hepcidin high so oral iron is barely absorbed. Suspected when iron deficiency from childhood fails to respond to tablets.

Symptoms that can go with it

Fatigue and low stamina, often before anemia develops
Hair shedding or thinning
Restless legs, especially at night
Brittle, spoon-shaped or ridged nails
Craving ice, clay or starch (pica)
Shortness of breath on exertion
Pale skin, headaches, dizziness
Sore tongue, cracks at the corners of the mouth, difficulty swallowing
Poor concentration and low mood
Feeling cold

Read it alongside

Transferrin saturation (TSAT) — over 45% with high ferritin suggests iron overload; under 20% with low or normal ferritin suggests iron deficiency, including deficiency hidden by inflammation.
Hemoglobin and hematocrit — tell whether iron deficiency has progressed to anemia, or whether high ferritin comes with anemia (thalassemia, myelodysplasia).
MCV and MCH — small, pale red cells confirm iron-deficient red cell production.
CRP — a raised CRP explains a high ferritin as reactive and means a 'normal' ferritin up to 70–100 ng/mL may still hide deficiency.
ALT, AST and GGT — abnormal liver enzymes with high ferritin point to fatty liver, alcohol or hepatitis rather than iron overload.
Serum iron and TIBC — the raw numbers behind transferrin saturation; low iron with high TIBC is the classic iron-deficiency pattern.
Celiac antibodies (tTG-IgA) — routinely checked in unexplained iron deficiency.
HFE gene test — ordered when ferritin is high with transferrin saturation over 45% to confirm hereditary hemochromatosis.

What usually happens next

Low ferritin: expect a full blood count, celiac screen, and in men, post-menopausal women, or anyone with gut symptoms, stool testing for blood and often a colonoscopy and gastroscopy. Iron replacement is usually started at the same time, not after.
High ferritin: expect transferrin saturation, CRP, liver enzymes and a review of alcohol, weight and recent illness; if saturation is over 45%, an HFE gene test; if ferritin is over 1,000 ng/mL, liver imaging or a scan that quantifies liver iron (MRI).
Recheck ferritin 2–3 months after a change: iron tablets, alcohol reduction, weight loss or treatment of inflammation all move it over that timescale.
Ask for your transferrin saturation and CRP alongside ferritin; the three together answer most questions that ferritin alone cannot.
If you are already taking iron, ask whether to pause it before a repeat test; it can distort the picture if deficiency has not been confirmed.

Diet, lifestyle and natural levers with evidence

What can move Ferritin once the cause is known. Nothing here replaces finding the cause.

Iron-rich foods with absorption helpers (for low ferritin)

Strong evidence

Heme iron from red meat, poultry, fish and shellfish is absorbed at 15–35%; non-heme iron from lentils, beans, tofu, pumpkin seeds and fortified cereals at 2–10%, rising two- to four-fold with vitamin C (a citrus fruit or peppers in the same meal) and falling by half or more when tea, coffee or calcium supplements are taken with the meal. Diet alone raises ferritin slowly (a few ng/mL per month) and is most useful for keeping it up once replaced.

Oral iron taken every other day (for confirmed deficiency)

Strong evidence

Randomized trials in iron-depleted women found that 60–100 mg of elemental iron taken every other day, in the morning, was absorbed about 30–50% better per dose than the same dose daily, because a daily dose raises hepcidin for 24–48 hours and blocks the next one. Ferritin typically rises by 20–50 ng/mL over 3 months; treatment continues for about 3 months after hemoglobin normalizes to refill stores.

Only after ferritin and a cause are established. Iron tablets worsen hemochromatosis, thalassemia and some anemias, cause constipation and nausea in about a third of users, and can delay the diagnosis of gut bleeding. Keep away from children; overdose is dangerous.

Lactoferrin (for low ferritin, especially in pregnancy)

Moderate evidence

Bovine lactoferrin, 200–250 mg once or twice daily, raised hemoglobin and ferritin as well as or better than ferrous sulfate in several randomized trials of pregnant women and adults with iron deficiency anemia, with fewer gut side effects; it appears to work by lowering hepcidin and improving absorption of dietary iron. Trials are modest in size and mostly from Italy and Egypt.

Not a reason to skip the search for a cause of iron loss.

Blood donation or therapeutic phlebotomy (for iron overload)

Strong evidence

Removing a unit of blood takes out 200–250 mg of iron, and ferritin falls by roughly 30 ng/mL per unit. Regular phlebotomy is the standard treatment for hereditary hemochromatosis, bringing ferritin to 50–100 ng/mL and preventing liver, joint and heart damage; once stores are normal, donating blood 2–4 times a year keeps it there. It is not appropriate for high ferritin from inflammation or fatty liver, where iron stores are normal.

Cutting alcohol and losing weight (for reactive high ferritin)

Moderate evidence

In people with fatty liver and metabolic syndrome, weight loss of 5–10% lowered ferritin by about 25–40% in intervention studies, in step with falling liver fat and ALT. Stopping alcohol in heavy drinkers often halves ferritin within 4–8 weeks. These are the first-line responses to the most common cause of a raised ferritin.

Tea with meals and limiting red meat and vitamin C with iron-rich meals (for hemochromatosis)

Moderate evidence

Tannins in black tea bind non-heme iron; in a controlled study in people with hereditary hemochromatosis, drinking black tea with meals for a year cut iron accumulation by about a third compared with water. Limiting red meat, avoiding iron-fortified foods and iron- or vitamin C-containing supplements, and avoiding raw shellfish (infection risk with iron overload) are standard advice alongside phlebotomy.

Only for people with proven iron overload; these habits can worsen deficiency in everyone else.

When to see a clinician promptly

Ferritin over 1,000 ng/mL, or any high ferritin with transferrin saturation over 45%: needs a diagnosis, not a repeat in a year.
Ferritin over 5,000–10,000 ng/mL, or a high ferritin with fever, rash, enlarged glands, jaundice or falling blood counts: urgent assessment for HLH, Still's disease or liver failure.
Low ferritin in a man or a post-menopausal woman, or with black stools, blood in stool, weight loss or abdominal pain: prompt gut investigation.
Low ferritin with chest pain, breathlessness at rest, fainting or a racing heart (likely significant anemia).
Low ferritin in pregnancy (under 30 ng/mL) or one that fails to rise after 2–3 months of iron tablets.
A family history of hemochromatosis with any ferritin above the normal range.

Frequently asked questions

What is a dangerously high ferritin level and what are the symptoms?

Over 1,000 ng/mL is the level that always needs an explanation, because in iron overload it marks the point where liver damage becomes likely; over 10,000 ng/mL suggests rare conditions such as adult Still's disease or hemophagocytic syndrome and needs urgent care. Symptoms of long-standing iron overload are fatigue, joint pain (especially the first two knuckles), abdominal pain, bronze skin, loss of libido, diabetes and heart rhythm problems. A reactive high ferritin from fatty liver or inflammation causes no iron symptoms of its own.

What level of ferritin indicates iron deficiency?

Under 15 ng/mL means stores are empty; most guidelines treat under 30 ng/mL as iron deficiency in adults, and under 45 ng/mL has the best sensitivity in people with symptoms. If CRP is raised or you have a chronic inflammatory condition, ferritin up to 70–100 ng/mL can still hide deficiency, and transferrin saturation under 20% is the clue.

Is a ferritin of 500 bad?

It is high and needs a look, but it is rarely an emergency. In most adults a ferritin of 500 ng/mL reflects fatty liver, alcohol, obesity or a recent illness rather than iron overload. The next tests are transferrin saturation, CRP and liver enzymes; if saturation is under 45% and CRP or ALT are raised, the cause is reactive and the fix is the underlying condition.

Can high ferritin be a sign of cancer?

Occasionally. Lymphoma, leukemia, liver, kidney, lung and breast cancers can raise ferritin through inflammation, but ferritin is not a cancer test and the common causes (fatty liver, alcohol, inflammation, hemochromatosis) are far more likely. A persistent unexplained rise with weight loss, night sweats, fever or new lumps is investigated.

What ferritin level is normal by age?

Ferritin rises slowly through adult life. In adolescents and young adults, anything under 30 ng/mL is low, and typical values are 20–100 in young women and 30–200 in young men. After menopause women's levels climb toward men's. Older adults often sit at 100–300 ng/mL, partly from accumulated stores and partly from low-grade inflammation. Children run lower (7–140 ng/mL).

Should I take a ferritin supplement?

There is no ferritin supplement; iron supplements raise ferritin. Take one only when a blood test shows low ferritin and the reason for the loss is being addressed. Alternate-day dosing of 60–100 mg elemental iron absorbs best; take it with vitamin C and away from tea, coffee, calcium and antacids. If your ferritin is normal, extra iron does nothing useful and can be harmful.

How long does it take to raise ferritin?

Hemoglobin responds first, within 2–4 weeks; ferritin lags because stores are refilled last. With oral iron expect a rise of roughly 20–50 ng/mL over 3 months, and continue for about 3 months after hemoglobin normalizes. IV iron can raise ferritin by several hundred ng/mL within a week or two, which is why it is used when tablets fail or are not tolerated.

Can low ferritin cause hair loss or fatigue if hemoglobin is normal?

Yes. Iron is needed by muscle, nerve and hair follicle cells, not only red cells, and symptoms such as fatigue, exercise intolerance, restless legs and diffuse hair shedding are reported at ferritin under about 30 ng/mL with a normal blood count. Trials of iron in non-anemic deficient women show improved fatigue; hair regrowth evidence is weaker but many dermatologists aim for ferritin over 40–70 ng/mL.

References

Ferritin Blood Test. MedlinePlus, National Library of Medicine (2022)View source
Iron: Fact Sheet for Health Professionals. NIH Office of Dietary Supplements (2024)View source
Koperdanova M, Cullis JO. Interpreting raised serum ferritin levels. BMJ (2015)View source
Cullis JO, Fitzsimons EJ, Griffiths WJ, Tsochatzis E, Thomas DW; British Society for Haematology. Investigation and management of a raised serum ferritin. British Journal of Haematology (2018)View source
Hemochromatosis. Mayo Clinic (2023)View source
Short MW, Domagalski JE. Iron Deficiency Anemia: Evaluation and Management. American Family Physician (2013)View source
Stoffel NU, Cercamondi CI, Brittenham G, et al.. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women. Lancet Haematology (2017)View source
Iron Deficiency Anemia. Merck Manual Professional VersionView source
WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. World Health Organization (2020)
Kaltwasser JP, Werner E, Schalk K, Hansen C, Gottschalk R, Seidl C. Clinical effects of black tea on iron absorption in hereditary hemochromatosis. Gut (1998)
Iron Overload. American Society of HematologyView source

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This page is educational and is not medical advice or a diagnosis. Lab results have to be interpreted together with your history, symptoms and other results by a clinician who knows you. Do not start or stop a supplement to change a lab value before the cause is known.