Ferritin analysis is one of the most important laboratory tests when it comes to chronic fatigue, hair loss, or low vitality. Very often, people confuse the concepts of «iron in the blood,» «hemoglobin,» and «ferritin.» To understand your body and read test forms correctly, it is worth understanding how this system works.

What is ferritin and why is it more important than regular iron?

In simple words, Ferritin is the main "depot", that is, the composition of iron in our body.

Iron in its pure form is toxic to cells. Therefore, the body has come up with a clever mechanism: it hides iron inside a special protective protein - ferritin. This protein is stored mainly in the cells of the liver, spleen and bone marrow. When the body needs iron (for example, to create new red blood cells), it takes it from this composition.

What is the difference between the analyses:

Hemoglobin — this is iron that is already "working" in the blood and carrying oxygen.
Serum iron — is the amount of iron that is currently being transported in the bloodstream. This indicator is very unstable: you ate a piece of meat or took vitamins and iron My blood pressure jumped.
Ferritin is a real reserve. It is the amount of money in your safe, while serum iron is just change in your pocket. You can have normal hemoglobin and good iron in the blood, but a completely empty "safe" (ferritin). This condition is called hidden (latent) iron deficiency.

Why do doctors prescribe this test?

A ferritin test is not only ordered when a person is already pale and losing consciousness. It should be done if the following symptoms are present:

Constant lack of energy, morning drowsiness, chronic fatigue.
Deterioration of hair condition (active hair loss, brittleness) and nails.
Dry skin, cracks in the corners of the mouth.
Shortness of breath with minimal physical exertion (for example, when climbing to the second floor).
Frequent dizziness, tinnitus, inexplicable irritability.
Desire to eat inedible things (chalk, ice, raw cereal) or sensitivity to strange smells (paint, gasoline).

Also this one The analysis is mandatory for women. with heavy menstruation, pregnant women and people who have given up animal food (vegetarians and vegans).

What does it mean if ferritin is elevated?

Many people believe that the more iron you have, the better. But this is not the case with ferritin. Its excess can be dangerous.

High ferritin levels usually indicate one of three problems:

Inflammatory process in the body. Ferritin is a so-called "acute phase protein." This means that during any inflammation, infection (for example, after a cold or Covid) or with autoimmune diseases (rheumatoid arthritis, etc.), the level of ferritin in the blood jumps sharply. Even if there is little actual iron in the body, during illness the analysis will show a high number.
Liver problems. Since the liver is the main storage site for ferritin, when its cells are damaged (hepatitis, fatty hepatosis, exposure to alcohol or toxic drugs), this protein is simply "washed out" into the blood in large quantities.
Hemochromatosis (iron overload). This is a rare genetic disease in which the body absorbs too much iron from food. This iron begins to be deposited in organs (heart, liver, pancreas) and literally destroys them from the inside. Iron overload can also occur due to uncontrolled or prolonged use of iron-containing drugs.

What does it mean if ferritin is low?

Reduced ferritin is an unambiguous marker iron deficiency. The body has already used up all its reserves from the "warehouse" and is starting to starve.

The main causes of low ferritin are:

Chronic blood loss. The body loses iron along with blood. In women, this is most often due to heavy or prolonged menstruation, fibroids. In men and older women, it is due to hidden bleeding in the gastrointestinal tract (ulcers, erosions, hemorrhoids, polyps).
Digestion problems in the intestines. You can eat a lot of meat, but the iron simply isn't absorbed. This happens with low stomach acidity, gastritis, celiac disease (gluten intolerance), or inflammatory processes in the intestines.
Unbalanced diet. Absence of red meat, liver, offal in the diet. Iron from plant foods (spinach, apples, buckwheat) is absorbed many times worse than heme iron from animal sources.
Increased need. The period of active growth in adolescents, as well as pregnancy and breastfeeding, when a woman gives her own resources to the child.

How to properly prepare for the analysis so as not to spoil the result

Laboratory studies of iron metabolism are very capricious. To ensure that the numbers on the form reflect the real picture, follow these simple rules:

Donate blood in the morning and on an empty stomach. There should be 8–12 hours between the last meal and blood sampling. You can only drink plain clean water. Coffee, tea, or juice in the morning are completely excluded.
Stop taking iron supplements. If you are already taking iron capsules, drops, or vitamin complexes, you should stop taking them at least 5–7 days before the test (unless your doctor has given you other instructions to monitor your treatment). Otherwise, the test will show a distorted result.
Do not take the test if you have a cold. If you have a fever, runny nose, an exacerbation of a chronic disease, or you have recently been sick, postpone the test for 2 weeks. Due to inflammation, ferritin will be falsely elevated.
Alcohol and sports. The day before the analysis, you should not drink alcohol and it is advisable to avoid heavy training in the gym, as this affects the biochemical parameters of the blood.

An important note about the "norm": Laboratory forms often list reference values from 10 to 120 ng/ml. However, modern progressive doctors believe that for good health, women's ferritin levels should be at least no lower than their ideal weight (at least 40-50 ng/ml higher). A number of 10 or 15 is already a deep deficiency, even if the laboratory has not highlighted it in red.
However, you should not self-medicate with iron — excess iron is more difficult to remove from the body than to cure deficiency. Show the results to your therapist or hematologist.