Testing blood

What does it mean when serum iron is high but ferritin is low?

This question comes up all the time. Patients are baffled when their serum iron levels come back elevated and their ferritin levels come back low even though they have all of the symptoms of iron depletion.

What’s going on?

Often doctors or even patients who see this think ‘oh no we better stop taking iron support’ or ‘iron isn’t the issue’ because they see the high serum iron.

However, usually, this is a misunderstanding of what serum iron is testing and what elevated levels mean versus what low ferritin levels mean.

Out of the gate, it is paramount that we test the same way consistently in order to get consistent results.

How to test for iron

Optimally you want to complete the blood draw in the morning in a fasted state. Patients should also not take any iron supplement within 12 hours of a blood draw.

In a non-fasting state you can get significant swings in transferrin levels especially in iron deficient patients. 

Serum iron concentration is also a poor measure of iron status in the body as levels fluctuate significantly due to diurnal variation and fasting status. Even when both morning and fasting blood draws are completed, accuracy is still hampered by the fact that iron is an acute phase reactant and could be falsely low in the case of acute inflammation. 

Specific tests to order: CBC, Ferritin, TIBC, Iron (Transferrin) Saturation and Serum Iron levels checked at the same time. 

What does your iron test mean

If you have high serum iron levels and low ferritin, you may want to check for underlying infections, oral contraceptive use, thyroid disorders and consider testing based on history for heavy metals (especially lead). 

The use of cast iron skillets can be another reason for elevated levels of serum iron, especially if used in the hours before a blood draw.  The initial dosing of iron supplementation can also cause serum iron to rise to the top end of normal or even over while ferritin is slower to reach normal levels. 

As iron deficiency is improved ferritin will rise and serum iron will normalize. 

When ferritin levels drop below 25, the liver will often compensate by synthesizing more transferrin which leads to a pooling of iron in the blood and increased serum iron levels in the face of iron deficiency. This occurs when there’s an iron deficiency or in patients with high estrogen levels such as in pregnancy or with oral contraceptive use.

Ferritin levels of less than 75 can have effects like fatigue and an increased risk of miscarriage.  This is why it is paramount we test patients and ensure they have optimal iron levels and not just a ferritin within the normal range. If you’re a woman who has had a difficult time raising her ferritin levels, check out this post for considerations and tips to achieve healthy iron levels.

Have you had low ferritin levels and tried supplementing with iron? I’d love to hear about your experience in the comments below.

225 thoughts on “What does it mean when serum iron is high but ferritin is low?

  1. Sandra Feldberg

    my Ferritin was 3.3 and my Iron was 15 started taking iron and three weeks later Ferritin is 10.1 and Iron is 45 two weeks later Ferritin is 9.2 and Iron is 190. Going to specialist on Feb 9.

    Reply
    1. rose

      Be sure to get your iron saturation checked and when getting labs done make sure they are fasting and in the morning.

      High iron essentially means high transferrin, so your body because of very low iron previously is shuttling iron around as fast as it can to make up for lost time. This will keep the ferritin low while iron (transferrin) is rising. Check out http://www.optimizeiron.com for more details.

      Reply
    2. Angela

      Hello,
      Just received ny results and have been dealing with exhaustion, joint pain, hair loss, heart palpitations, brain fog. I am deficient in vitamin D and take prescription strength for that deficiency. Please help me interrupt my iron labs.
      Iron = 51ug/dl
      Transferrin = 247mg/dl
      Ferrtin = 345 ng/ml
      TIBC = 346 ug/dl
      Iron Saturation = 15%
      Not sure if I need added labs…. Thank you.

      Reply
      1. Dr. Matt

        It looks like your body is inflamed given your ferritin being high and iron sat being low. Definitely want to look into inflammatory lab tests.

        Reply
        1. Isaac

          Hi dr Matt, I feel a little bit disoriented and little loss of short term memory. Have difficult to concentrate. Also my back hurts in the place of kidneys.
          I decided to test my blood, all values are ok except:
          hematocrit 50% (35.4%-49.4%)
          Serum Iron 214micrograms/dL (60-150)
          Transferrin saturation 71.17% (20-50)
          Ferritin 50.20 ng/ml (23.9 – 336.2)
          Total bilirubin 1.61 mg/dL. (0.22 – 1.04)
          Direct bilirubin 0.53mg/dL (0.12 – 0.42)
          Indirect bilirubin 1.08 mg/dL (0.09 – 0.65)
          Is the second time that this values of serum Iron and transferrin appear in a year. The first time that appeared took around 2 months to drop down and that values returned to normal but there are again now.
          It could be a type of secondary hemochromatosis or what do you think it’s happening there?
          My doctor suggested me to lower iron intake.
          I have a strange sensation of fatigue and lack of mental concentration.
          I will really appreciate your help.

          Reply
          1. Erica PA

            I’m a PA. It doesn’t really look like an iron issue to me. I would recommend abdominal ultrasound to assess gallbladder/liver disease. After addressing that retest iron panel.

          2. Dr. Matt

            Check for blood clots, liver function tests, imaging of liver/GB. Really looks like your liver is at issue.

            Labs: GGT, AST, ALT, LDH

            Let us know how it goes.

          3. John

            Hi Isaac, your bilirubin is high. If other liver markers are ok you may have Gilbert’s Syndrome. Worth checking perhaps?

        2. Seanie

          Serum Iron 11.3
          Transferrin 3.15
          Transferrin Sat. 14.3
          MCH 32.6
          Alk. Phosphatase 44

          Symptoms of dizziness faintness low energy and extremely fatigue chest pain SOB sore glassy eyes headaches heart palpitations happens to me once a month

          Reply
      2. Brian

        Taking the supplement ip6 is a very very effective iron chelating and anti-cancer supplement. That means it removes excess iron from the body. It works with several mechanisms to increase the production of natural killer cells that supports our bodies natural anti-cancer fighting ability. It also reduces oxidative stress in the body by removing excess iron from the body. It has a variety of life extending mechanisms that it triggers or enhances in the body. Men in the United States quite frequently build up toxic levels of iron over a Lifetime by about the age of 40 to 50 to the point where iron levels become so high in the body that they are triggering Cascades of excessive oxidation on various mechanisms. High levels of iron can certainly increase the chances of cancer development through its assault of oxidation on the body, and iron is needed by cancer cells to multiply. Having the right amount around is good but too much begins to work against your long-term health. We don’t have a biological way to remove iron from our body except through the ip6 that we get a tiny amounts in some fibers in a few commercially available foods. Other things that reduce iron is menstruation, or an injury where you bleed, and or giving blood several times to reduce your high iron levels. So many Americans have toxically high iron levels due to so many processed food products fortified with iron as well as from a diet with high red meat for an extended time in the past or present

        Reply
    3. Anna

      Hello! I had a blood test taken due to a number of intense symptoms, and have found that while before I thought I might be anemic the opposite might be the case, but I’m not sure.
      % Saturation: 67
      Ferritin: 38
      Iron binding capacity: 281
      Iron total: 187
      Transferrin: 206

      Reply
  2. JMO

    Can you please help me understand by Iron test results? I actually thought I may be Anemic, but it looks like the total opposite here? I’m so confused after just receiving my results.

    Total iron high (235), % Saturation high (73) but IBC normal, Ferretin normal, RBC Iron normal.

    I did not fast prior to my test and I took an iron supplement 2 days prior, for the first time. Could the supplement be responsible for the super high numbers here? I have stopped it since seeing these numbers. Thank you!

    Reply
    1. Dr. Matt

      Yes, your labs would suggest sufficient iron levels and iron stores. Curious what your ferritin level was?

      Reply
      1. Jordan

        Hey Dr Matt,

        Just wondering what you would make of these tests. Feel tired, brain fog, low energy. My tests came back as normal ferritin and high transferrin saturation. I am a 35 yr old male. Results are below. Thanks!

        Iron Plasma: 27 umol/L (7-29)
        TIBC: 49 umol/L (45-77)
        Transferrin Saturation: 0.55 (.20-.50)
        Ferritin: 181 ug/L (24-453)

        Reply
        1. Catharine

          Hi! Could you help me to understand if I have anemia, please?
          I’ve been taking iron supplements since February/22 because my iron was 40 and ferritin 66. I rechecked in May, and iron went up to 89 but ferritin dropped to 55. I don’t think supplementing with iron is really helping, because ferritin keep dropping. I did test again in August with the following results:

          RBC: 3.77 L
          Hemoglobin: 11.6L
          Hematocrit: 34.6L
          Total Iron: 158
          Iron Binding Capacity: 398
          Saturation: 40%
          Ferritin: 34
          B12: 910

          Reply
    2. jen

      My iron is and saturation are also very HIGH. What did you find out?
      I also thought maybe i was anemic before testing.

      Reply
    3. Mike

      Good afternoon. Just got back my labs and hoping to better understand the results. I currently take 325 Iron FE in morning and then another pill in evening as my doctor thought I was low on Iron several months ago. After on this regime for 3 months and fasting, below were my results. I’m wondering if I should go back to only 1 pill/day.
      Ferritin: 54
      TIBC: 339
      Iron: 203
      Saturation: 60%

      Reply
  3. Marla

    Have diagnoses of multiple myeloma (2-1/2 yrs. treatment, not having achieved remission) and Hashimoto’s thyroiditis (diagnosed 4 yrs. ago; stable though thyroid peroxidase antibody remains nearly 600 with serum iodine 70; T4 0.9; TSH 2.60; on 225 micrograms of iodine twice weekly); recently found to have ferritin of 8, total iron 73; TBIC 445, T-SAT 16). Oral iron supplements raised total iron and TBIC, but with little effect on ferritin. Now oncologist wants to initiate IV iron infusions… ??!! Is this simple iron deficiency anemia or something more complex due to multiple myeloma and/or Hashimoto’s?

    Reply
    1. Dr. Matt

      Unlikely to be more complex as far as your ferritin goes. I would ask your oncologist if you can try Blood Vitality 2 capsules per day and see if that doesn’t change your ferritin. If you have had treatment for MM it can effect digestion capacity so having an extremely absorbable iron is crucial. Also make sure are taking vitamin D to support iron metabolism. I am also hesitant with the iron infusions since they putting a bolus of iron directly into your blood with no carrier, which increases oxidation something you are trying to avoid with MM and Hashimoto’s. Would love to hear how it goes,

      Reply
  4. Alex

    Hi, I would greatly appreciate your opinion on my iron levels. Not sure if this is good or not? My blood test when fasted was:

    Iron 27umol/L
    Transferrin 2.67g/L
    Transferrin Saturation 41%
    Ferritin 52ug/L

    Should I take Ferritin, or lactoferrin supplements? Or am I all good? The reason why I ask is because my genetic report said that my genotype for ITLN1 expression was reduced and it recommended lactoferrin to help combat pathogens and reduce inflammation.

    Thanks in advance,
    Alex.

    Reply
    1. Dr. Matt

      Hi Alex,

      Your labs would suggest you have sufficient iron. A ferritin of 70-100 often is most desired for people living very active lifestyles so depending on your activity level you may want to add 15mg of elemental iron (Blood Vitality is my preference). Lactoferrin is great for immunity and for use in times of infection but will unlikely bring your ferritin up.

      Let us know how it goes.

      Reply
  5. Peter

    I have hemochromatosis diagnosed Nov 2019 with Ferritin of 479.
    My current numbers below.
    Looking back through my history since treatment Ferritin lowers but Serum Iron won’t budge. It has risen from within range to now 198.
    My Doctor wasn’t able to give me an answer on this.
    I took a vegan diet last year for 4 months and the doc gave me phlebotomy with ferritin of 33.
    Combined it looks like that has caused the rise according to what you’ve written.
    I am a bit worried as I feel more symptoms since it’s become higher and don’t see how it will ever lower.
    Doctors are only interested in Ferritin level. Is high serum Iron not problematic at all?

    Ferritin: 18.7
    Serum Iron: 198
    TIBC: 266
    TSAT%: 74

    Reply
    1. Dr. Matt

      As long as you are not getting iron deposits in organ tissue you don’t necessarily need to keep giving blood. Not all hereditary hemochromatosis is the organ damaging type.

      Reply
    2. Elizabeth Rogers

      Can you help me to understand this? I have severe fatigue and body pain. My serum iron came back high — 217 and iron saturation also high at 65 percent. My uibc was low — 119; but ferritin (33) and tibc (336) are normal. Should I try supplementing?

      Reply
        1. Wendy

          I too experience nonstop fatigue & body pain. I’ve ruled out most other root causes & nothing has helped. I too have high iron, low ferritin, and high Transferrin Saturation %. Hmm…after reading your comments, I wonder if iron imbalance is the elusive culprit behind me feeling like I’m triple my age?

          Reply
  6. kiki

    Hello. Can you please help me understand my lab results? My ferritin has been consistently on the low end for the past few years. I carry the gene for Hemochromatosis but it doesn’t seem to be an issue at this point. Would you recommend taking Ferritin or would that raise my already high Iron totals/sat? I’ve tried to research what these levels mean but can’t really find an answer. Many thanks in advance!

    Iron total: 215
    % Sat: 57
    TIBC: 374
    Ferritin: 21

    Reply
    1. Dr. Matt

      Many people the hereditary hemochromatosis gene profile do not manifest it. If you don’t have any symptoms of iron deficiency then you might want to look into something like lactoferrin. You situation can also be that the body has a higher iron and so is mobilizing a lot of iron which keeps iron total and sat up even though iron stores are low. This would mean you actually do need more iron. Correlation with symptoms and blood results over time is crucial in your situation.

      Reply
      1. Kiki

        Thank you so much for your response. This was the first time that my Iron and Sat were high. I had been cooking in cast iron quite a bit prior to the test, so maybe that could have skewed it.

        Reply
      2. Jamie

        Suffered PEs and DVTs as result of the vid. Put on Eloquis and follow up blood work found High Cardiolipin IgM antibodies 3 months after illness. Hematologist thinks it is also result of the vid but wants to keep me on blood thinner a year to be safe and if repeat still shows antibodies, then for life. She put me on iron as result of low hemoglobin and hematocrit (been low for years). They are back in range, but now iron is through the roof. Still waiting on repeat Cardiolipin results. Don’t feel comfortable continuing the iron at this point. Thoughts?

        Serum Iron high 246
        TIBC high 389
        Transferrin Saturation high 63%
        Ferritin in range 28.3 ng/ml
        WBC high 12.93
        Hemoglobin in range 12.6
        Hematocrit in range 39.5

        Reply
        1. rose

          Low iron can increase susceptibility to all manner of body dysfunction. Taking physiological doses of iron should only serve to help your body heal. This another reason I am big on using Blood Vitality with patients, to not only get the iron in a whole food like manner but also having the supportive minerals and vitamins for optimal red blood cell metabolism.

          Reply
  7. Melissa Lipka

    Hi! This is the first post I have fund regarding high iron and low ferritin. I’m so delighted as I was at a loss of what to do. I have hypothyroidism and I’m struggling getting my free T3 up. I’m wondering if I need to supplement iron. Can you give me any advice? I was worried because my total iron was high but now I’m thinking I DO need iron.
    % Saturation : 44 (16-45)
    Ferritin: 30 (16-232)
    Iron Binding CA: 441 (250-450)
    Iron, Total: 196 (40-190)
    Thank you so much!!!!

    Reply
    1. Dr. Matt

      Consider D3/K2, riboflavin, lipothiamine, magnesium, Active form B12/folate.

      Get zinc and copper checked.

      All effect iron metabolism and utilization.

      MCV is high could be low B’s, thyroid, mouth breathing.

      Symptoms?

      Antidepressants? Birth control?

      Reply
  8. Sarah BC

    Hi! Thanks for your post. It is so hard to find anything about this combination of results. I’d love to hear your thoughts on mine as I have heard fears of iron overload to suspicion of anemia from different doctors, but no recommendations to do anything. I’ve had high serum iron and percent saturation with low-normal ferritin for several years that I know of, but no tests for these prior to 2018 to know what was going on prior.
    Serum iron has ranged from 186mcg/cl (192 mcg/dl most recent) to 218mcg/dl,
    TIBC range has been from 292mcg/dl (336 mcg/dl most recent) to 430 mcg/dl,
    % saturation from 52% to 74% (57% most recent),
    ferritin from 28 ng/ml (most recent) to 52 ng/ml.
    HGB has ranged from 14 to 15.2 and HCT from 42 to 44.1, both above range, and high MCV from 93.1 to 94.

    Any thoughts/advice you might have is much appreciated!

    Reply
    1. Dr. Matt

      Consider D3/K2, riboflavin, lipothiamine, magnesium, Active form B12/folate.

      Get zinc and copper checked.

      All effect iron metabolism and utilization.

      MCV is high could be low B’s, thyroid, mouth breathing. Consider mouth taping.

      Symptoms?

      Antidepressants? Birth control?

      Reply
  9. Anisha P

    Hello, I just came across your article. Long story short my hair has been thinning and falling out, the thickness of my hair has halved (which is stressful). After doing a little research I decided to get blood work done. My iron levels and vitamin D seem high, but ferritin is really low. My doctors response to all my lab work was “all labs look normal. Iron is a little elevated but there are some natural fluctuations. For Iron you can purchase SlowFe over the counter. For vitamin D and calcium I suggest 400-800 IU/day. To maximize calcium absorption, calcium should be taken in divided doses of 500mg or less at one time.” I understand Ferritin needs to be over 100 for hair health (mine is at 17), vitamin D optimal range is 70-80 ng/mL (mine is at 34), but my iron is high.

    Here are my lab results:
    – Iron levels: 197 ug/dL, iron binding 352 ug/dL, Iron % saturation 56
    – Ferritin: 17 ng/mL
    – Thyroid (TSH) w/ reflex free T4: 2.0 uIU/mL
    – Vitamin D: 34 ng/mL
    – Vitamin B12: 704 pg/mL
    – Folic Acid: 30.7 ng/mL

    In terms of vitamins I take this everyday:
    – zinc 50mg, vitamin D 25 mcg, b-12 1000 mcg, two multi vitamins, omega 3 690 mg, biotin 10000 mcg
    (I am also on birth control Blisovi Fe 1mg/0.02 mg)

    I don’t know what to do or why my ferretin is low and iron is high, and am confused by the advice of my doctor. I’d really really appreciate any help or tips you have. Thanks so much!

    Reply
    1. Dr. Matt

      That is a lot of zinc to take on a regular basis. May want to decrease.

      I would used D3/K2 instead of D3 by itself. Ideally get D levels over 50.

      Iron is likely high with ferritin low because of OCP use. Given thinning hair and Ferritin is likely you are iron deficient.

      Blood Vitality is my favorite way to get iron levels up efficiently without all the inflammatory side effects of standard iron.

      http://Www.optimizeiron.com

      Reply
      1. Anisha P

        Thanks for your response! You said “Iron is likely high with ferritin low because of OCP use.” What is OCP use?

        Given my iron levels are high and low ferritin, is it okay to take iron supplements?

        I took a look at the blood vitality supplement facts and I’m getting all those in the multi vitamin I take, but the multivitamin has higher levels of each.

        Reply
        1. rose

          OCP = oral contraceptive (birth control)

          This is a common iron panel when a woman is on birth control.

          You can’t no for sure without stopping birth control where the numbers are at but yes you are likely low in iron.

          The main thing about iron supplementation is minimizing side effects and maximizing utilization. Neither are possible with a standard multivitamin.

          Reply
    2. Sara

      I was on the same birth control with similar numbers to you. Can’t help with the iron, but get the biopsy for scarring hair loss at the dermatologist… I had the gene that was sensitive to androgens in the birth control and that is what was causing the hair loss (which you don’t want!!). Every doctor told me I was crazy and that it was stress from caring for a sick parent since was probably 25-27 at the time and looked young and healthy. Best of luck babes!

      Reply
  10. Laura

    Your article is the first resource that has given me ANY insight into what I am dealing with, so thank you for that! But I still unsure how to move forward.

    Lab results:
    Iron: 258 UG/DL
    Ferritin: 13.9 NG/ML
    Vitamin D: 26.4 NG/ML
    Folate: 23.6 NG/ML
    B-12: 409 PG/ML

    To give some background, I have been experiencing intense hair loss (diffused but especially on top of scalp), dizziness, fatigue, brittle nails, irritability, easy bruising (all symptoms of ferritin deficiency!). All my thyroid labs were normal. However, I realize the other day, that my ferritin was extremely low (as is vitamin D, but the doctor has me on a supplement for that), even though it is in the “normal” range, but my iron was extremely high. My doctor informed me my labs are normal, and I should not supplement iron—to avoid toxicity.

    At the point, I feel I know the issue is ferritin (along with other deficiencies like vitamin D), but I do not know how to raise it without taking iron supplements.

    There is very few resources discussing low ferritin but high iron.

    What would you suggest I do to raise my ferritin levels? I am desperate, and doctors have literally been no help to me.

    Reply
    1. Laura

      And to give a little more insight, I am currently breastfeeding.

      Back in the 2009-2011 time frame (I cannot remember specifically), I tried to donate blood but they could not accept it because my levels indicated I was anemic.

      Additionally, this last week I was on my menstrual cycle (which returned 3 mont postpartum while exclusively breastfeeding), & all my symptoms became exponentially worse; which to me is further indication I have an iron deficiency.

      But all my doctors want to focus on is that my iron is extremely high, despite the fact that I have most of the symptoms of ferritin/iron deficiency. So frustrating.

      Reply
    2. Laura

      Your article is the first resource that has given me ANY insight into what I am dealing with, so thank you for that! But I still unsure how to move forward.

      Lab results:
      Iron: 258 UG/DL
      Ferritin: 13.9 NG/ML
      Vitamin D: 26.4 NG/ML
      Folate: 23.6 NG/ML
      B-12: 409 PG/ML

      To give some background, I have been experiencing intense hair loss (diffused but especially on top of scalp), dizziness, fatigue, brittle nails, irritability, easy bruising, heart palpitations, feeling cold (all symptoms of ferritin deficiency!). All my thyroid labs were normal. However, I realize the other day, that my ferritin was extremely low (as is vitamin D, but the doctor has me on a supplement for that), even though it is in the “normal” range, but my iron was extremely high. My doctor informed me my labs are normal, and I should not supplement iron—to avoid toxicity.

      At the point, I feel I know the issue is ferritin (along with other deficiencies like vitamin D), but I do not know how to raise it without taking iron supplements.

      There is very few resources discussing low ferritin but high iron.

      What would you suggest I do to raise my ferritin levels? I am desperate, and doctors have literally been no help to me.

      To give a little more insight, I am currently breastfeeding.

      Back in the 2009-2011 time frame (I cannot remember specifically), I tried to donate blood but they would not accept it because my bloodwork indicated I was anemic.

      Additionally, this last week I was on my menstrual cycle, & all my symptoms became exponentially worse; which to me is further indication I have an iron deficiency.

      Reply
      1. Dr. Matt

        I would also check your TIBC and transferrin/iron saturation. It does sounnd like you have insufficient iron stores which could be why there is so much in circulation.

        You can test all your levels and then recheck after taking a highly absorbable not digestion inflaming iron like Blood Vitality.

        https://drwholeness.myshopify.com/collections/nutritional-supplements/products/blood-vitality-1

        Definitely want to get your D levels up into 50-70 range. https://drwholeness.myshopify.com/collections/nutritional-supplements/products/vitamin-d3-k2-liquid

        Alps consider taking vitamin A 5000-10000IU for a while to make sure you are sufficient as vitamin A is very important just like vitamin D for iron utilization.

        Also birth control is an issue and will mess up lab results.

        Reply
  11. Elle

    Hi Dr. Matt!
    I am so thankful I found your website and post on this topic. I have been dealing with fatigue, hair thinning, hair loss, severe anxiety, dizziness, feeling unwell, and possible perimenopausal symptoms.
    Over the last month I had several things checked and of course my doctor says it all looks “normal” so no worries. Well I still don’t feel optimal so there must be something I am lacking. Can you offer me some insight?
    The only prescription medication I take is 25 mg Metoprolol for pvcs/pacs
    Folate – 11.5
    Vitamin B12 – 698
    Iron Bind TIBC – 325
    UIBC – 175
    Iron – 150
    Iron Saturation 46
    Ferritin – 41
    Transferrin – 276
    Vitamin D – 33
    TSH – 0.62
    Free Thyroxine (Ft4) – 1
    Sodium 138 mmol/L
    Potassium 4.8 mmol/L
    Chloride 104 mmol/L
    Carbon Dioxide (CO2) 26 mmol/L
    Anion Gap 8
    Glucose 89 mg/dL
    Blood Urea Nitrogen (BUN) 10 mg/dL
    Creatinine 0.77 mg/dL
    GFR Non African American 98 mL
    Calcium 9.5 mg/dL
    Protein Total 6.8 g/dL
    Albumin 4.2 g/dL
    Globulin 2.6 g/dL
    Albumin/Globulin Ratio 1.6
    Alkaline Phosphatase 58 U/L
    Aspartate Aminotransferase (AST) 17 U/L
    Alanine Aminotransferase (ALT) 16 U/L
    Bilirubin Total 2.0 mg/dL

    Reply
    1. Dr. Matt

      Might want to check progesterone, estradiol, estrone, free T3, testosterone.

      Given your overall iron picture it sounds like hormonal imbalance unless your iron has been low and has recently come up to its current level.

      Reply
  12. Marcella

    Thank you so much for taking the time to answer our questions!
    I have type 2 diabetes which I control with eating, currently my A1c is 5.3. Because my cholesterol started to climb (all that meat in lieu of carbs, I suppose) and reached 200, I backed down on meat, but my ferritin took a dive within two months. My saturation thee months ago was high (400 something), along with transferrin, but TIBC was normal, and my ferritin was 22. Now, two months later:

    Saturation: 23 (normal)
    Ferritin: 8 (very low)
    Binding Cap: 370 (normal)
    Iron Total: 87 (normal)
    Transferrin: 311 (normal/high-ish)

    After the blood draw, I came out with barely feeling my legs and arms and a bit dizzy, and two days later my arms and legs are still a bit funny (tingling/filled sensation). Shall I take iron tablets? When I did 60mg yesterday, I almost felt worse, but I’m really worried about my low ferritin, which after ten vials of blood draw is probably even lower. Blood count/RBW and platelets were normal. I have tingling in my hands often, which is why I went to get lab work done to begin with, but not as bad as now. I know it could be related to my diabetes in theory, but then my sugar level is really under control: I never go over 140 and my fasting sugar is in the low 90s. And, that heavy feeling in my arms and legs only started with the blood draw (not stiff, painful or weak, rather as if I have worked out too hard). Again, thank you for the advice.

    Reply
    1. Dr. Matt

      Definitely sounds like you need some iron. I would check out Blood Vitality so much of iron absorption and utilization is Locke up the lack of synergistic nutrients. http://Www.optimizeiron.com

      Your A1c suggests your diabetes is well controlled so it would be unlikely blood sugar is causing your symptom.

      Reply
      1. Marcella

        I received Blood Vitality and started taking it, thank you! Only I’m not sure if I should take on or two pills, given that while my ferritin is very low (it was 8 even before the 10 vials of blood draw, I think it is worse now), yet my serum iron levels are not particularly low. I’m worried about “overdosing” on iron because I know excessive iron is not healthy. I also found that other iron supplements (not Blood Vitality, which I’ve just started), give me acid reflux, even night sweats (or perhaps it’s the acid reflux that give me night sweats). Please advise on dosage and whether I should take Blood Vitality in the morning or at night, with food or without food – thank you.

        Reply
        1. Dr. Matt

          2 capsules per day taken together is my general recommendation.

          Also, it is most preferable to consume away from food.

          If your ferritin was 8 then you are nowhere close to iron overload.

          It is good to recheck your ferritin in 4-6 weeks to make sure dose is sufficient bringing your levels up.

          Keep us posted.

          Reply
    2. Sue

      Check your B12 blood level. Tingling, pins and needles, numbness were among my many B12 deficiency symptoms. Most people feel there best with their B12 blood level at 800. Mine was 220 when I was diagnosed. B12 injections bring your levels up quickly.

      Reply
  13. Sarah

    Hi!
    After months and months of fatigue, Inhad blood work and my iron labs were way off. I’m not anemic but have been told it seems i have a storage problem.
    Ferritin was 7
    Iron 103
    Transferrin 303
    Total binding 424

    I’ve completely changed my diet, taking iron, vitamin c and b every other day. I also suffer for very heavy periods which last a full 5 days- of bleeding. But why is my body have such a hard time?

    Reply
    1. Dr. Matt

      The heavy periods are the likely cause. You may want to see about utilizing a more efficient iron system though like Blood Vitality. This way you can take iron daily and get your ferritin levels up more efficiently. https://optimizeiron.com/

      Reply
  14. Kimberly P

    Hi Matt thank you so much for your article! I have been trying to understand my test results and symptoms for awhile now. I am 8 months postpartum and not breastfeeding anymore. During pregnancy I was mildly anemic and took supplements to help eventually my symptoms of palpations and lightnessness went away by the end of pregnancy and I stopped taking the iron at 3 months pp but now all the symptoms have came back and plus some. Muscle weakness palpations exhausted feeling always hungry and sometimes flu like symptoms. I started taking my iron supplement of 65mg 2x daily again about 3 weeks ago and hoping for some relief soon. Also got checked for diabetes etc all good there!
    Below are some of my recent labs
    Any advice?

    Ferritin 27
    Hgb 14.2
    RBC 4.9
    Hct 42.9
    UIBC 298
    Transferrin 18
    Vit B12 704

    Reply
    1. Dr. Matt

      I like to shoot for a ferritin of 50 at least, then depending on symptoms may push up to 100.

      Taking 65mg 2x per day ends up putting unnecessary stress on the body and will increase hepicidin production greatly decreasing your ability to uptake iron.

      I would consider a more efficient route of iron supplementation like Blood Vitality. http://Www.optimizeiron.com

      This way you can increase your ferritin but create excess oxidation and inflammation. Most women will do great on just 30mg of elemental iron through the Blood Vitality system.

      Let us know how it goes.

      Reply
      1. Kimberly P

        Thanks so much for your reply! I just ordered BV and can’t wait to try them out. How many pills should I take a day?

        Reply
  15. Eddy

    Hi, finally something on high iron in blood but low ferritin. There is not enough content on that topic on the internet. Thanks for that. Would really appreciate your opinion on my results and as I have high Iron but way to low ferritin

    Iron: 206 (33-193µg)
    UIBC: 154 (125-345µg)
    TIBC: 360 (250 – 450µg)
    Iron Saturaion: 57% (15-50%)
    Ferretin: 25.9 (30 – 300ng/ml)

    Phosphor, Calcium, Mangesium, Sodium, Potassium in normal Range
    Kidney: GFR 87.4 (> 90 mL/min/1.73m)
    HDL Cholesterol: 35 (40-60mg/dL)
    LDL Cholesterol: 142 (<100mg/dL

    Reply
    1. Dr. Matt

      Do you have symptoms of iron deficiency?

      Meat, vegetables, fruit and a resistance training program would go a long ways in helping your HDL level.

      Thyroid issue. Birth control?

      Reply
      1. Eddy

        Hello, thank you for the reply.

        My symptoms are: Fatique, Palpilations when walking. Hard time breathing when on the laying on the side.

        I do workout 3x per week in the gym, I have a normal BMI. I am male, so not on birth control.

        Also forgot to include hemoglobin levels which maybe not working properly in transporting oxygen?

        Maybe have to check thyroid have not checked it for a long time.

        Hgb: 17.5 (14-18 g/dL)

        Really not sure what is going on

        Reply
  16. Missy

    I just had a blood panel ran and for the first time I am being told that I have high iron and low ferritin. My doctor suggested I stop taking any iron supplements for four weeks and then have my levels rechecked. I do not take any iron supplements, and here are my results. I am also a pescatarian so fish is the only meat in my diet, and I do not take any OCP as I am menopausal.
    Ferritin – 24.8
    Iron – 170
    Folate – 16.70
    Vitamin D – 65.6
    B12 – 619
    I am being treated for hypothyroidism and my doctor just adjusted my medication dosage as my levels came back as
    TSH – 0.02
    Free T4 – 1.43
    Free T3 – 5.47

    Reply
  17. Josh P

    Hi,

    Please could you let me know your thoughts on my labs?

    Ferritin – 10 ug/L
    Iron – 17.7 umol/L
    Transferrin – 2.7 g/L
    Total binding – 68 umo/L
    B12 – 358 ng/L (Hydroxocobalamin 1mg/1ml every 12 weeks)
    Folate – 3.7 ug/L

    Many Thanks

    Reply
    1. Dr. matt angove

      These results suggest you have low iron, B12, and folate. Get those levels up and you should feel like a new human 🙂

      Check out
      Www. optimizeiron.com for help.

      Reply
  18. Josh P

    Hi Dr. Matt

    Please could you let me know your thoughts on my labs?

    Symptoms are:
    – Fatigue
    – Poor Memory
    – Unable to concentrate
    – Increased resting HR
    – Dizziness
    – Tinnitus
    – Restless Leg

    Have tried all ferritin supplements but all effect gastro so unable to tolerate.

    Ferritin – 10 ug/L
    Iron – 17.7 umol/L
    Transferrin – 2.7 g/L
    Total binding – 68 umo/L
    B12 – 358 ng/L (Hydroxocobalamin 1mg/1ml every 12 weeks)
    Folate – 3.7 ug/L

    Many Thanks

    Reply
  19. Dr. matt angove

    Have you tried Blood Vitality? It is only one I use in practice as I have not seen side effects with it and it raises levels extremely efficiently.

    Reply
    1. Nikki

      Transferrin-257
      Iron-105
      IBCU- 255
      Transferrin saturation- 360
      Ferritin -17
      Vitamin D -24
      B12-376
      Folate-14
      High ANA,Positive Anti ssb,low wbc and lymphocytes,joint pain, bad heart palpitations/ bradycardia and tachycardia, fatigue, shortnessof breath, confused at times, bruise easily, blacked out twice, and down almost 30 lbs in a month. Also I’m a 39 year old female, no birth control due to tubal ligation. Any idea what’s going on and if I should get supplements? Please any advice to feel better would be very appreciated 🙏

      Reply
  20. Jared

    Hey Dr Matt, thank you for sharing your expertise–very informative! I also posted this on one of your youtube videos… I’ve consistently checked low in ferritin the last few yrs. (hovering around 29) but having apparently normal iron levels otherwise. I’ve also been borderline hypothyroid with an elevated TSH and I’ve heard low ferritin can cause/exacerbate low thyroid. A few questions:

    1. Is ferritin truly the gold standard for the need for iron supplementation? Are there any instances/conditions where this is not the case?

    2. What do you think of bovine spleen to raise ferritin? I’ve tried iron supplements in the past (they were supposed to be the “safe” natural kind) and got weird symptoms–not gastro–but feeling spacey and depth perception/visual disturbances.

    3. I’ve read that for a man to have low ferritin is rare and internal bleeding should be ruled out. What’s your take–what would cause iron deficiency in a 34 yr old man? FYI, I do have chronic health issues, particularly lyme disease (diagnosed at 19) and pectus excavatum (rib cage compressing heart and lungs). I also struggle with persistent fungal skin infections and likely digestive as well (distended abdomen).

    Thank you for your time!

    Reply
    1. Dr. Matt

      1) in inflammed state ferritin can be high and yet a person be in significant need for iron.
      2) spleen is a reasonable source….Blood Vitality http://www.optimizeiron.com is also a very unique source for iron.

      3) chronic lyme can cause all manner of issues. Fungal infections if present suggest imbalance of flora generally, which can effect iron absorption. may want to look into getting that taken care of first, since you can readily notice it between the bloating and skin infections.

      Reply
  21. Michael

    Hi,

    I received the following blood results recently. I had done bloods a year previous, so I have points of comparison. I’m struck by the increase in my iron and transferrin saturation levels (72% seems way too high), but my ferritin is low. Could this be early-stage haemochromatosis? I’m Irish, a high-risk population, and I know my brother is a carrier with one gene, so it seems possible I could have two. Or is it more likely to be something else in my case?

    Iron: 47.2 umol/L (up from 18.4 a year previous)
    Transferrin: 2.63 g/L (down from 2.9)
    Transferrin saturation: 72% (up from 25%)
    TIBC: 66 umol/L (down from 73)
    Serum folate: 4.8 ng/mL (down from 9.9)
    Serum ferritin: 36 ng/mL (down from 46)

    Thank you.
    Michael

    Reply
    1. Dr. Matt

      Hi Michael, potentially but also could be a sign of increased iron utilization.

      This is why iron and iron saturation aren’t reliable markers of total body iron status as they can change fairly quickly with supplements, iron skillets, exercise, meals, whereas ferritin outside of acute inflammation is very consistent related to iron levels.

      I would recheck, fasting in the morning. Maybe get a hsCRP reading as well.

      Reply
  22. Kim

    I have had iron issues for some time. This last time my iron bloodwork has come back a lot different than other times. I have asked my DR to retake my iron after fasting and he says that it is not beneficial to do that. Everything I read online suggests that iron bloodwork should be done in the morning after fasting. What reasons could there be for the following results of my iron bloodwork? I have now been referred to a gastroenterologist with no explanation as to why.
    Ferritin 5
    Transferrin Sat 60%
    Total Iron 277
    Total Iron Bind – 463
    Thank you for taking the time to look at my question. It is greatly appreciated.

    Reply
    1. Matt

      Did you supplement with iron or eat high iron meal in the hours before blood draw? Looks like you are iron deficient and the body is transferring high amounts of iron to tissues in need.

      Reply
  23. Aaron

    Hello Dr, Matt
    Recently had CBC with Diff and discovered my iron levels are odd and never been like this before. 45 year old male pretty well in shape although i did suffer a broken femur which required a blood transfusion do to loss of blood. The surgery was over 6 months ago. Ever sense then Iron, Ferritin, RDW, Bilirubin have gone off the charts a bit.
    Bilirubin = 1.6
    RDW = 15.3
    Iron total = 246
    Ferritin = 22

    Should i just go donate blood to reduce the high Iron levels? Any other recommendations to correct the Bilirubin RDW factored as well? Thank you for your time

    Reply
    1. Dr. Matt

      You may want to look into Delayed Hemolytic Transfusion Reaction if these levels were all normal previously and then changed and remained post transfusion. Donating blood is unlikely to fix this.

      Reply
  24. taryn

    like the others, i was so confused to get my results. i read through the whole thread but I’m still not feeling like its clear. thryoid and CBCs all came back normal. I’m not on birth control, I don’t use a cast iron skillet and I fasted for about 16 hours before labs.

    iron profile:
    TRANSFERRIN 275
    IRON PLASMA 219 high
    TIBC 385
    PERCENT SATURATION 57 high
    FERRITIN 10 low

    other abnormal results:
    LDL 144 high
    TBIL 1.42 high
    BUN 7 low
    UA PH 8.5 high

    Reply
    1. Dr. Matt

      You need more protein in your diet to start, given your low BUN.

      And more Whole Foods, less processed sugars, fats and flours to get that LDL right.

      Reply
  25. Jessica Adams

    Hi Dr. Matt,
    My son just turned 7 and he has been off with his iron.

    Results from June 2021
    iron, total 125
    iron binding capacity 360
    % saturation 35
    ferritin 10
    Thyroid levels normal
    hemoglobin 14.6
    hematocrit 43.2

    Results from December 2021
    iron, total 178
    iron binding 391
    % saturation 46
    ferritin 9
    hemoglobin 14.3
    hematocrit 41.9

    I have not given him any otc supplements for this and he was fasting for both tests. All his other labs are normal. We do use an iron skillet maybe 2-3 times a week. Any insight would be so appreciated.

    Reply
  26. Danielle

    Hi Dr. Matt,
    I am a 44yo female and have been struggling for some time with low energy/ fatigue, cold hands/feet, brain fog, and hair loss. I have tried many different supplements and dietary shifts etc. with little improvement. I assumed it was stress and hormones. recently my acupuncturist recommended I get my Ferritin levels checked and low and behold my iron labs came back a little off. My provider suggested I may have a condition called genetic Hemochromatosis–but that doesn’t really resonate with me as I do not have anyone in my family with the disorder and my 23and me came back negative for the genes tested for this disorder. I plan to have my a redraw on my iron labs, thyroid and have a CBC done. But can you interpret my Labs? From your article I took away that I am most likely iron deficient. If this is the case can you recommend a supplement?
    Ferritin–11.8
    FE–204
    TIBC–353
    UIBC–149
    %FESAT–57.790
    TSH– .930
    FT4— .65

    Lipid Panel:
    CHOL–223
    Trig–135
    LDLC–134
    HDL–62
    LDL/HDL–2
    CMP–All normal range

    HBA1C–5.00
    INSULIN- 7.0

    Reply
  27. Danielle

    Hi Dr. Matt,
    Thank you fr this article it has been very helpful it is hard to find information on high iron and low ferritin. I have been struggling for quite some time with low energy, fatigue, low motivation mood issues, hair loss and cold hands and feet. I have tried many different avenues–supplements, dietary changes etc. I assumed it was all stress and hormone related. However, this past fall my acupuncturist recommended I have my Ferritin levels checked. Low and behold my iron labs came back a bit off. My thyroid and cholesterol are a little off as well which has not been the case historically. My provider has shared that she thinks I may have Genetic Hemochromatosis– however this does not resonate with me. I do not have anyone in my family with this disorder and my 23 and me id negative for the gene/s tested for this. I am wondering if you could help interpret my labs? I plan to have my iron labs redrawn as well as have a CBC done. My take away from your article is that I most likely am iron deficient. If this is the case would you recommend the blood vitality supplement?
    Fasting LABS:
    Ferritin–11.8
    FE–204
    TIBC–353
    UIBC–149
    FESAT%– 57.79
    TSH– .930
    FT4– .65
    CMP–All normal range
    LIPID panel
    CHOL–223
    Trig– 135
    LDLC– 134
    HDL– 62
    LDL/HDL–2
    A1C–5.00
    INSULIN–7.0
    Any insight would be greatly appreciated! Thank you!

    Reply
  28. Kristin

    Hi Dr. Matt! My recent labs are showing low-normal ferritin and high iron/% Saturation). My doctor wants to re-test in a fasting state in 2 months. In the meantime, can you please help me interpret these results?

    Iron = 176 mcg/dL
    Transferrin 254 mg/dL
    TIBC, Calc = 318 mcg/dL
    % Saturation Calc = 55%

    Ferritin was 14 while on multivitamins with iron. In the last year, Ferritin has been 12 and 22 while on iron and 8 while not on iron.

    All other blood work was normal or low-normal. RBD = low normal 3.75, Hemoglobin = low normal 12 g/dL, TSH Sensitive = .85 ulU/mL

    I’m a woman, no birth control, low use of cast iron, age 45, normal BMI. My doctor thought this might be hereditary hemochromatosis? Any other hypotheses or suggestions?

    Thanks so much!

    Reply
  29. Anna

    Hi, I recently got a blood test at an endocrinologist w some abnormal results. I’m a 20-year-old female and I have some chronic conditions such as POTS. I am a vegetarian and I exercise regularly.
    Iron 230 H 30-170 (ug/dL)
    UIBC 191 112-347 (ug/dL)
    TIBC 421 H 225-390 (mcg/dL)
    % Transferrin Saturation 54.6 H 14-50 (Percent)
    Ferritin 12.3 L 13-150 (ng/mL)
    Transferrin 350 200-360 (mg/dL)

    The ferritin is pretty low while the iron is very high. The endocrinologist also said I have slight Hashimotos:
    Thyroid Peroxidase Ab 9.2 H < 9 (IU/mL)

    This was the only abnormal thyroid result. I have been experiencing extreme fatigue for a long time as well. Any insight? A reply would be much appreciated!

    Reply
  30. Lauren

    Hello,
    I would appreciate any insight into some symptoms. Right now, I’m being monitored for potential lymphoma due to other symptoms such as drenching night sweats, enlarged lymph nodes, etc. However, I have become increasingly fatigued and found out my iron levels are 168 ug/dL and my ferritin is <5. What could be a cause for normal (somewhat high) iron levels and a very low ferritin? Could this be related to other symptoms of night sweats and persistent cold? Thank you. I brought it up to my PCP but they do not think that my low ferritin is even making me fatigued.

    Reply
  31. Alexis

    Hi Dr. Matt,
    Can you help me understand these results?
    Not on birth control, get my thyroid tested annually and it’s always been fine…
    Ferratin 25 ng/mL
    Iron 141 ug/dL
    Transferrin saturation 54%

    Reply
  32. Sarah

    Hi Dr. Matt,
    Can you help me understand these results? Am I iron deficient or is my iron too high?
    Iron binding capacity – 282mcg/dl
    Ferratin – 29ng/mL
    Iron – 210mcg/dl
    Iron saturation – 72%

    Reply
  33. Theresa

    hi Dr. Matt,
    can you please help me understand my results, i don’t know what else to do. i am a 24 year old female who has a history of kidney stones. I have severe symptoms and its beginning to get in the way of my daily life; I’m exhausted (completed fatigued all the time), I can’t stay awake for more than 4 hours at a time, i’m constantly out of breath after doing anything remotely physical, dizziness when standing, paler than I’ve been before, high blood pressure, zero tolerance to cold, ringing in ears, sharp pain in ears, constant headaches, joint pain and back pain, hair loss, mood issues, nausea.
    Ferritin – 19 ug/L
    Vitamin B12 – 231 pmol/L
    Iron – 38 umol/L
    Transferrin Sat – 54%
    Transferrin – 2.79 g/L
    TIBC – 70 umol/L

    Reply
  34. Sue

    Hi Dr. Matt,

    I am heterozygous for Hemachromatosis for the C282Y mutation. The last blood test was: SI: 105, transferrin sat 31, TIBC 343, Ferritin 34 (prior numbers in years past were 37, 27,40…and those were when I was on a multivitamin with iron and other numbers were high). I instead take a multivitamin without iron now…. But even on that the ferritin was never normal. Hemoglobin hovers around 12.7-14.1. My RBC’s hover around 4.5, WBC’s 3.4-5.3. I usually am borderline neutropenia, around 1.6-1.8 for absolute neutrophils, all else normal. My cholesterol is always high, over 200, but other numbers balance it out. Cardiologist not worried. I do have irregular heartbeat, on flecainide and metoprolol low dose. I eat healthy, but do have breast cancer, on arimidex, Vit D, (was low before) Calcium, prolia due to resultant osteopenia. I have had a hysterectomy. Had acute thyroiditis about 20y ago but that has normalized. Seeing endocrinologist soon. Thoughts? Recommendations? Much thanks!

    Reply
    1. Dr. Matt

      Vitamin K2 want to have it on board with BC as well as anytime you are taking D3 and calcium.

      Also look into thiamine theory and nutrient depletion from arimidex.

      May want to go to cardiologist and get a better understanding as to what is going on with the cardiac irregularity and if there is anyway around being on both of those meds. Given they plan on you being on those for life unless you say otherwise or ask them to think outside the box.

      https://drwholeness.myshopify.com/collections/nutritional-supplements/products/vitamin-d3-k2-liquid

      Reply
  35. Chris s

    Hi Dr Matt,
    I enjoyed your article, well written. Looking for some guidance on my labs. 49 yo male, 6 months post gastric sleeve. I am asymptomatic. I also am on Testopel for Idiopathic low T due to primary hypogonadal failure diagnosed 8 years ago. I have sleep apnea treated with Bi-pap. I have not been taking my vitamin supplement like I should, but will be starting after my lab results. Is my high serum iron due to late onset Haemochromatosis or vitamin deficiency or occasional alcohol use? My labs were fasting, and I had not taken any supplements. I infrequently use a cast iron skillet.

    2 years ago my labs were almost identical, but my tsat was 17% and my serum iron was 66. What changed in 2 years:
    1. Gastric Sleeve
    2. Consistent testoerone replacement with pellets, was non compliant with gel
    3. Compliant with bi-pap, was non compliant with c-pap.

    Serum iron: 223
    TIBC: 393
    TSAT: 57%
    Transferrin: 264
    Ferritin: 148
    B12: 323 (ref range: (211-911)
    Vit D: 21.8 (ref: 30-100)
    Folate: 11.81 ng/ml
    Hgb/hct 17.5/49.1 high due to testosterone therapy
    All other rec/wbc labs wnl
    AST/alt: 10/11
    Asp: 62
    Bilirubin total: 1.1
    Albumin 4.4
    Total protein: 7.1
    Scr:. 0.81
    BUN 18
    A1C: 5.1
    Chol: 162
    HDL: 46
    LDL: 101
    TG: 77

    Reply
  36. Allison

    Hello!
    I’ve been trying to conceive for over a year, and my acupuncturist says I need to have ferritin over 70ng and I cannot seem to get over 30ng. My iron labs are:
    Iron 171 ugh/dL
    TIBC 347 ug/dL
    Transferrin Saturation 49%

    I do have Hashimoto’s and my current thyroid lab is 1.060, I cannot seem to move the needle on the ferritin and fear that is causing implantation issues. I’ve been taking iron supplements (OptiFerin-C from Pure), two capsules a day. Any advice to increase ferritin levels?

    Reply
    1. Dr. Matt

      Might want to try Blood Vitality (www.optimizeiron.com) as it has all the cofactors and supportive minerals packaged uniquely to build ferritin. Also look at using thiamine. Are you ovulating?

      I wouldn’t say you need a ferritin over 70 to conceive or carry a pregnancy though.

      Reply
  37. Adam

    I know this is old, but I have low ferritin but high iron and saturation. Iron is at 385 sat is 97% ferritin was 25. I have hemochromatosis. I’ve never seen ferritin be low when my iron was high. It’s happened the last 2 labs I’ve had drawn. :/

    Reply
  38. Maria Elise

    Hi doctor Matt,
    Today I got to know my ferritin level is at 8 (doctor said it should be more than 15). After one year on iron supplementation, he said it has not worked and I should now go for intravenous iron. Any thoughts about it, is it really helpful or with side effects? My husband and I are trying to conceive for 1 and a half year with no result. I have also had bad morning allergies since childhood (sneezing, watery eyes, sinus pressure) which cause is unknown. Could the low ferritin and allergies be a result of chronic inflammation? If so, any advice on where to start? I am losing faith 🙁

    Reply
    1. rose

      Have you tried blood vitality?www.optimizeiron.com

      Inositol is great to support conception.

      I don’t think iron infusions are the answer. There is a reason you are having the sinus, eye thing work with a doctor to figure it out or go on your own study. Likely some environmental or food that is an issue. immunocap blood panel can help with this. Also get A, D, copper, zinc, B12, folate levels Checked.

      Reply
  39. Kim

    Hi Dr. Matt,

    I’ve been struggling with low ferritin and in and out of bouts of anemia for over four years now. My ferritin has fluctuated between 2 ng/mL and 22 ng/mL over the course of four years. A year ago my total iron was high, but with ferritin at 20 ng/mL after taking Floravital liquid iron for a year (my ferritin actually went down over the course of the year taking liquid iron almost daily). My doctor advised me to stop taking the supplement, and now my ferritin is down to 4, but I am not anemic. Could this be an absorption issue? I’ve had symptoms of anemia for the full four+ years, and doctors have not been very knowledgable about the issue.

    My most recent blood CBC and Ferritin results:
    White blood cell count 6.8 Thousand/uL
    Red blood cell count 4.45 Million/uL
    Hemoglobin 13.0 g/dL
    Hematocrit 38.8 %
    Mean corpuscular volume 87.2 fL
    Mean corpuscular hemoglobin 29.2 pg
    Mean corpuscular hemoglobin concentration 33.5 g/dL
    Red blood cell distribution width 12.9 %
    Platelet count 266.0 Thousand/uL
    Mean platelet volume 10.4 fL
    Ferritin 5.0 ng/mL

    Reply
  40. Pat Arsenault

    Hey dr Matt
    This is a long shot as I don’t usually ask on these websites I’ve been very sick over the last year I’ve had idiopathic pancreatitis ever since had gastritis acid reflux that won’t go away a few months later I was diagnosed with genetic hemochromatosis and small blood cloths in iv sites, I’ve been giving phlebotomys ands it’s worked a few times but now my iron is 47
    My saturation is 92%
    But my ferretin is at 42
    And my tibc is always low
    I’m extremely sick with chronic stomach pains burning swollen tongue I’ve been trying to treat it with Percocet 5mg but it’s not helping anymore am I able to give blood with low or normal ferretin but high iron?
    Thank you

    Reply
  41. Heather

    My 15 y/o son has low ferritin but his iron is at the top of the range. How do I get his ferritin raised without pushing his iron over the top? Thank you!

    Reply
  42. Lee

    Hi, I’m iron deficient with anemia and have been on slow release iron supplements for a while. Last blood work with new GP showed Total iron 323 mcg/dL, % Sat 90, and Ferratin 7 ng/mL. I’ve called four times to discuss my blood work and no one is calling back. It’s been 2 mo. I can see a specialist without a referral, so thinking maybe I should just go see a hematologist. Thank you.

    Reply
  43. Natalia

    I’m so happy I found your article, dr. I’ve always been anemic and recently went to high elevation area. I felt like a train went over me. So, I figured my iron was out of wack. I started taking iron supplements and had my iron test a month later.
    The nurse called me and told me to stop talking iron because my levels are nigh. The first time ever. She didn’t mention my low ferritin though.
    I was takung bcp for a month.
    Test results
    Iron total 216
    IBC 503
    Saturation 43
    Ferritin 13
    Thanks in advance!

    Reply
    1. Dr. Matt

      A TIBC of 503 definitely suggests your body is craving iron. Also, your ferritin of 13 suggests your iron stores are insufficient.
      The iron total and iron saturation can often be high if a person supplements with iron within 24 hours of a blood draw. This doesn’t mean you have excess iron, it means the body is readily putting the iron to work and you will need more.

      Reply
      1. Natalia

        I’m so happy I found your article, dr. I’ve always been anemic and recently went to high elevation area. I felt like a train went over me. So, I figured my iron was out of wack. I started taking iron supplements and had my iron test a month later.
        The nurse called me and told me to stop talking iron because my levels are nigh. The first time ever. She didn’t mention my low ferritin though.
        I was takung bcp for a month.
        Test results
        Iron total 216
        IBC 503
        Saturation 43
        Ferritin 13
        Thanks in advance!

        Reply
  44. Molly

    Hi,

    In June 2021 my ferritin was 30. I’d read from a different integrative/functional med doc that it should ideally be between 100-200 for women. I started taking iron supplements about 6 months ago and just did bloodwork last week.

    Total iron 164 (high)
    % saturation 52 (high)

    Unfortunately there was a mixup with the ferritin request and the lab never got it. Doc offered to run again but I’m overwhelmed with other health issues so skipped it for now.

    She said to STOP taking the iron supps as that likely spiked my iron readings (they’ve always been normal). I’m not so sure but have stopped for now.

    Curious to see what you make of this. I 53, perimenopausal, have thyroid nodules, and also just got low proten and low globulin results (never had those before either). I HAVE had slightly elevated bilirubin but it’s resolved. Also low in Vit D (I supp 5,000ius) and high cortisol (although better this year at 23.5 vs. 26.5 last year).

    Thank you! – Molly

    Reply
    1. Dr. Matt

      If you were supplementing with iron then your total iron and iron saturation may be high because of utilization of the iron you are consuming. If patients come back with high iron or iron saturation, I recommend they not take iron within 24 hours, sometimes 48 hours of getting the blood draw. Also, get blood draw first thing in morning, fasting and not just after exercise.
      Really need a ferritin value though.

      Reply
  45. Kathy mcccabe

    I am extremely fatigue. My blood test show low ferritin 29 ng/ml ,my iron is high 174 mcg/dL ,iron binding capacity is 391 ,%saturation /16-45%,mine is 45 .I would appreciate your input and comments

    Reply
  46. Kathy mccabe

    I am extremely fatigue. My blood test show low ferritin 29 ng/ml ,my iron is high 174 mcg/dL ,iron binding capacity is 391 ,%saturation /16-45%,mine is 45 .I would appreciate your input and comments

    Reply
  47. Carla

    Hi Dr Matt,

    First useful article on the article I have found, thank you.

    Results:
    S-Ferritin 7.3
    Iron 46.2
    Trans Ferritin 3.42

    Struggling also to understand if the course my Dr. is recommending is correct. Intravenous iron?

    Please can you help.

    Reply
  48. Victoria

    Hi Dr. Matt,

    53 year old female, athletic, vegetarian (had not been supplementing iron and was trying to get it from diet) and perimenopausal (irregular periods, thinning of hair, etc). I practice intermittent fasting and my energy levels have been good.
    Recent iron panel showed the following:
    Ferritin 17 (16-232)
    Iron Total 94 (45-160)
    Iron Binding Capacity 372 (256-450)
    % Saturation 25 (16-45)
    Sex hormones have not been tested yet. I realize that dropping/erratic estrogen levels play a role in hair thinning but with ferritin at low end of range, am I correct to assume that could be playing a part too? So a supplement like Blood Vitality will allow me to get the ferritin level up without the other numbers going too high/out of range? When do you recommend rechecking levels after being on it (3 months, 6 months, etc.,)?
    Thank you!

    Reply
  49. Ramy Aly

    Dear sir,
    My son is two years old , making routine blood test shows the following result
    CBC values : Hb 12.9 –
    HCT 38.4 –
    Red blood cell count 5.6 –
    MCV 68.6 –
    MCH 23 –
    MCHC 33.6 –
    RDW 13.4
    and normal TLC .
    The results is Normal HB , moderate microcytosis and hypochromia .

    The iron profile as follows:
    Fe 124 –
    TIBC 438 –
    Ferritin 22.6

    I am worried , could you tell me your opinion please .
    Thanks in advance

    Reply
  50. Ramy

    Dear sir,
    Thanks you for your blog. My son has 2 years old , after performing some routine blood tests we found the following results.
    CBC RESULTS:
    – Hb 12.9 g/dl
    – Hct 38.4 %
    – Red cell count 5.6
    – MCV 68.6 fl
    – MCH 23 pg
    – MCHC 33.6 g/dl
    – RDW 13.4
    – WBCs are within normal range.
    Iron profile ;
    – Iron 124 ug/dl
    – TIBC 438 ug/dl
    – Ferritin 22.6 ug/dl
    OTHER TEST RESULTS;
    – Ca total 12 mg/dl
    – Ca Ionized 5.5 mg/dl
    – Mg 2.4 mg/dl
    – 25 (OH) Vitamin D 56.6 mg/ml
    i do not know why his MCV and MCH is lower than normal limits , are this is the case for iron deficiency , but his serum iron and TIBC is high
    Please tell me your opinion ,

    Reply
    1. Ramy

      Hi Dr. Matt
      The pediatrician has reviewed the tests and he prescribed folic acid 400mcg daily for three months to improve red blood cells . He said , this case is not iron deficiency and he has enough iron and more iron could be harmful.
      What is your opinion.
      Ramy

      Reply
  51. Essie

    Hi!! This was a great read! Thank you 😊 I am hoping you can help make sense of my labs. I have seen similar results for over a year and have not been feeling well for a while.

    Iron, total – 26 mcg/dL
    Iron binding capacity – 490 mcg/dL
    % saturation – 5
    WBC – 5.4 thousand/uL
    RBC count – 5.27 million/uL
    Hemoglobin – 10.7 g/dL
    Hematocrit – 36.6%
    MCV – 69.4 fL
    MCH – 20.3 pg
    MCHC – 29.2 g/dL
    RDW – 15.6 %
    Ferritin – 2.0 ng/mL

    Reply
  52. Patricia

    Hello,

    I am getting a bit confused with recent labs and hoping you can shed some light. Iron came back slightly high but ferritin low, and slightly low MCHC.

    Iron: 155 mcg/ dl
    Ferritin: 18 ng/ ml
    MCHC: 31.4 g/ dl
    Iron Saturation: 42
    Iron Binding Capacity: 365

    Factor II, V, and VIII all came back slightly high. Everything else was within normal range. If I have iron deficiency anemia which I think I do, is the serum iron superficially elevated but I am still in need of iron? I received a round of iron infusions last year and went from a ferritin of close to 200 to 18 this year. Wondering why I’m not able to hold and store iron properly. Colonoscopy and endoscopy were normal. Thanks for your feedback.

    Habitually tired but grateful,
    Patricia

    Reply
  53. Rhonda Taylor

    Hi Dr. Matt! So grateful for this article and your willingness to help explain iron labs. 4 mos ago I had bloodwork and had a total iron of 242 which surprised the heck out of me. I don’t eat red meat, don’t take iron supplements but I was using my cast iron skillet daily. I stopped using it and just re tested. I’m 56 yrs old . Here are my results :

    TIBC. 321
    UIBC. 156
    Iron. 165
    Iron saturation. 51
    Ferritin. 14

    I did not fast for this last test. Perhaps I should do the lab again after fasting? I do have fatigue, some brain fog, muscle aches at times. Thank you so much for your help!!

    Reply
    1. kenia a Zingale

      Hi Taylor, just wondering if you wereable tofigure out your iron labs? Mine came in today.
      total iron 178
      IBC 318
      Saturation 56
      Ferritin 14
      Its similar to yours and don’t know what it all means. Would appreciate any help in understanding. Thanks Kenia

      Reply
  54. Pamela Ruiz

    Dr. Matt,

    I would like assistance. 34YOF, normal BMI.

    -Symptoms: hair thinning, joint pain, weakness.
    -Chronically with elevated vitamin B12 (>2000) for more than 5 years, normal folic acid (multiple times).
    -Not on birth control, not anemic (CBC/hemoglobin always wnl), no thyroid issues, not on any supplements.
    -chronically on Atomoxetine (60mg), low dose Vyvance (20mg)
    -recent history of on and off elevated ALT (40), normal T. Bili. Normal GGT.
    -recent iron studies:
    -ferritin 32
    -serum iron 174 (H)
    -iron sat 56% (H)

    Why are my serum iron and iron saturation high?

    Reply
  55. HLW

    In Jan:
    Iron 62
    TIBC 289
    Percent Saturation: 21%
    Ferritin 40
    Started Iron Supplement and rested in April:
    Iron 91
    TIBC 378
    Percent Sat 24%
    Ferritin 23

    Is this moving in the right or wrong direction?

    Reply
  56. Yoko

    Hello,
    Does anyone know what it means if my serum iron levels are high (254 ug/dl), but my ferritin is normal (87 ng/ml), also transferrin saturation is high at 72%. UIBC, TIBC, transferrin were all within normal range. Also my ALT was slightly elevated at 40 U/L. I was told this isn’t anything to worry about, that the numbers need to be much higher to be worried about hemochromatosis or liver issues. But I’m having a lot of liver related symptoms such as fatigue, depression, chemical and food sensitivities, alcohol intolerance, dark circles). Should I be concerned?

    Reply
  57. Paula

    I have compound heterozygous hfe on a genetic report w symptoms of bradycardia, joint pain, fatigue, early menopause with no hormones at 43 years old. brain fog, mch of 32.

    My ferritin was 26. (16-232)
    Total iron 243 (45-160)
    Iron binding capacity 355. (250-450)
    Percent saturation 68 (16-45).

    I’m confused because this shows high iron but ferritin is low end of normal. Can you help me understand this? Thank you!!

    Reply
  58. Deidre

    36 y/o fe here. No hx of abnormal labs prior to January. B12 and Vitamin D and TSH all Normal. No hx of IBS IBD. Hospitalized in January 2022 with Covid gastritis and Ileus. NG tube for 4 days. No other complications. I now have these labs. I take no supplements and was fasting each time. Also to add was not menses at these times.
    Feb 14 2022 serum iron 65 % sat 19
    Feb 28 2022 serum iron 271 % sat 75
    March 10 2022 “”. 87 % sat 24
    April 26 2022. “”. 260 % sat 74
    Iron binding on each occasion 345-360 normal.
    Ferritin 10 on each occasion.
    My doctor seems to think it’s fine. Normal CMP and CBC literally in middle for all. I do have Gilbert’s syndrome but normal billi only elevated when sick or tired at most 1.7.
    Any advice would be wonderful.

    Reply
  59. Nikki

    Here are some of my labs and background
    Transferrin-257
    Iron-105
    IBCU- 255
    Transferrin saturation- 360
    Ferritin -17
    Vitamin D -24
    B12-376
    Folate-14
    MCHC -low
    Hematocrit and MCV -high
    AST,ALT, and Alkaline phosphatase- low
    High ANA,Positive Anti ssb,low wbc and lymphocytes,joint pain, bad heart palpitations/ bradycardia and tachycardia, fatigue, shortnessof breath, confused at times, bruise easily, blacked out twice, and down almost 30 lbs in a month. Also I’m a 39 year old female, no birth control due to tubal ligation. Any idea what’s going on and if I should get supplements? Please any advice to feel better would be very appreciated 🙏

    Reply
  60. John

    This was a very informative article. My iron was 178 and my ferritin is 28. From your article, it sounds like I may need to do iron supplementation. Is that a correct interpretation? I have been dealing with exhaustion over the last few months.
    Thanks!

    Reply
  61. Brittney Hock

    Hi, I recently had a bunch of bloodwork done:
    Ferritin – 26 ng,mL
    HB 13.7
    HCT 40%
    Iron 132
    TIBC – 316

    I am 53 year old woman who had a hysterectomy a year ago and have Hashimoto’s. My doc wants to put me on iron supplement for 3 months to bring the Ferritin level up a bit, but I don’t really want to take another supplement and these levels don’t seem to bad to me. Would love your thoughts. Thank you.

    Reply
  62. Nikki

    Transferrin-257
    Iron-105
    IBCU- 255
    Transferrin saturation- 360
    Ferritin -17
    Vitamin D -24
    B12-376
    Folate-14
    High ANA,Positive Anti ssb,low wbc and lymphocytes,joint pain, bad heart palpitations/ bradycardia and tachycardia, fatigue, shortnessof breath, confused at times, bruise easily, blacked out twice, and down almost 30 lbs in a month. Also I’m a 39 year old female, no birth control due to tubal ligation. Any idea what’s going on and if I should get supplements? Please any advice to feel better would be very appreciated 🙏

    Reply
  63. Sara T.

    Hi Dr. Matt! I can’t believe I found this site. I’ve been searching over two hours to figure out an answer. I had my blood tested just for a “check-up” and to improve my health generally. I’ve been told in the past I was iron deficient, but I stopped taking iron pills about a month to two months ago. About a week ago, I had my blood tested after a 12 hours fast. I’m concerned because my TS is abnormally high (according to the results):
    Ferritin (ng/mL): 16
    Hemoglobin (g/dL): 11.8
    Iron (ug/dL): 159
    TIBC (ug/dL): 291
    TS: 55%

    Any insight you could give me would be GREATLY appreciated!! Thank you!!!

    Reply
  64. Elsy

    Hello! Thank you for the great information. I would like to know your thoughts on my Iron lab results. I’m a 44yold female. I’m not sure if I should increase iron or not…. Here are my results”

    Ferritin (ng/mL) 38
    Hemoglobin (g/dL) 14.6
    Iron (ug/dL) 138
    TIBC (ug/dL) 295
    TS (%) 47
    Red blood cells (x10E6/μL) 4.7
    Hematocrit (%) 42.8
    MCV (fL) 91.5
    MCH (pg) 31.2
    MCHC (g/dL) 34.1
    RDW (%) 12
    Platelets (thousands/uL) 190
    MPV (fL) 12.4

    Thank you again!

    Reply
    1. Elsy

      Just to note: I did fast, I do not take iron supplement, I’m 80% vegetarian and I do use the cast iron pan about 2-3 times a month.

      Reply
  65. Catarina

    Hi! Thank you for your website and for your help with this article.
    I would like to hear your opinion.

    My values are as follows – blood draw first thing in morning and fasting:

    Ferritin: 12 ng/mL
    Transferrin: 256 mg/dL
    Serum iron: 141 µg/dL
    Transferrin saturation: 44 %
    Iron Binding Capacity: 320 µg/dL

    Hemoglobine: 13.2 g/dL – All other blood count elements are within the normal values.
    B12 is 867 pg/mL

    I don’t have any symptoms but don’t understand why my ferritin is so low and why I can’t increase it.

    Appreciate your help!

    Reply
  66. Heidi

    Hi dr Matt
    My ferritin is 20 or less on average – iron saturation 57 – iron 193 – total thyrodectomy after cancer – one gene of hemochromatosis – no iron supplements – always take labs while fasting – enlarged liver and spleen – why such a continued contrast between ferritin and storage ? I appreciate any insight!

    Reply
  67. Annmarie

    Hi there! I’m so happy I stumbled upon your site. The information has been great.

    Mini back story – my ferritin has not gone past 16 in 6 years almost. It’s currently 11.24 and I feel horrible. This past week extremely out of breath, racy heart, RLS, exhaustion constantly, weak, and more.

    These are my labs
    Iron 126 ug/dl
    TIBC 403 ug/dl
    Hgb 13.8 g/dl
    T-SAT 31.6
    Ferritin 11.24 ng/ml
    Vitamin D 41 ng/ml

    Do you have any suggestions? I’ve started iron supplements and vitamin c along with a vitamin supplement. How long does it typically take to see a change? Could I benefit more or quicker from infusions?

    Thanks so much for any input!

    Reply
    1. rose

      I would try Blood Vitality. Most efficient with least side effect iron I have used in 13 years of practice.

      Reply
  68. Cathy

    Hi,
    Can you interpret my iron levels (female, 65 yes old):
    (started taking SloFe Iron several months ago. Every day for 2 weeks, and then 2x a week for several weeks, and now 1x a week – when I remember)

    6/2022:
    Ferritin 16.29
    Iron 117
    Iron TIBC sat ratio 29.66
    Total Iron binding cap TIBC 394.48
    Transferrin 284

    6/2021:
    Ferritin 8
    % saturation 33
    Iron Binding 366
    total iron 119

    GFR usually low – 59 to 65
    Bilirubin usually high 1.5 to 2.0

    Reply
  69. Natalie Coren

    A friend of mine shared with me this link and I am so happy I was able to find information on high iron, saturation and low ferritin. I spent so much time researching on internet and in my books and with not much luck. Thank you Dr Matt for this resource and your time. My question is suddenly i got very high iron level and high iron saturation. My ferritin was always kind of low but now it got even lower. I do have symptoms of my wrist aches. (I was thinking this is food intolerance like gluten) not on any medication or birth control. These results came abnormal. Everything else is optimal.
    TS – 53% (6 months ago 29%)
    Iron 170 (6 months ago 91
    Iron building capacity 321
    Ferritin 18
    B12 389
    VitD 45
    MPV 11.9
    Eosinophils 8.6%

    I am worry of this sudden iron markers that came off. Appreciate you help me to interpret my results! Many thanks in advance.

    Reply
    1. rose

      Your B12 is pretty low, I aim for 1000.

      Are you taking iron currently? If menstruating, were both tests taken at the same time of your cycle?

      Reply
  70. jrborenz

    Last year my iron was 130, transferrin 273, iron saturation 48%, and ferritin 47. I have hypothyroidism that caused heavy cycles for the past 5 months while I was adjusting my dose. I rechecked ferritin and it was 19. I took 25mg iron 3 X week and avoided coffee/tea near meals. I rechecked iron 5 weeks later and iron was 48, transferrin 273, iron saturation 18%, and ferritin 34. I’ve bumped iron up to 50mg per day for the next 4 weeks and then recheck. Is this too much per day? I suffer terrible weakness and fatigue.

    Reply
  71. Heather

    Can someone help interpret my results. 34 yr old female. I take one a day vitamin every morning, and red rice yeast. Wake up almost every morning at the same time, heart pounding, feel of anxiousness, and the river to jump out of bed and pace the house. Thought it was glucose related but glucose looks in range.

    Results – ferritin 4 no/ml
    TIBC 227 mcg/dl

    Reply
  72. Melissa

    Hi my doctors are stumped. Could you please help me? My serum iron is 207 (fasting) and has been elevated over the past 6 months. My ferritin is in the 20s usually but was 36 this last test when my serum iron was 207. % sat is high at 48 and TIBC high at 428. I think I am iron deficient despite my high serum iron levels. But also think I have heavy metal toxicity. I tested and my blood cadmium came back high at 1.8 (upper range is 1.2). I am doing a heavy metal urine test next. But can you please help me interpret my iron values and what I should do? Thanks so much Dr Matt!

    Reply
  73. Bailee

    Hi Dr. Matt. My iron was high (200mcg/dL iron, 58% saturation, 21.90ng/ml ferritin), they thought I might have hemochromatosis so I had a liver MRI and it was determined I do not have it (just iron overload), and was told to donate blood to lower iron. I donated blood twice and iron fell to 56 with 14% saturation 3 months later. I was on OCP at the time. 1 year later: after donating blood once more and being off OCP for 6 months, my iron is now at 40 with 11% saturation. My cholesterol is also high (232). I had low energy and fatigue when my iron was high, and I still have it now that it is low. Any thoughts? Thank you.

    Reply
  74. Olga

    Dr. Mark I am a little worried I had I the past iron deficit and I have some iron infusions and I take iron supplements.
    My resent blood test show this results And I don’t know how to interpret this
    .Cal%Iron Sat 68 ref range 20-50%
    .Iron Serum 247 ref range 37-145 (UG/DL).
    Ferritin 32 ref range 13-200(NG/ML
    What I need to do?
    My cholesterol is 228 <200
    My calc ldl chol 142 <100
    Thanks for your help and advice

    Reply
  75. Olga

    Dr. Mark I am a little worried I had I the past iron deficit and I have some iron infusions and I take iron supplements.
    My resent blood test show this results And I don’t know how to interpret this
    .Cal%Iron Sat 68 ref range 20-50%
    .Iron Serum 247 ref range 37-145 (UG/DL).
    Ferritin 32 ref range 13-200(NG/ML
    What I need to do?
    My cholesterol is 228 <200
    My calc ldl chol 142 <100
    Thanks for your help and advice

    Reply
  76. SD

    Dr. Matt!
    My ferritin is 18 ng/mL (ref range 7.3-270.7)
    Iron is 96 ug/dL (ref range 50-170)
    Transferrin is 310 mg/dL (ref range 215-365)
    TIBC is 372 ug/dL (ref range 250-425)
    Iron/Transferrin % saturation is 26 (ref range 15-50)

    My PCP want’s me on IV iron infusions. I feel great, high energy, active with no symptoms. I’m 34. Do you think my iron levels are normal?

    Reply
  77. Colleen C

    I’d appreciate your advice with my labs. My whole life I’ve been anemic and iron deficient (I’ve been on iron supplements since I was a kid but nothing really seemed to help). However today my serum iron level came back 195! Saturation was 52% & Total iron binding capacity was 374. Ferritin is low at 19. Hemoglobin was 9.4 (when previously it was 11.7). Hematocrit =28.9, Erythrocytes = 3.06, MCV = 94.4, RBC Distribution width = 27.4. I haven’t taken any iron medication for 2 months! What could cause this? I’m a 30 year old female not on oral contraceptives. My thyroid has been removed due to papillary thyroid cancer so I take levothyroxine. My TSH is 58 and T4 1 (my doctor has increased my dose). I have deficiencies in vitamin A. Vitamin C, E, K, D, & B12 are low normal range. Potassium, calcium, & magnesium are all normal. Liver was tested a month ago – values were all normal (they were – Billirubin = 0.3, Bilirubin total = 1, AST = 31, ALT = 11, Alkaline Phosphatase = 96, Albumin = 4.4, & Protein = 6.5). I have 2 genetic disorders – Factor V Leiden (d- dimer was checked to rule out clots – was normal at 233) & Ehler Danlos Syndrome Hyper mobility type 3. Thank you for any help. My doctors are stuck! (They are thinking a bleeding ulcer for the drop in hemoglobin but can explain the high iron).

    Reply
  78. Margaret F

    There is a study published on pubmed that indicates that turmeric supplementation can inhibit iron absorption by 20-90%. I have ulcerative colitis which can cause anemia. I am normally responsive to iron supplementation, but now I have high iron serum levels but very low ferritin levels. However, I have been supplementing turmeric. I am now taking a ferritin (only) supplement made by Flora, along with vitamin C, to raise my ferritin levels without raising my already high iron levels.

    Reply
  79. Preyanka

    Hello! I could use some help analyzing my lab results. I was given a full panel test and these are the results that came up as flagged. Other vitamins/results came back as normal.

    IRON, TOTAL: 226 H Reference (Range: 40-190 mcg/dL)
    IRON BINDING CAPACITY: 393 (Reference Range: 250-450 mcg/dL (calc))
    % SATURATION :58 H (Reference Range: 16-45 % (calc))
    FERRITIN: 13 L (Reference Range: 16-154 ng/mL)
    VITAMIN D, 25-OH: TOTAL 24 L (Reference Range: 30-100 ng/mL)
    PARATHYROID HORMONE, INTACT 19 (Reference Range: 16-77 pg/mL)
    Interpretive Guide; Intact PTH; Calcium
    —————— ———- ——-
    Normal Parathyroid: Normal (Intact PTH); Normal (Calc)
    Hypoparathyroidism: Low or Low Normal (Intact PTH); Low (Calc)
    Hyperparathyroidism-
    Primary: Normal or High: High
    Secondary: High: Normal or Low
    Tertiary: High; High
    Non-Parathyroid Hypercalcemia: Low or Low Normal; High

    ANTINUCLEAR ANTIBODIES TITER AND PATTERN
    ANA TITER: 1:80 H
    ANA PATTERN: Nuclear, Dense Fine
    Speckled
    ANA TITER: 1:40 H
    ANA PATTERN: Nuclear, Discrete Nuclear
    Dots

    Reply
  80. Paul Kutton

    Hello Dr Matt,
    Can someone help me with my results:
    B12: 167 pmol/L (>177)
    Active B12 67 pmol/L (>35)

    Iron 36.0 umol/L (9.5-29.9)
    Transferrin 2.5 g/L (2.0-3.2)
    Trans Sat 63% (10-45)
    Ferritin 57 ug/L (30-400)

    So weird – high iron, low B12. Everything else on FBC in order. No symptoms.
    Hemochromatosis genetic testing being done but none in family.

    Any ideas? Test was done none fasting mid day.

    Thanks for reading!!

    Reply
  81. Erin

    Hi Dr. Matt,

    I am confused about my lab results, and would appreciate any insight you could provide. I have experienced extreme fatigue, low energy, hair loss, amenorrhea, worsening depression, and weight gain over the past couple of years. My labs show severe Vitamin D deficiency, but I’m confused about my iron results. They are:

    Iron Bind.Cap.(TIBC) -364 ug/dl
    UIBC – 316 ug/dl
    Iron – 50 ug/dl
    Iron Saturation – 14%

    Reply
  82. Jen

    Hi there,
    I have had low iron for the past 5 years and can’t seem to get it up. My Ferritin is 12, iron 68, iron binding 276 and total iron binding capacity 344, transferrin 20%. My vitamin D is 29.
    I have been taking a liquid iron Floralvital. The highest my Ferritin has ever been was 36 in 2016 and the lowest was last Aug at 6.

    My body dose not seem to absorb iron – I also take vitamin C and I also eat a Whole Food Plant Based diet. However my Ferritin was low when I used to eat meat. I also run and exercise about 4x a week.

    Reply
  83. AFerg

    Hi I have normal levels of everything except:
    Iron – 215 mcg/dl
    Ferritin – 17 – normal 30-424
    Vitamin D – 16 ng/ml – normal 20-80

    I could really use some help figuring out what this might be. Thank you!

    Reply
  84. Peggy Hinkle

    My total iron is 205, ferritin is 62. In December 2021, my ferritin was 18. I have felt better, esp more clear headed, with ferritin higher. My new anti-aging doctor told me to stop taking so much iron without any explanation. I dropped it down to once a week… but don’t feel as good as I did while taking it daily. HemeVite. Is 205 really that high/dangerous? Thank you – just happened upon your site while doing a search.

    Reply
  85. Kesha

    Hello I hope all is well. Please help me understand my labs. I’m exhausted and have been for several years. Dark circles under my eyes. No energy. Started taking iron for awhile not too long didn’t seem to help. My right side hurts around liver and gallbladder. Ultrasound done. Normal. Colonoscopy done. Normal.
    Thyroid nodules no antibodies. Dr says labs are “within normal limits”. I feel so tired that I wanna quit but I believe there is hope. I’m just so exhausted.
    TSH 2.390
    IRON 210 High
    IRON SATURATION
    53.0 High
    FERRITIN 6.4
    TRANSFERRIN 284.0
    HGB 12.3 g/dL
    HCT 37.9
    MCV 84.2 fL
    MCH 27.3

    Reply
  86. Aimee S

    Hello,

    Can you please help me interpret my blood work, as I’ve struggled as a women with heavy periods with ID for 15 years.
    Iron Serum 166 ug/dL
    TIBC 398 ug/dL
    Unsat. Iron Binding Capacity 232 ug/dL
    Transferrin % 42
    Transferrin 284 mg/dL
    Ferritin 15ng/mL
    Red Blood Count 4.83
    Hemoglobin 14.7
    Hematocrit 44.3

    I’d love to hear your thoughts on these numbers and where I’m at with my ID. I am currently taking Slow Fe every other day since these findings. Prior to that I was taking a Women’s One a Day. Thanks for your thoughts!

    Reply
  87. Rachel Traficante

    Please help if you can. My son is a college distance runner, averaging 65-80 mile weeks as well as 2 days week in the gym lifting. He is 21 yrs old and a vegan/vegetarian. He began struggling with performance about March 2022 during track season. Complaints have been general fatigue, heart rate increasing too quickly and general fogginess. He cut his season short, took 2 weeks off and began training for a marathon scheduled early June. After two weeks rest, he was back to his old self, hitting his paces in workouts. Did great in the marathon. Took two weeks off and began cross country season training. Did well the first month back and then as soon as the heavier workouts hit, once again, he couldn’t hit his targeted paces. NCAA was requiting bloodwork and it was the first time he had it done.
    Iron 263
    Transferrin 281
    TIBC 351
    Transferrin sat 74
    Ferritin 24.7
    HCT and HGB were normal

    Per his coaches suggestion he has been taking an iron supplement. He has been on it for almost two weeks. My son has noted that he is sleeping much better. My concern is the high saturation level and I’d very much appreciate your input.

    Reply
  88. Kass

    Greetings,
    Thank you for this fabulous article!
    I have had hair loss for years, and am starting to see a correlation with my iron storage. Not on birth control, very conscious whole foods diet, do not use cast iron. Would love your suggestion – these are fasting results.
    Iron, Total: 240
    Ferritin 14
    B12 404
    T4 1.4
    T3 3.0

    My integrative practitioner suggested i taking milk thistle as it binds to iron.
    Please advise, thank you!

    Reply
  89. kristina

    Hello,

    Can you help interpret my iron results?

    Iron – 425
    Binding Capacity – 490
    Saturation – 87
    Ferritin – 8

    Reply
    1. rose

      Either you took iron just before the test or you need more testing beyond iron. Copper, D, retinol, B12, folate. Dietary change.

      Reply
  90. Tiffany

    Hello Dr Matt, Wow! I’m so happy to see this article!! Would you be able to help me with these labs? A short background, I’m an active 54 year old female. Not overweight. I workout 3-4 times and week and eat healthy (I’m a registered dietitian). At the end of June I was sitting at my desk and the tops of my feet and calves started burning!! They were also swollen. It went away but I still have been having symptoms of tingling and swelling in those areas but mostly when I am sitting. I’ve also been losing my hair like crazy, I noticed it starting about a year ago but the last 6 months have been bad. I went to a dermatologist who said I have androgenic alopecia but no women in my family have hair loss. I also started hormone replacement therapy 2 years ago of 10mg estradiol and 65mg testosterone injection monthly and 100mg progestone cap each day. This has helped my menopausal symptoms immensely. I went to my primary and they did a lot of labs and sent me to a neurologist as they thought I might have a nerve in my back (although I have no back pain) that is injured. I had MRI which was normal. They didn’t really say anything about my labs but I’ve been reviewing them. I was not fasting.
    Ferritin 46 (ref 8-252)
    iron 173 (ref 39 – 150)
    TIBC 435 (ref 241 – 421)
    Hemoglobin 14.3 (ref 12 – 16)
    Mg 1.9 (ref 1.8 – 2.4)
    I’m wondering if this has anything to do with my hair loss and the continuing feeling of tingling and swelling in my lower legs. I’m not sure where to go from here… Thanks so much!!

    Reply
    1. Dr. Matt

      I would look into your hormones, Testosterone, Dht, estrone, estradiol, DHEA. Testosterone injection one time per month is sure to set you out of balance. Lower more consistent dosing is how I prescribe. Testosterone can greatly effect iron metabolism.

      Reply
  91. Graham Maxwell

    Hi.
    I’m a male, 44 yes old, 6’8″ tall, 110kg, lean, very active job.
    I’m on TRT, 200mg p/w testosterone enanthate (im a big guy) and do micro dosing every other day.
    My irons been changing over last 4 years, now
    my levels are (im in Australia)
    Heamogloben 173 g/L
    RBC 5.63
    HCT 0.52
    Serum iron 46.0 umol
    Transferrin 2.04 g/L
    Transferrin saturation 90%
    Ferritin 77 ug/L

    Transferrin and ferritin has been dropping consistently and serum and saturation increasing the same.
    Can’t figure this out due to the ferritin dropping even though it seems I have increasing iron overload.
    I’m also positive for one gene for hemochromatosis (carrier, not sure which SNP it is). Does this effect it?

    Hopefully you can help
    Graham

    Reply
  92. Kathleen Studebaker

    HI there, I see that many people are asking for your advice and I want to say it’s very kind of you to offer it for free to so many. My problem is hair loss. I’m a 40yo female, and have been more-or-less vegan for 20 years. Over the past year my hair loss has really increased (I’m losing 300+ hairs/day now). Had some (non-fasting) blood tests done and I guess my “normal” ferritin is actually quite low. My question: how much iron should I take daily and do I need to take anything else (e.g. the lactoferrin I’ve heard mentioned here)? Oh also I’m very active 🙂 I’m now taking some hair-related supplements that have about 25mg iron/day (started them after the tests). Thank you!

    My iron levels:
    Iron Bind.Cap.(TIBC) 388 ug/dL (250 – 450 ug/dL)
    UIBC 290 ug/dL (131 – 425 ug/dL)
    Iron, Serum 98 ug/dL (27 – 159 ug/dL)
    Iron Saturation 25 % (15 – 55 %)
    Ferritin, Serum 17 ng/mL (15 – 150 ng/mL)

    Reply
  93. Trish

    Hi Dr Matt,
    I was wondering if you could let me know your thoughts on my iron situation. I am a 39 year old healthy female. I had a very heavy menstrual cycle where I lost over a pint of blood. I had my ferritin checked about 2 weeks after that and it was at 6 ng/ml, so I started taking oral iron supplements. After 3 weeks of that, these are my labs:
    Ferritin: 11.4 ng/ml
    Iron: 76 ug/dL
    UIBC: 302 ug/dL
    Calculated TIBC: 378 ug/dL
    Iron saturation: 20%
    Hgb: 12.2 g/dL
    HCT: 38.5%
    RBC: 4.56 x 10(6)/uL
    The rest of my CBC is wnl except RDW at 15.5%
    Also, I am a runner. I run about 20-30 miles per week. For the last few months I felt a lack of endurance. I’m about to start marathon training again and I want to make sure any iron issues are resolved. I feel like my ferritin is still very low, especially for the amount of physical activity that I partake in. Is it too soon to know if my bloodwork has stabilized after 3 weeks of oral iron? Thank you for your input.

    Reply
  94. Megan

    I have had been on the low and sometime below normal side of Ferritin for a long time and take Reactive Iron for it and then iron Saturation is also typically low. My current blood tests really caught me off guard as my iron and saturation came back high.
    Here are the results.
    Iron: 252
    Transferrin Serum: 287
    Total Fe Bind Cap: 399
    %Fe Saturation: 63
    Ferritin : 22
    I am uncertain as to what this means. This is a new one for me. Any help would be greatly appreciated.

    Reply
    1. Dr Matt

      Consider looking into testing Vitamin D and A levels. Also, maybe look at taking a more comprehensive formula for iron repletion support like Blood Vitality (www.optimizeiron.com).

      Reply
  95. Jeff Roman

    Hello. My 13-year son is very active — he’s a runner, lifts, active in other activities and eats a mostly vegan, whole foods diet. He also uses whole food supplements including Sun Warrior protein powders. He has not been himself this season so we just wrapped up a full round of blood work. We are concerned about his results and any feedback would be appreciated. We can’t find anyone to get him into in a reasonable amount of time and the “interwebs” have us concerned. Thank you!

    Saturation %: 54
    Ferritin: 14ng/mL
    Iron Binding: 407
    Iron Total: 219 mcg/dL

    Reply
  96. Gin

    I had iron deficiency in the past (iron as low as 21, ferritin as low as 4) and have been taking 65 mg iron supplements 3x a week since April 2022. I got back my blood test results yesterday
    Iron 141
    TIBC 318
    Iron saturation 44%
    Ferritin 23
    Ferritin still seems a bit low. But iron seems to be approaching high. What is happening? Should I be continuing iron supplements?

    Reply
  97. Sunny

    Hi – Thanks for the focus on low ferritin. Our family is working with my daughter to help her with low ferritin. She is now a professional athlete suffering from low ferritin (mostly low teens) for over 10 years since middle school ferritin at 39. She is not anemica and most of her labs (CBC, ferritin, and iron panel) have been normal other than ferritin for the last six years. (She does not have CBC or iron panel for the four years previous other than ferritin mostly in teens.)
    Hepcidin tested normal.
    She has taken just about every iron supplement available from isolate, food based, and liquid forms of iron without success of raising ferritin over 20. Her diet is vegetarian but excellent and takes NSF approved supplements (multi, C, B12, D, Omega Algea, magnesium, and probiotic. No oral contraceptives. Extremely light periods.
    She trains in a remote area so not access to functional physicians to help her solve this mystery of why her body does not seem to be absorbing the iron supplements.
    Thoughts?

    Reply
  98. Michael

    How about men? Results below indicate increasing serum iron with decreasing ferritin levels. Definitely was taking too much zinc during the pandemic without enough copper (stopped many months ago). Maybe that produced a deficiency that requires copper supplementation to balance.

    Iron Serum
    2020 – 144 mcg/dl (49-199)
    2022 – 211 mcg/dl (49-199) HIGH

    Ferritin (downward trend)
    2017 – 63 ng/mL
    2020 – 43 ng/mL
    2022 – 33.9 ng/mL

    Iron Saturation
    2020 – 41% (20-55)
    2022 – 55% (20-55) BORDERLINE HIGH

    TIBC
    2020 – 352 ug/dl (260-490)
    2022 – 384 ug/dl (260-490)

    Reply
    1. Dr. Matt

      You definitely could have over ridden your copper. I have had plenty of patients come in who did that during COV with all the zinc.

      Check your copper, retinol, vitamin D, ceruloplasmin.

      Reply
      1. Michael

        Thanks Dr. Matt: Ceruloplasmin and Copper serum is in the low range “normal”, D high. Everything else in the middle.

        Copper was high/Iron low in a metals urine challenge test a few months ago. Life is complicated. Some recommend hair analysis for evaluating the metals.

        Ceruloplasmin, S –
        23.1 (19-31 mg/DL)
        Vitamin D 25 Hydroxy
        92.4 (30 – 100 ng/mL)
        Zinc, S
        79 (60-106 mdb/dL)
        Vitamin A
        71.6 mcg/dL (32.5-78.0 mcg/dL)
        Copper, S
        78 mcg/dL (73 – 129 mcg/dL)
        Transferrin, S
        305 mg/dL (200-360 mg/dL)

        Reply
  99. Dr.Matt

    She may want to try out Blood Vitality (www.optimizeiron.com) in tandem with Vitamin A (not beta carotene but preformed Vitamin A), vitamin D3 with K2..this would be first line.

    Is she getting her iron saturation, TIBC, serum iron/transferrin checked along with her ferritin? Copper, retinol, iodine would also be good to check.

    Vegetarian and competitive running in my experience generally do not allow for peak performance.

    Reply
  100. Bev Bearden

    Thank for this wonderful discussion. Information on this topic is hard to find and very confusing.
    For the last 7years my labs have been consistently showing high iron serum (150-250) and ferritin on the low normal scale (17-47) but mostly on huvering on the lower side. My last lab a month about was iron serum 157 and ferritin 25. I am a carrier of hemochromatosis gene. When I received my labs my Dr recommended that I gstart taking iron so I ordered your blood supplement but then ahe changed her mind and said that because of the hemochromatosis I should not take any iron. I am super confused. I have lots of symptoms of fatigue, hair loss, muscle aches,headache, and joint pain, brain fog, and the works. Through the years I have tested for all kinds of auto immune disease but nothing comes back abnormal. When I saw your post I thought maybe low ferritin could be to blame. Any wisdom would be greatly appreciated. Sincerely Bev

    Reply
    1. Dr. Matt

      What is your iron saturation and tibc?

      Also I would get your retinol, copper, ceruloplasmin checked.

      What is your age? Menstruating?

      Reply
  101. Holly

    Question, I have always struggled with my Ferritin being low. I lost my thyroid in 2013 and have had issues since. A 4 month systemic infection from the surgery caused me to develop Fibromyalgia. Also, was anemic (low hgb) and diagnosed with pernicious anemia. I take B12 shots twice a month to get my levels where I can actually function. Eventually my ferritin was checked and had a few iron infusion to help my ferritin to get to 70. When it’s at 70 I feel really good.

    Now, I am having problems still with my ferritin – doctors won’t prescribe Iron Infusions – and my B12 levels won’t stay up with my shots. My ferritin now is 37, B12 is 600 (I need at least 800) but my Iron Saturation is at 61%. Can you give me some information on what you feel about this? I have tried oral iron, B12 and neither will get into my gut that way. I have to do injections but IV is a much better route. I used to be very good at eating clean so I don’t have the inflammatory issues with my Fibromyalgia. I am going to get back on being better with that – NO dairy. soy, gluten, sugar.

    My levels now:
    IRON AND TOTAL IRON BINDING CAPACITY
    IRON, TOTAL 153
    IRON BINDING CAPACITY 251
    % SATURATION 61
    FERRITIN 37

    Reply
    1. Dr. Matt

      Your food routine is huge. I know it’s tough but keep putting out before yourself the benefits of making these adjustments, it is worth it.

      If no thyroid, are you taking T4 and T3, thyroid can really effect iron.

      Also have you looked at hydrochloric acid (Hcl) supplementation with meals? The right probiotics and enzymes and colostrum could all potentially be very helpful.

      Sublingual B12 in the right can still raise levels even In Pernicious anemia. Also you really want to think about all your fat soluble vitamins and making sure they are sufficient give the absorption issues.
      https://drwholeness.myshopify.com/collections/nutritional-supplements/products/b12-squared

      Reply
  102. Marie

    H!i! Wondering if you could help me interpret my latest results? Curious as to why the %saturation may be high (52), Ferritin 18, Iron total 175, and iron binding capacity at 336. I fasted and do not take an iron supplement. I am on hormonal birth control – Skyla. Hope that information is helpful. Thanks so much!

    Reply
  103. Yarely

    Hello I was curious if you could help me. I currently see a hematologist and looking into seeing a rheumatologist soon. I’ve been dealing with anemia for pver 2 years now. I take iron twice a day with vitamin C, I have also alternated to twice a day early in the morning. I have had iron infusions but they help only for the moment and make me feel worse to be honest. I also take a Vitamin D 50,000 iu weekly. I have been tested for autoimmune disease that came back borderline positive. My thyroid has been tested various times and it is normal. I have been having severe pain where my kidneys are but CT was clear. I’m extremely tired, have shortness of breath, rapid heartbeat and brain fog.
    My recent lab work showed these numbers.
    MCHC: 32.7 g/dl
    RDW: 15.4%
    MPV: 8.7fl
    HGB: 12.8 g/dl
    HCT: 39.1%
    Ferritin: 6 ng/mL
    Iron Serum: 77 mcg/dL
    Iron binding: 321 mcg/dL
    Iron saturation: 24%
    Vitamin D: 25NG/ML
    Creatine: 0.60 mg/dL
    BUN/Creatinine Ratio: 25+

    Reply
  104. Akasha

    Hello,
    I have been trying to figure out why I have been having extended hair loss for awhile now. I am on birth control but have been for almost 15 years but planning to come off of it. I have been supplementing iron due to low Ferratin levels. In May 2022 my Ferratin was 17 and now I have been supplementing since then and just this week me Ferratin only reads 24. But interesting that they told me fasting wasn’t needed. I did fast when it was at 17. But not this last time. Here are my iron levels below the that was also tested at the same time. I have actually been only supplementing iron every other day and did not take anything 12 hours before test. But now I feel like maybe I need to retest since I did eat something small this last blood test? I passed out the last time when I didn’t eat so then they said I didn’t have to fast. My doctor is sweet but very new in career and she seems unsure as what steps for me to take next so I’m feeling a bit lost.

    October 2021
    Iron-188ug/dl
    Transferrin-319mg/dl
    Saturation-42%

    Ferratin- 17 in May 2022

    October 2022
    Iron-238 mcg
    Iron binding capacity- 392mcg
    Saturation- 61%
    Ferratin 24

    Reply
  105. Alfonso

    Hi! I’m Wondering if you could help me interpret my latest results? Curious as to why the Saturation % may be high,Iron high but Ferritin normal:Fasting blood draw
    TIBC:308
    UIBC:116
    IRON:192 H
    IRON SAT:62% H
    FERRITIN:76
    My Doctor says to go donate blood when serum Iron is high.I went to donate blood but I feel a deficiency now.
    Checked B12/Folate levels after giving blood along with Zinc/Copper/Ceruloplasmin:
    B12:401
    Folate:5.8
    Zinc:65
    Copper:89
    Ceruloplasmin:22

    Reply
  106. Sherri

    Hi Dr. Matt 😊
    I am a 52 year old women, 5’2, 117lbs and fit. Recently my blood results of iron were high at 267, and the ferritin was normal at 100. Here are a list of my meds, which may or may not affect these levels.
    *Trazadone 300mg
    *Progesterone 200mg
    *Celexa 20mg
    *Bio B12 injections 1mg
    *Testosterone pellets 137mg – the pellets include additives such as estradiol etc.

    Any advice you could give would be incredibly helpful!

    Thank you!
    Sherri

    Reply
  107. Vil

    Hi Dr Matt,
    I have been having issues with low ferritin levels and anemia for while. I have Graves’ disease which is well managed. I started taking iron supplements for 4 months now in order to raise my Ferritin levels which were below normal range (as I recall 10). I just had a blood test and I am surprised to find out that ferritin is still not optimal and on the low side but Iron is high now. Is this due to iron overload, should I stop supplementing? If I stop with the iron supplements, how can i raise ferritin levels?
    Here are my results:

    CBC all normal
    Ferritin – 26 ng/Ml
    Iron, Total – 198 mcg/dl High (range 40-190)
    Iron Binding Compacity – 344 mcg/dl
    % Saturation – 58 High (range 16-45%)

    Thank you!
    Vil

    Reply
  108. Todd

    I’ve had a number of blood tests over the past couple years with some concerning results. The latest include:
    % Saturation – 58 (high)
    Ferritin – 11 (low)
    Iron Binding Capacity 379 (normal)
    Iron, Total – 219 (high)
    Stool Calprotectin 240 (high)
    Things with my physician seem to be moving very slowly, and I’d love some insight. Thoughts?

    Many thanks in advance.

    Reply
  109. Sarah

    IRON, TOTAL 77
    IRON BINDING CAPACITY 408
    % SATURATION 19
    FERRITIN 10
    3 months of iron supplements went to
    IRON, TOTAL 226
    IRON BINDING CAPACITY 399
    % SATURATION 57
    FERRITIN 10 L
    Told me to stop the iron because I’m not converting and then never addressed it again. Still abnormally fatigued. My esthetician NP also does functional medicine and, in generally conversation during my injections, suggested taking chelated iron supplements instead of FeSO4. PCP seems to think that maybe that’s just how my ferritin is, and that it’s not that low. Says that it’s not likely the cause of my fatigue. Any thoughts on this?

    Reply
  110. mandy sockwell

    Glucose 85 MG/DL
    BUN 12 MG/DL
    Creatinine 0.75 MG
    Sodium 139 MMOL
    Potassium 4.8 MMOL
    Chloride 103 MMOL
    CO2 19 MMOL/L L
    Calcium 9.5 MG/DL
    Total Protein 7.1 G/DL
    Albumin 4.6 G/DL
    ALT 13 IU/L
    AST 17 IU/L
    Alk Phos 52 IU/L
    Total Bili 20.0
    IRON 325 UG/DL HH
    Iron Binding Capacity 487 UG/DL H
    Iron Binding Capacity (unsaturated) 162 UG/DL
    Iron Sat Percent 67 %

    Reply
  111. Doug

    Hi Doc,

    I just had test results come in for a morning fasting blood draw:

    Ferritin – 34.3 ng/mL (28-397)
    % Saturation – 48.8% (20-55)
    Direct TIBC – 383 ug/dL (261-462)
    Iron – 187 ug/dL (49-181)

    I also tested positive for HFE Gene Pathogenic Variant (H63D Heterozygote). I am taking https://globalhealing.com/products/iron, and am wondering if I should stop. I do seem to yawn a lot, which I’ve always heard is symptom of iron deficiency. My thyroid hormones are normal, but TSH slightly elevated. Any advice/thoughts you have would be appreciated.

    Reply
  112. Jane

    Hello,

    Please help me to understand my blood test results:
    IRON, TOTAL 155 45-160 mcg/dL
    IRON BINDING CAPACITY 296 mcg/dL
    % SATURATION 52 H Reference Range: 16-45 % (calc)
    FERRITIN 13 L
    I’ve been diagnosed with hemochromasis (C282Y). I used to donate blood, but after my last blood donation in 2020 my ferritin level is low.

    Reply
  113. M Glenda Y

    Hello,
    Thank you so much for this website and the information on the website.
    I was lightheaded and sometimes dizzy, and have palpitations sometimes.
    My heart checked out fine at the cardiologist and my thyroid levels are normal.
    My Kidney and Liver functions are Normal.
    I am a female, 21 years and heavy periods.
    At fasting:
    My TIBC is 430 ug/dL – Normal
    My UIBC is 390 ug/dL – Normal
    My Iron is 41 ug/dL – Normal
    My Ferritin is 5 ng/mL – Low
    My Transferrin is 369 mg/dL – High
    My Iron Saturation is 10 % – Low
    My Haemoglogin is 11.6 g/dL – Normal
    Can you kindly help interpret this please.
    Many many thanks and appreciations.
    Thank You.

    Reply
  114. Elaine Snowbeck

    My levels are:

    Iron 243, iron binding, 406, saturation 60, Ferretin 10. This is new as my iron was fine last year.
    I think my doctor is taking this too lightly. Two weeks ago she had me take iron supplements, but with the high iron she wants me to increase my iron food intake and stop taking the supplements. I already have a very high iron diet and use cast iron pans.
    Where do I go from here?

    Reply
  115. Ron

    Hi,
    This is very helpful as I was a little befuddled by my results.
    Ferritin 39
    Iron 175
    IBC 338
    Saturation % 50
    Based on what I read here I believe I should probably increase dietary iron so that ferritin will rise some and iron will then gravitate more to optimal levels?
    Thank you for any input.

    Reply
  116. Marianne

    I am a 48 year old female with no known medical issues. I have suffered with Restless Legs Syndrome for about 30 years. It runs in my family in both parents sides. I have been taking Pramipexole for about 10 years. I am not taking any other medications. I am currently trying to taper off Pramipexole after I read about augmentation in dopemine agonists medications and I would like to avoid this, also my RLS have worsened since taking the medication. I went to my general practitioner 2 weeks ago to ask about weaning from Pramipexole and I had my labs done at the same appointment as per my research I read that for RLS sufferers ferritin levels should be above 100 and increasing iron could help with RLS symptoms. My ferritin came back as 47, what was puzzling though was my iron was 150 (range 37-145) and iron saturation was 51% (range 20-50%) so my doctor wants to have an appointment to discuss my high iron, however I do not eat iron rich foods, or take supplements and I drink a ton of coffee so I’m confused on how my iron could be high. I also have symptoms of low iron, thinning hair, brittle nails and fatigue. I posted this on a RLS support group and I was advised to email this organization. Any insight you could offer would be great. Thank you!

    Reply
  117. Colleen

    I am a 42 year old female. Generally healthy, work out daily, take supplements/vitamins.
    Symptoms include fatigue, brain fog, low motivation, irritability, POTS, numbness/tingling in fingers, poor temperature control.
    Labs are as follows:
    25OH, Vit D = 60.5
    B12 = 1550
    Folic acid = 9.53
    TSH, free T4 = 1.55
    Ferritin = 30
    Iron = 181
    Iron saturation = 67
    TIBC = 269
    Hgb = 14
    Copper = 64
    Ceruloplasmin = 19
    Zinc = 99
    Thanks for your help!

    Reply
  118. Jodi

    HI! I was wondering if you can help me..my Ferritin 582 and transferritin 186..I have been very weak and fatigue and my joints are bothering me. what does this mean?

    Reply
  119. Meg Rowe

    Hello! I was wondering if you could help me with this. My son is almost 9 years old and he was first diagnosed with IDA around 4-5 years old. He received PO Iron supplementation and they over shot the mark so he had to stop. At a 6 month f/u his labs were WNL and iron was completely discontinued. Flash forward to now, he has been eating ice a lot, tires easily, not interested in sports anymore, has dark/blue circles under his eyes bilaterally and he isn’t as hungry as normal. Blood tests revealed the following:
    Hgb 12.7
    Hct 39.5
    MCV 73 (low)
    MCH 23.6 (low)
    TIBC 367
    UIBC 337
    Serum Iron 30
    Iron Saturation 8% (CRITICAL LOW)
    Ferritin 27

    Any thoughts about the labs above especially relatively normal(ish) labs but a random critical thrown in there. In addition, my sisters and I as well as 1 (out of 2) nephew have been diagnosed with Natural Killer Cell Deficiency. I decided not to test him thus far, but now I wonder if I should.
    Thank you!!!

    Reply
  120. Kate

    Hello, Thank you for posting this! I have been so puzzled by my results. I’m planning to retest on Monday. My recent results indicate that I have hashimoto’s. (I knew I had low thyroid/ but this showed 359 TPO antibodies, so I assume.) My thyroid levels are normal and I am treated with dessicated thyroid.

    My results also show high Iron (212) and %saturation (61) but normal TIBC 347 and Ferritin. (43) I had been taking a lot of Airborne that week to stave off sickness. Could that cause high iron? I am a woman, 48, of northern european descent. Do you offer zoom medical appointments, by any chance? I have an appointment with an endocrinologist but the first available is in March.

    Hopefully, retests on Monday will show something better.

    Reply
  121. Kem

    Hello can anyone explain my blood test results thank you i was tested back in December, But cant get into the doctors until February .
    10/1/22 18/7/22 13/12/22
    Iron 15 8 22
    TIBC 61 68 73
    Saturation 24 12 30 %
    Ferritin 17 12 7 ug/L

    EOS 0.34 0.66 0.81

    TSH 1.8 2.6 3.7

    Reply
  122. Mark Schanlan

    Hello Matt. 67 yr old male, diagnosed with Hemochromatosis approx 15 years ago. Also have Thrombocytopenia (platelet count consistently just below normal). Have kept my ferritin number in the “normal” range (100-300) during that time. Last 4 tests: TIBC 217-242, Saturation 87%-93%, Total iron 209-224, Hemoglobin 15.1-17.1. The high saturation began 2 1/2 years ago. My hematologist says that as long as total iron is low that saturation % doesn’t matter. My readings (Pierre Brissot) seem to indicate that the sat % is an issue even at lower iron levels. We are currently trying to get me under 50 to see if that drops the sat% (doc is amenable to that). Any thoughts on my high sat/low iron situation?

    Reply
  123. Daniel

    hi Dr. Matt,
    Have had a feeling of fullness with reduced meal sizes, especially with animal protein and fats. Discomfort in upper right abdominal area, sometimes feeling of scratching while urinating. Have ruled out infections, stones, ultrasound came out normal. Changed my diet and over the past 3 weeks, my Alanine aminotransferase decreased from 81 U/L to 67 and 37. I have had a high ferratin level through out the three tests, around 279. My iron is on the lower end at 11 umol/L. Could this indicate an inflamed body? What additional test would you recommend?
    Thank you

    Reply
  124. Sami

    I am extremely fatigued, anxiety, panic, shortness of breath, heart palpitations, dizzy for the last 6+ months. I just received my lab results and my doctor doesn’t think this is a concern. Thoughts? Should I take iron supplement?
    Ferritin 8.4
    Iron 97
    Transferrin 246
    Total iron binding capacity 244
    %iron saturation 28%

    Reply
  125. Areil

    Ferritin 23ng
    iron 79ug
    Transferrin 275mg
    Saturation 23%
    TIBC 343
    My Hemacrit/Hemoglobin is always under by 1 – 1.5, but doc never seems to think it can be responsible for my symptoms. Are these normal numbers? Please help me interpret. Thanks.

    Reply

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