Optimal ferritin levels?

What would be optimal levels for ferritin in a range of 10-291?

Has anyone experienced that their half moons on nails comes back when their ferritin levels improve?


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29 Replies

  • Half way through range is optimal.

  • Do you have any idea how it is this range is so wide. If I Google it says optional is around 70-100 but then it says the range for women is 10-150

  • I don't know why it's such a wide range except that I suppose anything below 10 must be critical and anything above 150 signifies you have too much iron stored and it need investigation. Ferritin is the storage of iron so it's good to have at least 70 to mid-range in storage when you have hypothyroid conditions. Your iron status is also important in conjunction with ferritin.

  • What should the iron status be?

  • It needs to be in range and preferably not right at the bottom of the range.

    If you have blood test results then post them here and people will give you good advice.

  • "In range" reminds me of my doctor telling me my ferritin at 24 is "in range" and is good level, but now I'm seeing that it should be over 70 and closer to mid range. So, ferritin should be closer to mid range, but iron should be "in range" but not at the bottom of the range? How close to the bottom of the range, is not at the bottom of the range? ;-) My ferritin isn't at the bottom of the range either. Bottom is 10.

  • There are several iron markers all indicating different aspects so if you want good advice you could post your results. Mostly we see below range results on this forum and people then need to visit their GP for iron supplements or see a haematologist for an infusion.

  • "What should the iron status be"

    See rt3-adrenals.org/Iron_test_...

  • Optimal is always in the middle.

  • GP Notebook website shows different ranges for pre and post menopausal women, and again different ranges for men.


    However, all mine with Blue Horizon and Medichecks have had a range of about 13-150 and I am post menopausal.

    Optimal is said to be half way through range, although I have seen it said 100.

    My last test showed 119 (13-150) and it started as low as 35. During all this time I've only had good half moons on my thumbs, very small ones on index fingers, and nothing on other fingers. They've never changed whatever my ferritin level has been.

  • There is a strong temptation to assume that if ferritin is low then serum iron must be too. And if we assume both of those are low then maybe haemoglobin is low too. But these assumptions are not necessarily true, and supplementing iron without checking other things is not a safe thing to do. And even then, it is essential to test frequently in the early days of supplementing just in case some other problem pops up.

    People can have low ferritin and high serum iron. Under those circumstances, supplementing iron may push serum iron even higher without making much of a difference to ferritin. Having masses of free iron in the blood stream is not healthy at all. This combination may suggest that the patient has a problem with the MTHFR mutation, and they would have to deal with that before even thinking about iron.

    People can have high ferritin and low serum iron together. Seeing this combo might persuade some people to supplement iron to try and raise their serum iron. But this combo of results is more likely to suggest the patient suffers from inflammation or infection, and has Anaemia of Chronic Disease.

    Other combinations of ferritin and serum iron can occur. Then haemoglobin gets into the act as well, and muddies the waters even further.

    Something I haven't mentioned, but which is also relevant is how saturated blood is with iron. It isn't a good idea to supplement if blood is already highly saturated with it.

    Some links I've found useful :

    1) Optimal results for iron (already posted by SeasideSusie above)


    2) A table showing lots of different ways in which different kinds of anaemia and/or iron problems can occur - see bottom of page but read the rest of it too :


    3) Anaemia of Chronic Disease (or Chronic Inflammation)


    4) Info on the Iron Withholding Defence System - see page 8 :


    5) General info on ferritin :


    6) More info on parts of an iron panel :


    I have iron problems - I tend to lose it very quickly if I stop supplementing. I try to keep it at reasonable levels by taking a couple of iron tablets a week.

    When I test I rely on getting an iron panel done :


    And I also like to know my haemoglobin level if possible :


    One thing to watch out for is the possibility that someone may have two forms of anaemia in the same body e.g. iron deficiency and vitamin B12 deficiency.

    Iron deficiency reduces ferritin and B12 deficiency can increase ferritin. Put them both in the same body and ferritin can look normal - and this is another reason why just relying on a single measure is not a good idea.

  • Great information HB, I'm saving this post!!!

  • Thank you :)

  • Thanks; this is very helpful indeed.

  • how do you deal with the mthfr please? i have a friend with this who is really suffering and this part of he rillness doesn't seem to be addressed at all, she has started iron suppliments but its making her her so ill :-( now im wondering if its also because of her mthfr problem

  • If iron supplements are making your friend very ill then she should stop taking them immediately and ask her doctor for a full iron panel, or use a company like Medichecks to do finger-prick testing of an iron panel. If she decides to get an iron panel done herself then she will need someone to interpret the results. You could write in the results and ask here.


    Someone with an MTHFR problem could end up with sky-high serum iron and yet ferritin may continue to be low.

    I have little knowledge of MTHFR so I'll just give you some links I liked on the subject. Supplementing to help deal with an MTHFR problem could make someone feel ill to begin with, so care is required not to take too high a dose of anything. Pass these links to your friend and tell her to read them all before she does anything or buys anything or takes anything :





    If your friend is lucky then she may do well with just buying and taking a methylfolate supplement or a B Complex with methylated B vitamins in.

    For a more sophisticated (and very expensive) protocol to supplement for a MTHFR problem you could read this :


    I've read it several times but never got beyond doing the reading! ;)

  • The doctor has prescribed what she is taking :-( she daren't take anything off her own bat as lots of things are making her ill :/(

  • I forgot to say, if your friend starts to feel better after a while with the methylfolate or the methylated B vitamin supplements, then eventually she may be able to tolerate iron better. But I would suggest she gets an iron panel done before taking iron again, after she has been taking methylfolate or methylated B vitamins for a while.

    Another link she might like to explain methylation and how to fix it :


  • Tell your friend to use daily Spatone... a sachet of liquid iron with vitamin C ..

    Its fantastic!!! No side effects

  • Thank you, she is already taking that and still having problems

  • So interesting thank you! I have had sustained low ferritin (8) for years and hair loss. But they have never suggested testing myvserum iron - I assumed ferritin was the test for iron...? Despite x3 ferrous fumate 220 for 5 years it has not gone up.. very interesting that others with thyroid issues sometimes seem to have low ferritin too as I assumed it was an unrelated problem, more linked to my heavy periods. Will do more research

  • You could do a private test - an iron panel - using a finger-prick sample yourself - no doctor required, and the results are given to you :


    Once you have the results you could post them on the forum and ask for feedback. If you wanted to do a really thorough job you could get a Full Blood Count done as well, which would tell you about your haemoglobin level and several other things that could be helpful, but the iron panel would probably be enough.


    Low iron and low ferritin are very common in people with hypothyroidism. Usually it is caused by poor gut health, but the MTHFR stuff I posted about a few posts up may be relevant too. But to check if MTHFR is relevant requires DNA testing (something I've never bothered doing myself).

    People with hypothyroidism almost always have low stomach acid and so they don't absorb nutrients very well. I improved my own absorption of iron by going 100% gluten-free - no cheating. I don't have coeliac disease, but it still helped enormously.

  • I forgot to say...

    Iron is tested in several ways by doctors.

    I've had tests of ferritin to determine if I had enough iron.

    I've had serum iron alone tested.

    I've had haemoglobin alone tested.

    I've had a Full Blood Count done (which includes haemoglobin).

    In my (untrained) opinion, people should have a full iron panel done. As extra icing on the cake, a Full Blood Count could be helpful too.

    You might find this interesting - the full version is available too if you are interested :


  • Really fantastic links. Super informative!

  • I will come back on this great info. Just a bit busy but I want to:)

  • Great info. Not only that I keep looking for someone who will concur with me (on the subject in context of a specific iron disorder - that I have) but also I would simply like to add to the complications presented by you as might help someone.

    It is not uncommon worldwide for physicians to prescribe iron supplements whenever they see low HB. When it comes to iron disorders, it is important to make a 'differential diagnosis'.

    A common example of importance of differential diagnosis is:

    B12 deficiency produces larger than normal red blood cells (macrocytic). Iron deficiency causes the blood film to become microcytic and thus produces smaller than normal RBCs. if someone has both then the RBC size might well lie in the normal range. This shows that everything is fine. Therefore, specific testing becomes important to rule out individual underlying conditions. Otherwise both go unnoticed.

    Now, if the blood film is microcytic due to iron deficiency then iron supplementation is reasonable regardless of B12 deficiency. However, if blood film is microcytic due to an 'iron disorder' then iron supplementation may not be of any use. It must, however, be remembered that, just to complicate things further, iron deficiency can still co-exist with an iron disorder and may well need treatment through iron supplementation but must be constantly and closely monitored. It’s easier said than done. Whenever we say something must be regularly checked, who we are talking about? Doctors, who not only don’t know about many blood disorders but also who have no interest in primary investigations let alone in depth investigation and close monitoring. But that's a different issue.

    One of the iron disorders mentioned in your links is 'thalassemia'. I have a thalassemia trait. I am fortunate that I don't have the full blown disease. This makes my fbc abnormal. Many of my figures in an FBC are always out of range but they are not considered dangerous, which is fair enough in a person with this trait. The HB is usually slightly below range e.g. 11 - 12 when range starts at 13. This is OK.

    As described in the chart of ‘iron disorders’, ferritin is ‘increased’ in someone with thalassemia trait. If someone has full or thalassemia major, they have high very high ferritin can easily be above 1000 or even above 2000, I have seen in my family. This happens due to iron not being utilised by the body to make blood. It’s a bone marrow disorder. However, in a minor/ trait only, the fault in the bone marrow is only partial. So, bone marrow does make blood from iron but at a slightly reduced rate. Thalassemia major can only live on blood transfusions which elevates their ferritin exponentially. Someone with a trait, on the other hand, does not need transfusions but iron, if consumed normally (as should be as part of an iron rich diet) then it can push the ferritin levels slightly on the higher end of the range or even slightly above. Therefore, a carrier of thalassemia trait has to be careful with iron supplements BUT many doctors don’t realise this.

    I am a carrier but my ferritin used to be around 60 when tested a couple of times 2 years ago when I fell ill. It is not great but is not very very bad by general standards. But when I raised this with my haematologist, he said its fine.

    My analogy is that being a carrier of thalassemia trait, if my ferritin is not slightly elevated or at least in the upper half then I am either not consuming enough iron through diet or my body is not absorbing enough. And therefore, I have a deficiency despite being a carrier. But no one seems to agree. I insisted and got iron tablets (one a day) 200 mg and I have got it on my record to monitor ferritin every 6 months.

  • That's very interesting, thank you. I haven't come across anyone with thalassemia trait before.

    My own struggles with iron have been life long - on my mother's side of the family all the females and even a couple of the males have struggled with iron deficiency anaemia, or very low iron without being officially anaemic.

    In the last 10 years I have had additional serious problems with iron levels, bleeding, and severe chest pain brought on by very low iron. In the end I had to learn to test and fix and maintain my own iron levels. I'm just glad that I found out such self-help was possible.

  • You are welcome. I am from north of India. This is a common genetic disorder in some north Indian communities. Hardly prevelent in western countries. That's why doctors knowledge is also very limited. Just whatever they read in the book while studying chapter of blood disorders.

    Rule is : If both parents carry the trait, 25 % chance that child born to them will be a thalassemia major. If one is carrier then 50% chance of being a carrier (no chance of major) and if none is carrier then no chance of any.

    Carriers don't usually have problems. I found out about it only when I was 28. Just got tested after my nephew diagnosed with major at age 1 after falling seriously ill. He is now 21 on regular blood transfusions since then. His ferritin is above 2000 despite the fact that he chelates iron from his body at least 4 times a week using a medicine through an infusion pump which is needled into him overnight!!!!

  • Dr Chris Masterjohn Masterclass One of the best for understanding in depth what is happening with Iron or indeed anything he covers


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