Iron deficiency and ferritin levels

Iron deficiency and ferritin levels

If you’re a Friends fan, you may remember an episode from season 2 where Monica has lost her job, is worried about being unable to pay her rent and decides to ask her parents for a loan. Her dad jumps in before she can pluck up the courage to ask for money, though. He’s convinced Monica will be fine because he assumes she’s followed his oft-repeated advice on money.

‘Ten per cent of your paycheck – where does it go?’ he queries his adult kids.

‘In the bank,’ replies Monica’s big brother, Ross, with great confidence. He’s a cautious man with a good job and is clearly in the habit of saving some money.

‘In the bank…’ echoes a glum Monica, who has clearly never followed this advice. She’s either had lower-paying jobs or has spent most of what she earned. In the end, Ross loans her the money she needs.

What does this have to do with your iron levels? It helps explain the difference between iron and ferritin. 


What’s the difference between iron and ferritin? 

There are two types of iron. There’s the iron in your blood, which is absorbed from the food you eat. This type of iron oxygenates your blood but is used up quickly, much like Monica’s pay. Then there’s ferritin, a type of protein that stores spare iron for use on the days when you don’t get enough from your food. Ferritin is a bit like a healthy savings account – you can use it when needed to keep your iron levels steady.

Blood tests can tell you about your levels of both iron and ferritin. A serum iron test will measure the amount of iron in your bloodstream while a ferritin test will measure the amount of iron stored in your body. Both tests are important when assessing your iron levels.

If you have low iron levels in your bloodstream, your doctor may diagnose iron deficiency anaemia. It is possible, though, to have normal iron levels in your blood but low ferritin levels. This is known as non-anaemic iron deficiency. You’re getting enough iron to meet your immediate needs but there’s nothing left over to store. It’s a bit like having an income that’s only just enough to meet your living costs. You’re OK for now…but there’s nothing to fall back on. 


What is iron and why do you need it?  

Iron is an important mineral that:

  • Produces red blood cells and haemoglobin, which carry oxygen around your body
  • Supports your immune system
  • Provides energy.

You can’t make iron, though. It comes from the food you eat, meaning it’s important to eat an iron-rich diet. Iron requirements vary depending on your age and gender. Women of reproductive age tend to have the highest needs due to monthly blood loss through menstruation or the extra demands of pregnancy and breastfeeding. 


Iron deficiency symptoms

Symptoms of non-anaemic iron deficiency include: 

  • Fatigue
  • Reduced attention, memory and productivity
  • Poor condition of skin, nails or hair (including hair loss)
  • Skin wounds healing more slowly
  • Restless leg syndrome.  

Sometimes, people are told their iron levels are fine based on their serum iron levels. But that’s only one part of the picture. 

Iron supplementation may still be needed if you: 

  • Are otherwise healthy
  • Have symptoms
  • Have low ferritin levels. 

Some people, including those whose iron levels have not improved after 2-3 months of iron supplements, may benefit from an iron infusion


Interpreting your ferritin levels in light of your overall health 

Ferritin levels can be a helpful indication of your iron status if you’re in otherwise good health. 

However, your ferritin levels may be higher than normal if you are elderly or if you have an inflammatory condition, heart failure or chronic kidney disease. In these groups, we use a different definition of ‘normal’ ferritin and a different threshold for diagnosing non-anaemic iron deficiency.  


What should you do? 

  1. Ensure you’re eating an iron-rich diet that supplies enough iron for your gender and life stage
  2. Ask your GP to test your iron levels if you’re showing symptoms of low iron
  3. Enquire about the results of both your serum iron and your ferritin stores
  4. If you have low ferritin, follow your doctor’s advice to raise your iron intake through dietary changes and supplementation
  5. If 2-3 months of improved iron intake does not improve your ferritin stores, ask for a referral to a gastroenterologist, who may conduct further investigations and may recommend an iron infusion. 


What is an iron infusion?

An intravenous (IV) iron infusion involves placing a needle into the vein (usually in your arm or hand) and allowing the intravenous drip solution to infuse into your bloodstream. It may suit you if you can’t tolerate supplements well or need a faster way to restore your iron levels. 


How can we help?

At Moonee Valley Specialist Centre, we have a patient-centred approach to iron infusions and an excellent track record. We have performed over 3,500 iron infusions without staining a patient (staining is an unwanted and sometimes permanent adverse effect from an iron infusion).

Please ask your GP for a referral or contact us today. 



All information is general and is not intended to be a substitute for professional medical advice. Moonee Valley Specialist Centre can consult with you to confirm if a particular treatment or procedure is right for you. Any surgical or invasive procedure carries risks. A second opinion may help you decide if a particular treatment is right for you.

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