Ferritin
Ferritin reflects iron stores and is one of the most underdiagnosed contributors to fatigue, hair loss, and poor recovery — especially in cycling women and athletes.
What Ferritin measures
Ferritin is the primary intracellular iron-storage protein. Serum ferritin reflects the size of the body's total iron stores and is the most sensitive single marker for iron deficiency and iron overload.
Clinical significance
Iron is required for oxygen transport, mitochondrial energy production, thyroid hormone synthesis, neurotransmitter function, and hair-follicle cycling. Low ferritin drives fatigue, exercise intolerance, hair shedding, restless legs, cold intolerance, and impaired cognitive performance — often long before hemoglobin falls into anemic range. Elevated ferritin can reflect inflammation, metabolic dysfunction, or iron overload.
How oMeds reviews it
Ferritin is an acute-phase reactant — it must be interpreted alongside hs-CRP. Provider-reviewed optimization targets sit well above the lab 'normal' floor because symptomatic iron deficiency commonly occurs at ferritin 15-50 ng/mL despite being flagged in-range. In hormone-optimization pathways, ferritin is re-checked when fatigue, hair, or performance complaints persist after hormones are tuned.
Standard clinical reference intervals
Lab-reported reference ranges from established standards bodies. These are diagnostic thresholds — they do not represent optimization targets.
Source: LabCorp / Quest standard adult reference interval
Source: LabCorp / Quest standard adult reference interval
oMeds optimization targets
Editorial bands that inform provider-reviewed conversations. These are wellness targets, not diagnostic thresholds.
Provider-reviewed wellness consistently targets ≥50 ng/mL in cycling and post-menopausal women where energy, hair, and exercise tolerance resolve. Levels >200 ng/mL warrant inflammation and iron-overload workup.
oMeds optimization ranges are editorial targets that inform conversations with a licensed provider. They are NOT diagnostic thresholds and do not replace lab reference ranges.
In men on testosterone optimization, ferritin is monitored because erythropoiesis can shift iron utilization. Targets >75 ng/mL support energy and recovery; sustained >300 ng/mL prompts inflammation and hemochromatosis screening.
oMeds optimization ranges are editorial targets that inform conversations with a licensed provider. They are NOT diagnostic thresholds and do not replace lab reference ranges.
Ferritin — frequently asked
Is ferritin the same as iron?
No. Serum iron fluctuates hour-to-hour with diet and timing. Ferritin reflects stored iron and is the more stable marker. Both, plus transferrin saturation, are reviewed together when clarifying iron status.
Why is my ferritin 'normal' but I still feel exhausted?
Lab reference floors (as low as 15 ng/mL) were derived from anemia thresholds, not symptom resolution. Provider review commonly identifies symptomatic iron insufficiency in the 15-50 ng/mL band — particularly in cycling women and endurance athletes.
Can ferritin be falsely elevated?
Yes. Ferritin rises with inflammation, infection, liver disease, metabolic dysfunction, and recent alcohol intake. This is why oMeds interprets ferritin alongside hs-CRP rather than in isolation.
Source literature
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