Low ferritin: when should you worry and what should you do?

What is ferritin?

Ferritin: a protein that stores iron

Ferritin is a protein that is essential for the body to function properly.

It is responsible for storing iron and releasing it according to physiological needs.

It is found mainly in the liver, spleen, bone marrow and muscles, where it constitutes a strategic reserve of iron, a mineral essential for many biological processes, including oxygen transport and energy metabolism.

Ferritin levels

Ferritin levels are generally measured by a blood test.

It varies according to the person's age and sex.

In general, ‘normal’ levels are defined as between 20 and 400 ng/mL of blood in women, and between 30 and 400 ng/mL in men (1).

Hyperferritinaemia (high ferritin) may indicate iron overload or other pathologies: chronic inflammation, liver disease, metabolic syndrome, cancer, etc.

Hypoferritinaemia (low ferritin), on the other hand, may indicate an iron deficiency in the body's reserves (2). Hypoferritinaemia does not usually result from a defect in ferritin production, but rather a reduction in the body's iron reserves available for storage, which in turn leads to a drop in ferritin levels.

Low ferritin: symptoms, causes & solutions

Diagnosis and symptoms of hypoferritinaemia

Hypoferritinaemia is diagnosed when a blood test reveals a ferritin level of less than 20 to 30 ng/mL of blood.

This condition is often initially silent, but over time it leads to symptoms typical of iron deficiency (3):

• persistent fatigue
• pale complexion
• shortness of breath on exertion
• reduced concentration
• headaches
• hair loss and brittle hair

When hypoferritinaemia has been present for some time or worsens, it can develop into iron deficiency anaemia.

This is a form of anaemia caused by a lack of iron and characterised by a drop in haemoglobin levels in the blood.

Haemoglobin is a protein found in red blood cells, responsible for transporting oxygen from the lungs to the body's tissues. The iron it contains enables it to bind oxygen.

People at risk of low ferritin and common causes of this problem

Low ferritin can have several causes, generally linked to insufficient iron intake, excessive iron loss or poor iron absorption.

Some people are therefore more prone to hypoferritinaemia than others:

• women with heavy periods or haemorrhagic bleeding
• pregnant women, whose pregnancy tends to increase their iron requirements
• endurance athletes
• the elderly
• children and adolescents during their growth period
• people on a diet low in iron (unbalanced vegetarian or vegan diet, for example)
• patients suffering from certain chronic digestive disorders that impair iron absorption (coeliac disease, Crohn's disease, etc.)
• people who have undergone digestive surgery that may have altered their ability to absorb iron (gastric bypass, small intestine resection, etc.)
• people who have suffered haemorrhage or unidentified internal blood loss (digestive bleeding, for example)
• people who donate blood frequently

Solutions for correcting a ferritin deficiency

Make the right diagnosis

To correct low ferritin, it is essential to look for the underlying cause, in order to provide an appropriate response.

If the cause is a pathology or hidden haemorrhage, only your doctor will be able to advise you on the appropriate treatment.

On the other hand, if inadequate iron intake is to blame, one of the first steps to take is generally to increase dietary intake.

The best food sources of iron

Iron-rich foods can be of plant or animal origin.

However, meat is a source of haem iron, which is better absorbed by the human body (4): poultry or veal liver, black pudding, beef or lamb, sardines, mackerel, seafood, etc.

On the plant side, you can opt for legumes (lentils, kidney beans, etc.), tofu, spinach, pumpkin seeds or wholegrain cereals (quinoa, oat flakes, etc.), which contain non-haem iron.

To improve absorption of non-haem iron, ideally eat it with a source of vitamin C (orange juice, kiwi fruit, peppers, etc.) and avoid drinking tea or coffee immediately after a meal.

If eating iron-rich foods is not enough, or if you need more iron, you may consider taking iron-based food supplements, subject to medical approval.

Iron supplementation in cases of low ferritin

Iron supplements: only in cases of proven deficiency

Before taking an iron supplement, however, the deficiency must be clearly diagnosed by a doctor following a blood test.

Excess iron in the body can be a source of health problems if it lasts or is particularly high (oxidative stress, liver overload, etc.).

The most absorbable form of iron

Not all iron supplements are created equal.

Some forms of iron are better absorbed during digestion and therefore offer better bioavailability.

This is particularly true of iron bisglycinate (5), a chelated form that is gentle on the digestive system and has good bioavailability.

It is often better tolerated than ferrous sulphate, iron citrate or iron D-gluconate, which are known to cause numerous side effects.

Discover the Iron Bisglycinate iron supplement, which contains a form of iron that is both well tolerated and well assimilated, ideal for correcting a deficiency gently and without side effects.