Low Ferritin, Normal Iron: What Your Blood Test Might Be Telling You

July 31 2025, by Tatianna Gerard, 18 min reading time

If your recent blood test showed low ferritin but your iron levels are within the normal range, it can be puzzling — even frustrating. At first glance, it may seem like a contradiction: how can you be low in iron storage, but still have enough iron in your blood?

This is actually a fairly common scenario, and understanding the difference between iron and ferritin is key. Ferritin is your body’s way of storing iron for future use, while serum iron measures how much is circulating in your bloodstream at the time of the test. You can have one without the other — and when ferritin is low, it can signal the early stages of iron deficiency, even if your iron level looks fine.

In this article, we’ll explain:

The difference between iron and ferritin
Why your ferritin might be low while your iron appears normal
The symptoms to watch out for
What can cause this imbalance
How to restore healthy iron stores through diet, testing, and treatment options

What’s the difference between iron and ferritin?

Although the terms “iron” and “ferritin” are often used together, they refer to different aspects of how your body handles iron — and understanding the difference can help make sense of your blood test results.

Serum iron

Serum iron refers to the amount of iron currently circulating in your bloodstream at the time of your blood test. This is the iron that your body is actively using to:

Help produce haemoglobin (which carries oxygen in your red blood cells)
Support metabolism, energy production, and immune function
Fuel various cellular processes

But serum iron levels can fluctuate daily, and they can be temporarily affected by things like recent meals, inflammation, infection, or even the time of day your blood was drawn. That’s why a normal iron reading doesn’t always reflect your true iron status.

Ferritin

Ferritin is a protein that stores iron in your body. It’s found mainly in the liver, spleen, muscles, and bone marrow, and a small amount circulates in your blood — which is what’s measured on a blood test.

Think of ferritin as your body’s iron reserve tank. When your body needs more iron — for example, to make new red blood cells or deal with physical stress — it draws from those stored supplies. If ferritin levels are low, it means your iron storage is depleted, even if your serum iron appears normal in the moment.

An easy way to think about it:

Serum iron = cash in your wallet
Ferritin = money in the bank

You might have enough iron “on hand” to get by today, but if your ferritin is low, your body has nothing saved for later. Over time, this can lead to symptoms of iron deficiency — even if your haemoglobin and iron look okay.

Low ferritin with normal serum iron often represents the early stage of iron deficiency — before your circulating iron or red blood cell levels are affected. It’s a signal that your body is dipping into its reserves, and without intervention, full-blown iron deficiency (or iron deficiency anaemia) may follow.

Why would ferritin be low if iron is normal?

It’s a common question: if your serum iron levels are normal, how can your ferritin be low? Shouldn’t they rise and fall together?

Not always.

Ferritin reflects your iron storage, while serum iron reflects the iron currently circulating in your blood. There are several reasons why your body might appear to have enough iron on a blood test, but still be running low on reserves — and most of them come down to how your body is using, losing, or absorbing iron.

1. Early-stage iron deficiency

This is the most common reason for low ferritin with normal serum iron.

In the early stages of iron deficiency, your body starts drawing from stored iron (ferritin) to meet its needs. Your serum iron levels may stay within the normal range — for now — but your reserves are quietly shrinking.

Eventually, if nothing changes, your ferritin will drop even lower, and your serum iron may follow, leading to iron deficiency anaemia.

💡Ferritin is often the first indicator of iron deficiency, even before your iron, haemoglobin, or red blood cell levels are affected.

2. Poor iron absorption

You might be eating enough iron — but that doesn’t mean your body is absorbing it properly. Absorption can be affected by several factors, including:

Low stomach acid
Coeliac disease or gluten sensitivity
Inflammatory bowel conditions (like Crohn’s or ulcerative colitis)
Certain medications (e.g. antacids or proton pump inhibitors)
Gut dysbiosis or SIBO (small intestinal bacterial overgrowth)

When absorption is impaired, your serum iron levels might still look normal immediately after a meal or supplement — but your long-term stores (ferritin) remain low because the iron isn’t making it into your system in sufficient amounts.

3. Ongoing or hidden blood loss

Even small but regular blood loss can deplete your iron stores over time. Common causes include:

Heavy or prolonged menstrual periods
Postpartum recovery
Frequent blood donation
Internal bleeding (e.g. from ulcers, haemorrhoids, or the gastrointestinal tract)

Often, these losses are gradual and go unnoticed — until ferritin levels begin to drop.

4. Increased iron demand

At certain life stages or under specific conditions, your body simply needs more iron than usual. For example:

During pregnancy or breastfeeding
During childhood and adolescence (rapid growth periods)
In people with high athletic or training loads
During recovery from illness, surgery, or injury

If your intake or absorption doesn't keep up with the demand, your body will draw from stored ferritin to bridge the gap.

5. Recent inflammation or illness

Here’s where it gets tricky: serum iron levels can rise temporarily during acute inflammation or infection, giving a false sense of normal.

At the same time, ferritin is a reactive protein — it may either go up slightly in response to inflammation (even if stores are low), or reveal true depletion once the inflammation settles. That’s why iron studies often include C-reactive protein (CRP) to give context around your results.

6. Diet low in absorbable iron

Not all dietary iron is created equal. The body absorbs heme iron (from animal sources like red meat, chicken, and fish) much more efficiently than non-heme iron (from plant foods like spinach or lentils).

Even with an iron-rich diet, if it’s mostly plant-based and not paired properly (e.g. with vitamin C), your iron stores may gradually decline.

Summary: What low ferritin with normal iron might mean

Possible Reason	What’s Happening
Early iron deficiency	Body is using up stored iron, blood levels still appear normal
Poor absorption	Iron from food or supplements isn’t being absorbed properly
Hidden or chronic blood loss	Iron loss exceeds intake, slowly draining reserves
Increased demand	Body needs more iron than usual (growth, pregnancy, exercise)
Recent illness or inflammation	Temporary rise in serum iron, masking true deficiency
Low dietary intake	Not enough absorbable iron in the diet over time

Symptoms of low ferritin

One of the most frustrating things about low ferritin is that you can feel unwell long before your iron or haemoglobin levels fall out of range. That’s because ferritin reflects your iron reserves — and when those reserves are running low, your body may start to struggle, even if your blood iron levels haven’t dropped (yet).

So if your iron is “normal” on your test results, but your ferritin is low and you’re experiencing unexplained symptoms, it’s important to take those signs seriously.

Common symptoms:

1. Fatigue and low energy

This is the most well-known sign. When ferritin is low, your body doesn’t have enough stored iron to produce energy efficiently — which can leave you feeling constantly tired, sluggish, or “wiped out,” even after a full night’s sleep.

2. Brain fog and poor concentration

Iron is vital for proper brain function. Low ferritin can cause mental fatigue, difficulty focusing, and slower thinking. Many people describe it as feeling “foggy” or like they can’t find the right words.

3. Hair thinning or hair loss

Iron supports healthy hair growth. Low ferritin has been linked to increased hair shedding, especially in women, often noticed when washing or brushing hair.

4. Restless legs or muscle cramps

Restless legs syndrome (RLS) and nighttime leg cramps have been associated with low ferritin — particularly when levels drop below 50 ng/mL.

5. Shortness of breath with light activity

Even without anaemia, your muscles may not get enough oxygen if iron stores are low, making simple tasks like climbing stairs or carrying groceries feel harder than usual.

6. Frequent headaches

Iron deficiency can reduce oxygen supply to the brain, sometimes resulting in recurring headaches or migraines.

7. Pale skin or dark circles

Low ferritin may affect circulation and oxygen delivery, leading to a pale complexion or persistent dark under-eye circles.

What should you do if you suspect that you have low ferritin?

Today, there are also at-home ferritin and iron test kits available, which can provide a convenient way to get a snapshot of your iron status — whether you’re checking for a possible deficiency or monitoring existing levels. These finger-prick blood tests are generally easy to use and give you lab-verified results within a few days.

Looking for a test kit to check your ferritin level at home? Check out TouchBio Ferritin / Iron Rapid Test at Aussie Pharma Direct.

That said, self-testing is not a substitute for professional care. If your results show low ferritin — or if you’re experiencing symptoms like fatigue, hair thinning, or brain fog — it’s important to follow up with your doctor.

Low ferritin is treatable, and with the right approach, most people can restore their levels and start feeling better.

Here’s what you should do:

Step 1: Talk to your doctor

Your first step should always be to discuss your results with a healthcare professional. Your doctor will consider:

Your full iron studies (including ferritin, serum iron, transferrin saturation, and TIBC)
Your symptoms
Your medical history, medications, and lifestyle
Any underlying conditions that might affect iron absorption or loss

They may also run additional tests to check for inflammation, gut health issues, or internal bleeding — especially if your ferritin is very low and the cause isn’t obvious.

Step 2: Address the underlying cause

Your doctor may also explore why your ferritin is low in the first place. Some possibilities include:

Heavy menstrual bleeding
Digestive disorders (e.g. coeliac disease, IBS, ulcers)
Frequent blood donation
Pregnancy or recent childbirth
Inflammatory conditions or infections

Addressing the root cause is essential for preventing ferritin from dropping again once your levels are restored.

Step 3: Focus on iron-rich foods

In mild cases, your doctor may recommend improving your dietary iron intake before turning to supplements. This includes:

Heme iron sources: red meat, chicken, turkey, fish, liver
Non-heme iron sources: lentils, beans, tofu, leafy greens, fortified cereals
Pairing iron-rich foods with vitamin C (e.g. citrus, tomatoes, capsicum) can significantly boost absorption
Avoid tea, coffee, and calcium supplements around mealtimes — these can inhibit iron absorption

Step 4: Supplementation (if needed)

If your ferritin is very low — or if diet alone isn’t enough — your doctor may recommend iron supplements. These come in many forms, including:

Ferrous sulfate, ferrous gluconate, or ferrous fumarate
Liquid or capsule forms
Prescription vs over-the-counter options

Always follow your doctor’s guidance when taking iron supplements. Taking the wrong dose or type can lead to side effects like constipation, nausea, or iron overload.

⚠️ Important: Don’t start iron supplements without medical supervision — excess iron can build up in the body and cause harm, especially if misdiagnosed.

How to improve ferritin naturally

There’s plenty you can do to support your iron stores naturally. Restoring ferritin levels can take time, but with the right habits, you can steadily rebuild your iron reserves and support your overall wellbeing.

1. Prioritise iron-rich foods

Start by including more iron-rich foods in your daily diet. These fall into two categories:

Heme iron (easily absorbed)

Found in animal-based foods, this form of iron is absorbed most efficiently:

Red meat (e.g. beef, lamb, kangaroo)
Chicken, turkey
Liver and organ meats
Seafood (especially oysters, sardines, tuna)

Non-heme iron (plant-based)

Plant-based sources contain iron too, but are not as easily absorbed:

Lentils and beans
Tofu and tempeh
Chickpeas
Spinach and silverbeet
Fortified cereals and grains
Nuts and seeds

Eating a mix of both can be helpful, especially for those following a vegetarian or vegan diet.

2. Pair iron with vitamin C

Vitamin C increases iron absorption, particularly from plant-based sources. To get the most from your meals, try pairing iron-rich foods with:

Citrus fruits (orange, lemon, grapefruit)
Berries
Tomatoes
Capsicum
Broccoli

Example: Add lemon juice to sautéed spinach, or eat strawberries with iron-fortified cereal.

3. Avoid inhibitors around mealtime

Some everyday foods and drinks can block iron absorption if consumed at the same time as your iron-rich meals:

Tea and coffee (contain polyphenols)
Calcium supplements or dairy (compete with iron for absorption)
High-fibre bran cereals (contain phytates that reduce absorption)

Aim to space these at least 1–2 hours away from iron-containing meals or supplements.

4. Cook in a cast iron pan

Believe it or not, cooking acidic foods (like tomatoes or vinegar-based dishes) in cast iron cookware can increase the iron content of your food — especially helpful if you're boosting iron naturally.

5. Support gut health

Iron absorption happens mostly in the small intestine, so a healthy digestive tract is key. If you have underlying gut issues like coeliac disease, inflammatory bowel disease, low stomach acid, or SIBO, your body might struggle to absorb iron efficiently.

Eating fermented foods (such as kefir, sauerkraut, kimchi, and yoghurt) can help support a healthy gut microbiome, which plays a role in nutrient absorption — including iron. If you have dietary restrictions, sensitivities, or prefer not to consume fermented foods, you can also consider probiotic supplements to support gut health.

Shop Australian NaturalCare Probiotic 32 Billion at Aussie Pharma Direct.

6. Be mindful of iron losses

Some people have higher iron needs or lose more iron than average. If you:

Have heavy or prolonged menstrual cycles
Are pregnant or breastfeeding
Do endurance training or intense physical activity
Donate blood frequently

…you may need to pay extra attention to maintaining iron levels through diet, regular monitoring, and professional guidance.

Be patient — it takes time

Natural replenishment of ferritin is a gradual process. It can take several weeks to months for levels to rise, depending on how depleted you are and how well your body absorbs iron.

Routine blood tests can help track your progress and guide whether diet alone is enough, or if you may need further intervention.

Final thoughts: Don’t overlook low ferritin — even if you feel fine

If your blood test shows low ferritin but normal iron levels, it’s not something to dismiss. Ferritin plays a vital role in your body’s ability to store and access iron when you need it — and when your reserves are running low, your body starts to feel the effects long before anaemia sets in.

Understanding the difference between iron and ferritin is key to getting the right treatment. While your circulating iron may appear fine today, low ferritin often signals that your body is drawing down its reserves — which can leave you feeling tired, foggy, or run down without a clear explanation.

Whether your low ferritin is due to poor absorption, high demand, dietary gaps, or ongoing blood loss, there are clear steps you can take:

Eat a diet rich in absorbable iron
Support gut health (through food, probiotics, or targeted care)
Monitor symptoms and test regularly
And most importantly, work with your doctor to find and address the root cause

At-home iron and ferritin test kits can be a helpful tool to track your levels over time or screen for deficiency — but they don’t replace professional medical advice. If you’re feeling off, or your test results raise questions, always consult a healthcare provider who can assess the full picture.

The path to restoring ferritin takes time, but with the right guidance and daily habits, it’s absolutely achievable. And once your iron stores are back on track, you’ll feel the difference — more energy, better focus, and overall improved wellbeing.