06/01/2026
I can’t tell you how many times I’ve had women walk into the store with blood work in their hand saying, “My doctor said everything is normal,” and yet they feel absolutely exhausted.
One of the markers I always ask about is ferritin. Not iron. Ferritin.
Most people don’t realize these are two different things.
Iron is the mineral itself. Ferritin is your storage form of iron. Think of ferritin as your savings account. You might still have a little money in your wallet today, but if your savings account is almost empty, sooner or later you’re going to feel it.
I recently saw blood work where ferritin was 13. The lab marked it as normal because it falls inside the laboratory reference range. Technically that’s true. But when I see a ferritin of 13, I’m also asking questions. How is your energy? Are you losing more hair than usual? Are your nails breaking? Do you feel short of breath going upstairs? Do you need coffee just to get through the afternoon? Are you freezing when everyone else is comfortable?
Because numbers on paper only tell part of the story.
One thing I always remind people is that normal and optimal are not necessarily the same thing. Laboratory ranges are designed to identify disease and severe deficiency, not always to tell us where people feel their best. I've seen women with ferritin in the teens who are struggling with hair loss, fatigue, poor recovery, anxiety, dizziness, brain fog, restless legs, and feeling like they're dragging themselves through the day. At the same time, I've seen people with similar numbers who have very few symptoms. That's why I never look at ferritin in isolation. I look at the person sitting in front of me.
As a general guideline, ferritin below 30 ng/mL often deserves a closer look, especially when symptoms are present. Many practitioners who work extensively with hair loss and fatigue like to see ferritin above 50, and sometimes closer to 70-100 depending on the individual situation. There is no single perfect number for everyone, but there is a big difference between barely making it into the laboratory range and having healthy iron reserves available when your body needs them.
One of the biggest mistakes I see is people looking only at their iron level. Iron can appear normal while ferritin is sitting on the floor. That's why someone can be told their blood work looks fine while they feel like they're running on empty.
Low ferritin doesn't happen overnight. Heavy menstrual cycles are one of the most common causes I see in women. Pregnancy can deplete iron stores. Digestive issues can affect absorption. Low stomach acid can make it harder to absorb minerals properly. Certain medications can interfere with iron status. Frequent blood donation, restrictive dieting, intense exercise, and vegetarian or vegan diets can also contribute in some individuals.
This is where the conversation becomes important because not all iron supplements are the same.
For years, many people were told to take basic iron supplements that often caused constipation, nausea, bloating and stomach discomfort. Some people stop taking them because they feel worse on the supplement than they did before. Then they assume their body doesn't tolerate iron.
In reality, sometimes it's the form of iron that's the problem.
This is why I often recommend looking beyond the cheapest iron supplement on the shelf. I generally prefer gentle, highly absorbable forms such as iron bisglycinate because many people tolerate them much better than traditional iron supplements. When appropriate, I also look for formulas that contain supporting nutrients such as vitamin C, methylfolate, vitamin B12, vitamin B6 and copper because the body doesn't simply absorb iron and magically fix everything. It has to absorb it, transport it, utilize it and store it.
The other thing people don't realize is that iron doesn't work alone. Your body needs supporting nutrients to absorb, transport and store iron properly. Looking at ferritin without looking at the bigger picture is like trying to solve a puzzle with half the pieces missing.
Food matters too. Red meat, liver, shellfish, sardines and other iron-rich foods can be helpful for some people. For those following a plant-based diet, paying attention to iron intake and combining iron-rich foods with vitamin C can make a significant difference.
I've also seen people spend months taking iron with very little improvement because nobody investigated why the ferritin became low in the first place. Sometimes the answer is heavy periods. Sometimes it's digestive inflammation. Sometimes it's low stomach acid. Sometimes it's years of chronic stress, restrictive eating or medications that interfere with absorption. If we don't address the reason ferritin became low, it often falls again once supplementation stops.
If you've been told your ferritin is normal but you're dealing with hair loss, fatigue, brain fog, dizziness, poor exercise recovery, shortness of breath, restless legs, heart palpitations, brittle nails or that feeling that you're simply not functioning the way you used to, it may be worth taking a closer look.
I always tell people that blood work should match how you feel. If the numbers say one thing but your body is telling a completely different story, that deserves a conversation.
If you have questions about ferritin, iron, supplements or your blood work, bring it in when you come to the store. I love helping people understand what these markers actually mean, what may be contributing to low ferritin, and what options may be available to support healthy iron stores naturally.
Eugenia
