Ferritin

So baritone level.

Ferritin is a measure of your iron.

You may have enough to maintain healthy red blood cells, but not to maintain your hair.

And a lot of perimenopausal women are also enjoying vicious menstrual cycles and their iron levels are depleted and their ferritin is depleted.

All of that heat training we're doing or VO2 max workouts or tempo runs, guess what? it's not going to make up for not having enough iron to fuel the hemoglobin in red blood cells to get the oxygen to our working muscles.

Ferritin is another key player in iron deficiency.

Ferritin is a transport protein that binds to iron and releases it in the body when it is needed.

It keeps iron from traveling in the body as a free radical.

Make note of ferritin as this is a key player in understanding both anemia and iron deficiency.

Okay, that's your number for ferritin.

Great.

Ferritin, by the way, everybody, your ferritin should be a minimum of 50.

Ferritin on your blood work looks at your stored iron, essentially, iron stores.

Should be at least 50.

In our practice, we always want it 75 to 150.

So 21 is very low.

How long after supplementing could I retest bloods to see any improvements? I know it's not about one marker only.

And one of the huge culprits can be iron deficiency.

The problem is that nobody checked a really important lab, which is your ferritin.

Ferritin is an extremely important blood level to check because that is literally the definition of iron deficiency.

So one important distinction is iron deficiency is not the same as iron deficiency anemia.

So what is anemia? Anemia is basically when you don't have enough red blood cells.

But iron deficiency can exist long before someone develops overt anemia.

Ferritin, which reflects iron storage, may become depleted first.

And some patients may experience symptoms even when standard blood counts still appear technically quote-unquote normal.

So this issue may not be at all clear really from the outset.

which is why thoughtful interpretation matters so much.

So we have to consider, and that's part of my job as an integrative endocrinologist, we have to consider a person's symptoms for actual iron saturation, meaning the cells that have iron or want iron, receptors for iron have it.

Ferritin, that storage form of iron.

We have to look at overall inflammation.

It's my job to figure that out, but it is telling me that there's inflammation there.

Ferritin, which we have a whole episode on, can also be a marker of inflammation.

Most people know it as our iron storage marker, and that's true, but it's also an acute phase reactant, so ferritin can rise during inflammation completely independent of iron stores.

And so a really high ferritin of a two fifty, for example, is very different in someone with hereditary hemochromatosis causing that or someone with maybe rheumatoid arthritis or someone recovering from a viral illness.

should probably.

But, so, I can confidently tell you that, apparently, because I had so many people message me, same thing, like, it's very common for ferritin to be low in women because we lose so much blood.

Ferritin Don't quote me on this, but I believe it is your iron stores in your body.

So you've got iron available to you.

So you get tested for iron as well.

It gives us the size of your red cells, the MCV.

which runs smaller in iron deficiency and it's a good test but it is not a test of your iron stores the test of your iron stores is called a ferritin ferritin is like your savings account it falls first long before the hemoglobin number even barely flinches and for pregnancy ACOG uses a ferritin under 30 as iron deficiency in any trimester a deliberately generous threshold really because they'd rather catch you early the who the world health organization says under 15 is anemia so depending on whose number your lab prints the same result can come back either flagged or not flagged which is exactly the kind of thing you'd never know unless somebody told you so two honest complications first Ferritin is what we call an acute phase reactant.

It goes up with inflammation and with infection.

So if you have a raging cold or an autoimmune flare the week of your blood draw, a falsely reassuring ferritin is possible.

The answer I have here it says, "It's because iron doesn't just build hemoglobin.

It's stored as ferritin and used directly inside the muscle cell for oxidative en- enzymes.

Ferritin depletes first, hemoglobin drops last.

So a runner can be running on fumes at the cellular level, struggling through quality sessions, recovering slower, feeling flat for weeks or months before a standard hemoglobin test would even flag them as anemic." Yes? No?

Ish.

It's, it's a little bit of probably truth with a little bit of, like, mayonnaise from the, uh, from the AI.

Um, some of that is true.

Ferritin's an interesting thing, and it's like, it's, it's a little bit technical and, uh, can be a little bit hard to understand.