Iron Panel Test Results - Low Ferritin, High Total Iron

Male or Female? Sorry if you included it. I didn't see it.

Also, you should keep supplementing. It will likely just go back down if you stop. Take with OJ or vitamin C and avoid milk or calcium while you're taking it. You will need to get tested every 6 months or so just to make sure it isn't too high, but you're nowhere near the mark for iron toxicity.

If it persists, I'd also check your vitamin B on the very off chance you have pernicious anemia.

TBH, a doctor visit would help a lot if it hasn't gone up in 3 months.

As a runner, I wouldn't worry about the readings other than the ferritin level.

You can eat a lot of dark leafy greens, but you're going to have to be careful with the rest of your diet in order for the iron to be absorbed. That means increasing certain vitamins in your diet and staying away from high levels of other foods that block that absorption.

The truth is that meat is your best, most efficient bet for iron and increasing those ferritin levels. And supplements, I guess.

I have had similar results in the past. Ferritin/iron was tested years ago, ferritin was low 20s but iron and other marker fine. Retested less than a year later, ferritin slightly better (mid/upper 20s) but iron and some other related markers were very high. Took a while before I ever got tested again and my iron is back to normal levels but ferritin still hanging in the 20s ( I stopped taking iron after the second blood test with the high serum iron).

After some research, I think it is just a more recent picture if your iron consumption and ferritin is more long term. Especially with your iron binding capacity being normal. If you're truly concerned, talk to a doctor, but I think you're generally correct. (male here).

Male, age 31. I tried to give a complete picture but missed that very important point. Any conversation on iron should include male or female.

We normally have females supplement below 30. Males are usually higher than females. If you don't want to continue supplementing, I'd get the full blood draw done and talk to a doc.

I've been testing athletes for close to 20 years now and usually anything below a Ferritin of 50, I have them supplement. There is current research out that states that if you are having absorption issues and you are taking a 65mg elemental iron supplement daily, you may want to switch to every other day to help with absorption.

As the other posters mentioned, you want to take with Vitamin C, Vitamin D and B12, but stay away from caffeine, zinc, magnesium, calcium as those will block the absorption.

I've had good luck with hemoplex pills as they already have Vitamin C and Vitamin B12 built into them. I tell my athletes to take their iron pill in the morning and then any other supplementation, zinc, magnesium etc., in the evening.

If you eat red meat, eat as much as you can and can afford (as its gotten expensive). Cherrios, is a good trick too as they are cheap and fortified with iron. You just want to a take Vitamin C source when eating anything that is a non-heme iron (non-meat).

Hope that helps!

Supplement with red meat (heme iron), not pills (vegan sources, non heme).

Thanks for the feedback all, I will do a little more diligence on ensuring my food provides iron and supplement on days when it might not plus try to have some Vitamin C with the iron. I have been meaning to see a doctor for a routine physical since it has been probably 10 years, I'll get bloodwork again in a few months either way to make sure I don't overdue it. I've been good about making sure I don't have calcium/coffee around my iron rich meals or pills. I am going to cut down on the caffeine some as well.

ferritin 26 seems incredibly low for a ~30M. 29M and my ferritin w/o supplementation is ~100ng/ml (healthy diet of red meat) and w/ ferrous sulfate 1x every 2 days it's ~150 ng/ml.

i would start with supplements every other day, until you go for your physical and you can bring it up then.

Doctor here. If you didnt not confirm you had anemia before starting iron pills, get off them for a few weeks and repeat these labs to see what they are without the iron supplementation.

If you started the iron pills because you confirmed anemia in the past, continue the pills and recheck in a few weeks.

These labs do not clearly say whata going on, so need a trend of labs.

best case (and likely case): low ferritin is just fluctuating

worse case: you sele correct your anemia but its not fully correct, or, you have early onset iron overload (less likely)

Doctor here. If you didnt* confirm you had anemia before starting iron pills, get off them for a few weeks and repeat these labs to see what they are without the iron supplementation.

If you started the iron pills because you confirmed that you had* anemia in the past, continue the pills and recheck in a few weeks.

These labs do not clearly say what is*going on, so need a trend of labs.

best case (and likely case): low ferritin is just fluctuating

worse case: you self* corrected* your anemia but its not fully correct, or, you have early onset iron overload (less likely)

Following up with my initial post so that when people search for ferritin related posts they can see start to finish. I had my second set of blood work done and everything is back in the normal ranges. Ferritin is still a little low for an athlete. I am planning to start back on some supplements 1x ~3 days per week to try to reach 75+ ferritin. I started feeling pretty ill (not stomach) every time I consumed added/processed sugar and I got concerned so I stopped taking anything, thus the A1c test in the last sample. I have a doctors appointment scheduled for end of January, but haven't seen one yet. For anyone who wants to try to calculate how much iron was needed to increase my level I am 150lb, 6'4" and Male.

6/28/2025 Start 4-5 day/week 50mg
8/27/2025 First Blood Work, started to eat more meat in diet
9/1/2025 Start Twice Daily 65mg with VitC
9/22/2025 Start every other day, twice a day 65 mg with VitC
10/12/2025 Paused taking Iron
11/7/2025 Second Blood Work

I ran a bad 1:25:31 half on 9/21/25 and a 18:45 5k on 10/16 (maybe good for 18:15 given the course and a few days after becoming a new dad). Workouts have been trending in the right direction since end of September.

Iron, TIBC and Ferritin Panel 11/7/25
Test - Result (Normal Range and unit)

Ferritin - 43 (38-380 ng/mL)
Total Iron - 109 (50-180 mcg/dL)
% Saturation - 35 (20-48% Transferrin percent saturation)
Iron Binding Capacity - 309 (250-425 mcg/dL)

Complete Blood Count (CBC) - All show as normal 11/7/25
Test - Result (Normal Range and unit)

White Blood Cell Count - 4.2 (3.8-10.8 Thousand/uL)
Red Blood Cell Count - 4.80 (4.2-5.8 Million/uL)
Hemoglobin - 14.4 (13.2-17.1 g/dL)
Hematocrit - 43.3 (38.5-50 %)
Mean RBC Volume - 90.2 (80.0-100.0 fL)
Mean RBC Iron - 30.0 (27.0-33.0 pg)
Mean RBC Iron Concentration - 33.3 (32.0-36.0 g/dL)
RBC Distribution Width - 12.1 (11.0-15.0 %)
Platelets - 222 (140-400 Thousand/uL)
MPV - 11.7 (7.5-12.5 fL)
Absolute Neutrophils -2142 (1500-7800 cells/uL)
Absolute Lymphocytes - 1550 (850-3900 cells/uL)
Absolute Monocytes - 378 (200-950 cells/uL)
Absolute Eosinophils - 71 (15-500 cells/uL)
Absolute Basephils - 59 (0-200 cells/uL)

Hemoglobin A1c - Shown as normal 11/7/25
Test - Result (Normal Range and unit)
Hemoglobin A1c -5.2% (Sub 5.7 %)

At least you are trending in the right direction. I would agree that your ferritin needs to be greater than 50, and your 75 target is best. You say you are eating more meat, but, if you're not including a big, juicy steak at least once per week, I'd add it. The Heme-iron is just so valuable.

Once upon a time, I drove my ferritin all the way down < 15, and my performances really suffered. Eating red meat twice per week and supplementing improved my 10k time like three minutes inside of six months. I was a heavy coffee drinker, and that was the big culprit. So, cutting way back on the coffee, which inhibits absorption, and adding iron to the diet were game changers.