Ferritin is a protein that stores iron in the body, acting as a buffer against both deficiency and overload. Its levels indicate the body’s total iron reserves. This article explores strategies to increase ferritin levels.
Understanding Ferritin and Low Levels
Low ferritin levels mean depleted iron stores. Causes include insufficient dietary iron, compromised absorption (medical conditions), chronic blood loss (e.g., heavy menstrual periods, gastrointestinal bleeding), or increased physiological demands (e.g., pregnancy, rapid growth, intense athletic activity). Unaddressed, depleted iron stores can lead to iron deficiency anemia.
Symptoms of low ferritin and iron deficiency include persistent fatigue, pale skin, weakness, shortness of breath, headaches, dizziness, or cold hands and feet. Less common signs include brittle nails, a sore tongue, or restless legs syndrome.
Dietary Strategies: Iron-Rich Foods
Incorporating iron-rich foods is key to increasing ferritin levels. Dietary iron comes in two forms: heme and non-heme. Heme iron, from animal products, is more readily absorbed.
Excellent heme iron sources include:
Red meat (beef, lamb)
Poultry (chicken, turkey)
Fish
Organ meats (liver, heart, kidney)
Shellfish (clams, oysters, mussels)
The body can absorb up to 40% of consumed heme iron.
Non-heme iron is found in plant-based foods, but is less efficiently absorbed than heme iron. Sources include lentils, beans, legumes, dark green leafy vegetables (spinach, kale), fortified cereals, tofu, nuts, and seeds. Absorption rates for non-heme iron range from 2% to 17%.
Optimizing Iron Absorption
Beyond consuming iron-rich foods, enhancing iron absorption is also important. Vitamin C plays a key role in improving non-heme iron absorption.
Vitamin C-rich foods include citrus fruits, bell peppers, broccoli, and strawberries. Combining these with non-heme iron sources, like adding bell peppers to lentils or drinking orange juice with fortified cereal, boosts iron uptake. Cooking in cast iron cookware also increases food’s iron content.
Conversely, certain substances hinder iron absorption. Phytates, in whole grains, legumes, and nuts, reduce iron absorption. Tannins and polyphenols, found in tea, coffee, and some fruits/spices, also inhibit absorption. Calcium, in dairy products and supplements, interferes with both heme and non-heme iron absorption.
To mitigate these inhibitory effects, consume foods or beverages high in phytates, tannins, or calcium separately from iron-rich meals. For example, avoid tea, coffee, or calcium supplements within an hour of iron-rich meals. Soaking, sprouting, or fermenting grains and legumes also reduces phytate content, improving iron availability.
Iron Supplementation Guidelines
Iron supplementation is often needed when dietary changes alone are insufficient to raise ferritin levels. However, supplements should only be taken under healthcare professional guidance after a diagnosis of low ferritin or iron deficiency. This ensures appropriate dosing and minimizes risks.
Common oral iron supplements include ferrous sulfate, ferrous gluconate, and ferrous fumarate. Ferrous sulfate is often recommended due to its elemental iron content. The amount of elemental iron varies among these forms.
Supplements are often taken on an empty stomach for optimal absorption. If stomach upset occurs, taking with food helps. Adhere strictly to dosage instructions. Potential side effects include constipation, nausea, and dark stools. Manage side effects by adjusting dose, taking with food, or trying a different iron type.
Increasing ferritin levels through supplementation requires consistent intake. Energy improvements may be noticed within weeks, but it typically takes 3 to 6 months of consistent supplementation to replenish iron stores. Individuals with severe deficiency or ongoing iron loss may require longer treatment.
Medical Supervision and Monitoring
Consulting a healthcare professional is essential for the diagnosis, treatment, and management of low ferritin levels. A doctor diagnoses iron deficiency through blood tests, including:
Complete blood count
Hemoglobin levels
Iron studies (serum iron, total iron-binding capacity (TIBC), transferrin saturation, and ferritin levels)
Ferritin is the diagnostic test of choice for assessing iron stores.
A healthcare provider identifies underlying causes of low ferritin, such as dietary deficiencies, chronic blood loss, or malabsorption issues. Based on this, they develop a personalized treatment plan involving dietary adjustments, iron supplementation, or addressing contributing medical conditions.
Regular follow-up blood tests are important to monitor ferritin levels and adjust the treatment plan. This monitoring ensures iron stores are replenished and treatment progresses safely. Self-diagnosing or self-treating with iron supplements carries risks, as excessive iron can lead to toxicity or overload, which is harmful.