Did you know that low ferritin is the most common deficiency in women?

Do you feel as though your energy has disappeared, your concentration is no longer what it used to be, and every time you brush your hair, more strands are left behind than you would care to admit? Perhaps you have thought it was simply stress. Age. Motherhood. Working too much. Or simply “life”. But what if your body is simply trying to tell you that it

is lacking something essential?

One of the most common nutritional deficiencies in women is also one of the most overlooked: low ferritin.

In a functional approach, we learn to look beyond the “normal” values on blood tests. Because the body does not wait for a diagnosis of anaemia before it starts to struggle. Long before that, it may already be sending subtle signs that your iron stores are running low. And when we learn to listen to these signals, we can often completely change the way we feel.

What exactly is ferritin?

Imagine that iron is like the fuel that every cell in your body needs to function. Ferritin is the storage tank where that fuel is kept.

Whenever the body needs to produce energy, transport oxygen, strengthen the immune system or produce neurotransmitters responsible for focus, memory and emotional wellbeing, it draws iron from this reserve. When the tank begins to empty, the body continues to function… but no longer in quite the same way.

That is why you may experience deep fatigue, difficulty thinking clearly or persistent hair loss, even when your blood tests do not yet show anaemia.

Low ferritin is often the first warning that iron stores are running out.

The symptoms that so many women mistakenly learn to normalise

There is something I observe repeatedly: many women get used to living tired. They adapt. They convince themselves that it is normal to need coffee to get through the day, feel exhausted by late afternoon or forget words halfway through a conversation. But these symptoms should not be viewed as an inevitable consequence of being a woman.

Low ferritin can manifest through:

• Constant tiredness

• Lack of energy

• Hair loss

• Brittle nails

• Paler skin

• Difficulty concentrating

• A feeling of “mental fog” (brain fog)

• Dizziness

• Shortness of breath during exertion

• A persistent feeling of being cold

• Restless legs at night

• Frequent headaches

None of these symptoms, on their own, confirms an iron deficiency. But when several appear at the same time, it is worth investigating. Because the body rarely speaks only once.

Why do so many women have low ferritin?

The answer often lies in female biology itself. Every month, during menstruation, we lose blood and, with it, iron. If that blood loss is heavy, iron stores can gradually decline over the years without us realising it.

Pregnancy increases iron requirements even further, as the body is now supporting two lives simultaneously. But there are other equally important causes.

A diet low in iron-rich foods, difficulties with intestinal absorption, digestive problems, inflammatory conditions or small amounts of blood loss from the digestive tract can all contribute to a silent deficiency.

We cannot simply ask “what is low?” We should ask above all: “Why has this happened?” Because increasing ferritin without understanding the cause is like filling a bucket that still has a hole in it.

Low ferritin does not necessarily mean anaemia

This is one of the biggest misconceptions. Many people are told that they “do not have anaemia” and automatically conclude that everything is fine.

Not necessarily. Anaemia occurs when haemoglobin has already decreased. Ferritin, on the other hand, shows us how much iron is still stored. It is entirely possible to have almost depleted iron stores, experience all the associated symptoms and still have haemoglobin within the normal range.

That is precisely why looking at just one laboratory marker can mean missing what the body is already trying to communicate.

How to replenish your iron stores

The good news is that, once we identify the underlying cause, recovery is possible. It all starts with food. Meat, fish, shellfish, legumes, dark green leafy vegetables and seeds can all contribute to increasing iron intake. Whenever possible, combine these foods with sources of vitamin C, which significantly enhance iron absorption.

In some situations, however, diet alone is not enough. When a deficiency has been confirmed, supplementation, always guided by a healthcare professional, may be necessary. Not all supplements are the same, and not everyone absorbs iron in the same way. In addition, inappropriate supplementation can cause gastrointestinal side effects or mask problems that need to be addressed.

More importantly than simply increasing the levels is understanding why they have decreased. Is it very heavy menstruation? Is there a digestive issue? Is there intestinal inflammation? Is absorption impaired?

These are the questions that help us find long-lasting solutions.

Is there an “ideal” ferritin level?

Laboratory reference ranges are helpful, but they do not tell the whole story. A result within the reference range does not always mean that the body is functioning optimally. For this reason, ferritin should always be interpreted in the context of clinical history, symptoms, diet, hormonal status and other laboratory markers, such as haemoglobin, transferrin saturation, serum iron and C-reactive protein (CRP), as ferritin can also increase in situations involving inflammation.

In practice, many professionals consider ferritin levels of approximately 50 to 100 ng/mL to be frequently compatible with adequate iron stores for most women, although the ideal range may vary according to age, sex, physiological status (such as pregnancy), the presence of chronic disease and each person's health goals. The aim is not simply to increase a laboratory marker, but to restore iron stores safely and sustainably, allowing the body to regain its ability to produce energy, transport oxygen and function at its best.

Listen to your body before it starts shouting

The body communicates with us long before disease develops. First, it whispers. Then it insists. And only later does it begin to shout through symptoms that we can no longer ignore.

If you live with unexplained fatigue, feel that you have lost your vitality, notice that your hair is becoming thinner or feel that you no longer recognise the energy you had a few years ago, do not automatically accept that “it is normal”. Perhaps it is not. Perhaps it is simply your body asking you to pay attention.