High ferritin is commonly associated with iron overload. But today you’re going to learn about two hidden causes of high ferritin and what to do about them.
My name is Dr. Tom Rofrano, author of the FreeDiet®. I’ve been blessed to have seen over 100,000 patient visits over the last 39 years, many involving thyroid issues—and abnormal ferritin levels are something I see all the time.
This patient was one of them.
Patient Background: High Ferritin After Recent Illness
A 62-year-old man came in feeling exhausted. He had COVID about 10 days earlier, and his lab testing revealed a high ferritin level of 465.
Ferritin is a protein that stores iron in your cells. High ferritin can indicate iron overload—but it can also indicate inflammation, infection, and several other causes.
Normal ferritin ranges:
- Women: 15–150 ng/ml
- Men: up to 400 ng/ml
- Optimal range: 50–80 ng/ml (this can vary, depending on the person)
His ferritin was 465—well above optimal.
Why Ferritin Alone Doesn’t Tell You the Cause
Most doctors will order:
- CBC
- Chemistry panel
- Lipids
- TSH
If you ask for ferritin, they’ll often add it. But ferritin alone does not tell you the cause.
Many patients are told:
“Your ferritin is high—go donate blood.”
But that can be the wrong advice.
To understand what’s really going on, you need a few additional markers.
The Minimum Tests You Need for High Ferritin
In addition to the basic labs, you should also get:
- Serum iron
- Iron saturation
- TIBC
- CRP
- LDH
- GGT
- Insulin
- A1C
- Uric acid
- Free T4
- Free T3
These help determine whether high ferritin is due to:
- Iron overload
- Inflammation
- Infection
- Insulin resistance – metabolic issues
- illness
- Liver dysfunction
- Alcohol overuse
Hidden Cause #1: Inflammation
In this patient’s case, his ferritin was high—but his iron and saturation were low, which is the opposite of iron overload.
He also had low hemoglobin, again the opposite of what you’d expect with too much iron.
His CRP (inflammation marker) was 154. Optimal is less than 1.
Six weeks earlier, his CRP was under 1, and his ferritin, hemoglobin, and iron were all normal.
So what changed?
Hidden Cause #2: Infection
His neutrophil percentage was high, indicating acute infection.
When the body has an infection, it sequesters iron because iron feeds bacteria and viruses. This causes:
- Low serum iron
- Low saturation
- Low hemoglobin
- High ferritin
This is a protective mechanism—not iron overload.
How We Helped Him Recover
To speed up his recovery, I put him on an anti-inflammatory diet and specific supplements.
After One Month
The following returned to normal:
- Ferritin
- Iron
- Percent saturation
- Serum iron
- Hemoglobin
- White blood cells
- Neutrophils
And he was feeling significantly better.
The FreeDiet®: The Foundation of His Recovery
I had him follow the FreeDiet®, a plan I developed years ago while healing my own Hashimoto’s, rheumatoid arthritis, IBS, fatigue, skin issues, and other chronic health problems.
The FreeDiet® is free of:
- Gluten
- Grains
- Sugar
- Yeast
- Dairy
- Eggs
- Soy
- Legumes
- Nightshades
- Processed foods
These are the foods most commonly responsible for inflammation, gut issues, thyroid dysfunction, and chronic health problems.
If you’d like the FreeDiet® Phase 1 food chart, I’ll include a link below and at the end of this post.
Supplements That Supported His Recovery
He took the Functional Five, the foundational nutrients I find most people need:
- Multivitamin
- Fish oil
- Vitamin D with K
- Magnesium
- Probiotic
Plus immune-supportive nutrients:
The Bottom Line: High Ferritin Isn’t Always Iron Overload
If you have high ferritin, don’t assume it’s from too much iron.
Get the proper testing so you can uncover the real cause—whether it’s inflammation, infection, metabolic issues, or something else.
When you identify the root causes and are provided with the right solutions, I believe almost anyone can get better.
Go here if you would like a free copy of the FreeDiet® phase 1 food chart.
