The thresholds
These come from the WHO guideline on the use of ferritin concentrations to assess iron status in individuals and populations, published 21 April 2020. Every value below is WHO's own, with the strength of recommendation the guideline development group attached to it.
| Situation | Threshold | What it indicates |
|---|---|---|
| Apparently healthy adults | Below 15 | Iron deficiency (strong recommendation) |
| Adults with infection or inflammation | Below 70 | May indicate iron deficiency (conditional recommendation) |
| Menstruating women, otherwise healthy | Above 150 | May indicate risk of iron overload (conditional) |
| Men and non-menstruating women, otherwise healthy | Above 200 | May indicate risk of iron overload (conditional) |
| Adults who are not otherwise healthy | Above 500 | May indicate risk of iron overload or other disease (conditional) |
WHO applies the same adult figures to people aged 20 to 59 and to those 60 and over. Unlike eGFR or TSH, this is not a marker whose thresholds move with age.
Why there are two deficiency thresholds
Ferritin is an acute-phase reactant. When you have an infection, an inflammatory condition, or any of a long list of ordinary illnesses, ferritin rises for reasons that have nothing to do with your iron stores. A person who is genuinely iron deficient and also inflamed can therefore produce a ferritin that looks unremarkable.
WHO's response is Recommendation 1.2: "In individuals with infection or inflammation, a ferritin concentration below 30 µg/L in children and 70 µg/L in adults may be used to indicate iron deficiency." The guideline notes that an alternative approach exists for populations, applying correction factors to ferritin values based on measured inflammation markers. For an individual reading their own result, the practical version is the raised threshold.
A high ferritin is not a diagnosis of iron overload
WHO is unusually direct here, and it is a strong recommendation: "Ferritin concentration should not be used alone to identify risk of iron overload. Patients with elevated ferritin levels should receive clinical and laboratory evaluation to establish the underlying cause."
The same property that hides deficiency also creates false alarm in the other direction. Because ferritin rises with inflammation, liver disease, heavy alcohol use, infection and a range of other conditions, a raised result far more often reflects one of those than it reflects accumulated iron. The 500 µg/L threshold for people who are not otherwise healthy is described by WHO as carrying very low certainty of evidence, which is worth knowing before treating any single number as decisive.
Our ferritin reference page lists each threshold with its source and effective date, and the lab result lookup will place a specific number against them.
Frequently asked questions
What is a normal ferritin level?
WHO defines iron deficiency in apparently healthy adults as a ferritin below 15 µg/L, and in adults with infection or inflammation as below 70 µg/L. On the upper side, above 150 µg/L in menstruating women and above 200 µg/L in men and non-menstruating women may indicate risk of iron overload. Laboratory reference intervals are usually wider than these.
Can I be iron deficient with a normal ferritin?
Yes, and this is the main reason ferritin is misread. Ferritin is an acute-phase reactant, so infection and inflammation raise it independently of iron stores. WHO therefore raises the deficiency threshold to 70 µg/L in adults with infection or inflammation, well above the 15 µg/L used in otherwise healthy people.
Does the normal ferritin range change with age?
Not in the WHO guideline. It gives the same adult cut-offs for people aged 20 to 59 and for those 60 and over: below 15 µg/L for deficiency in healthy individuals, below 70 with inflammation, and the same overload thresholds.
Is high ferritin dangerous?
A high ferritin is a reason to investigate rather than a diagnosis. WHO states as a strong recommendation that ferritin should not be used alone to identify risk of iron overload, and that an elevated result should prompt clinical and laboratory evaluation to establish the underlying cause. Inflammation, liver disease and alcohol use all raise ferritin.
What ferritin level means iron overload?
WHO gives above 150 µg/L in menstruating women and above 200 µg/L in men and non-menstruating women who are otherwise healthy, and above 500 µg/L in adults who are not otherwise healthy. All of these are conditional recommendations, and the 500 µg/L figure is graded very low certainty of evidence.
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When to talk with a clinician
Bring ferritin up together with a full blood count and, if deficiency is the question, an inflammation marker such as CRP, since that is what decides which WHO threshold applies to you. A high ferritin warrants the work-up WHO describes rather than a conclusion. Do not start iron supplementation on a ferritin result alone.
