Most dermatologists recommend ferritin above 70 ng/mL for hair density recovery, yet the average American woman has ferritin of only 35 ng/mL. This gap between what your lab report calls "normal" and what your hair actually needs is one of the most common reasons women experience diffuse shedding that goes undiagnosed for months or years. Tracking your ferritin alongside your density data reveals the connection and documents the recovery.
Why Ferritin Matters More Than Hemoglobin for Hair
Iron serves multiple functions in the body, and the body prioritizes them in a specific order. When iron stores drop, the body pulls iron first from non-essential functions (including hair follicle cell division) to protect essential functions (like red blood cell production).
This means your hair starts suffering long before your hemoglobin drops. A woman with ferritin of 25 ng/mL and normal hemoglobin of 13 g/dL will have a normal CBC (complete blood count), and her doctor may tell her she is "fine." But her hair follicles are already iron-starved.
The Ferritin Spectrum and Hair
| Ferritin Level (ng/mL) | Lab Status | Hair Impact |
|---|---|---|
| Below 12 | Iron deficiency anemia | Significant diffuse shedding, brittle hair |
| 12-30 | "Normal" on most lab reports | Active shedding, slowed growth rate |
| 30-50 | Normal range | Suboptimal hair growth, may shed if other stressors present |
| 50-70 | Normal range | Approaching hair-optimal, gradual improvement |
| 70-100 | Optimal for hair | Sufficient for hair follicle cell division |
| Above 100 | Upper normal | No additional hair benefit above this level |
The critical insight: you can be "normal" on paper and still have iron-depleted hair follicles. Tracking density alongside ferritin levels is the only way to identify and prove this connection for your specific situation.
Who Is At Risk for Low Ferritin
Several groups are particularly susceptible:
- Menstruating women: Monthly blood loss depletes iron. Heavy periods (menorrhagia) are the most common cause of low ferritin in premenopausal women.
- Vegetarians and vegans: Non-heme iron from plants is absorbed at 2-20% efficiency vs. 15-35% for heme iron from meat.
- Endurance athletes: "Foot strike hemolysis" and sweat losses can deplete iron.
- Pregnant and postpartum women: Fetal iron demand and blood loss during delivery deplete stores.
- Women with celiac disease or IBD: Malabsorption reduces iron uptake regardless of dietary intake.
- Frequent blood donors: Each donation removes approximately 250mg of iron.
Setting Up Your Ferritin-Hair Tracking Protocol
Step 1: Get a Complete Iron Panel
A ferritin test alone is useful but incomplete. Request the full panel:
- Ferritin: Your iron storage protein (the primary marker for hair)
- Serum iron: Circulating iron in your blood
- TIBC (Total Iron Binding Capacity): Measures how much transferrin is available to bind iron. Elevated TIBC suggests iron deficiency.
- Transferrin saturation: Serum iron / TIBC. Below 20% suggests functional iron deficiency.
- Hemoglobin and hematocrit: To assess whether you have progressed to anemia
- CRP or ESR: Ferritin is an acute phase reactant that rises with inflammation. If CRP is elevated, your ferritin may be falsely normal.
Step 2: Pair Your Baseline Labs With a Density Session
Within the same week as your blood draw, complete a full density tracking session:
- Photos from 5 angles (frontal, temples, crown, part line)
- AI density analysis at myhairline.ai
- Log your current shedding level (1-5 scale or daily hair count)
- Note hair texture (dry, brittle, or normal)
Step 3: Begin Iron Supplementation (Under Medical Guidance)
Common supplementation protocols include:
- Ferrous sulfate 325mg (65mg elemental iron): Most commonly prescribed, taken every other day for better absorption
- Ferrous bisglycinate 25-50mg: Better tolerated with fewer GI side effects
- Iron polysaccharide complex: Good tolerance, moderate absorption
- IV iron infusion: For severe deficiency (ferritin below 15) or when oral supplements are not tolerated
Absorption tips:
- Take with 250mg vitamin C to increase absorption by 2-3x
- Take on an empty stomach (or 2 hours after meals)
- Avoid taking with calcium, dairy, tea, coffee, or antacids (all inhibit absorption)
- Every-other-day dosing may provide better absorption than daily dosing due to hepcidin regulation
Step 4: Track Ferritin Every 8-12 Weeks During Repletion
Iron stores rebuild slowly. Even with aggressive supplementation, ferritin typically increases by 10-20 ng/mL per month in the absence of ongoing losses.
At each lab draw, also complete a density tracking session. Your paired timeline might look like:
| Week | Ferritin (ng/mL) | Density Score | Shedding Level | Notes |
|---|---|---|---|---|
| 0 (Baseline) | 18 | Baseline | 4/5 | Starting ferrous bisglycinate 50mg EOD |
| 8 | 32 | -2% | 3/5 | Shedding decreasing |
| 16 | 48 | +1% | 2/5 | New vellus hairs visible at part line |
| 24 | 65 | +5% | 1/5 | Approaching target |
| 32 | 78 | +9% | 1/5 | Target reached |
Step 5: Maintenance After Reaching Target
Once ferritin is above 70 ng/mL, your focus shifts to maintaining that level. Most women need ongoing low-dose supplementation (25-50mg elemental iron, 3-4 times per week) to prevent levels from dropping again, especially if they menstruate.
Check ferritin every 3-6 months during maintenance. If levels drop below 50, increase supplementation before hair shedding recurs.
When Ferritin Optimization Is Not Enough
If ferritin has been above 70 ng/mL for 6+ months and density has not fully recovered, investigate additional causes:
- Thyroid dysfunction: Hypothyroidism and iron deficiency frequently coexist. Both need to be optimized for hair recovery.
- Vitamin D deficiency: Often concurrent with iron deficiency, especially in women with limited sun exposure or malabsorption conditions.
- Androgenetic alopecia: Iron optimization addresses the diffuse telogen effluvium component but not genetic pattern loss.
- Zinc deficiency: Zinc and iron compete for absorption. Supplementing one without the other can unmask a secondary deficiency.
Your tracking data distinguishes these scenarios. Diffuse shedding that resolves with ferritin optimization looks different on your timeline than patterned loss that persists despite adequate iron stores.
Start Tracking Your Iron-Hair Connection
Iron-related hair loss is fully reversible when properly identified and treated. Upload your photos to myhairline.ai/analyze to establish your density baseline, then pair it with your ferritin levels to build the evidence that connects your lab values to your hair outcomes.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Iron supplementation should be guided by blood work and supervised by a healthcare provider. Excess iron can be harmful, especially in individuals with hemochromatosis. Always test before supplementing. Individual results vary.