Low Ferritin Levels Despite Normal Iron Tests: Possible Explanations
At 39 years old, I have maintained a healthy lifestyle with no smoking, substance abuse, or alcohol consumption. I received a diagnosis of Celiac Disease in June. Additionally, I take 40mg of Omeprazole daily to manage GERD and Barrett's Esophagus. Recently, I had been experiencing intense symptoms of Restless Legs Syndrome (RLS) and significant hair thinning over the past few months. Concerned about these symptoms, I approached my doctor to discuss the possibility of low iron levels, particularly in light of my Celiac condition and the usage of Omeprazole. My physician proceeded to order various tests, which revealed that while my ferritin levels are low, other iron metrics are within normal ranges. What could this indicate? I will provide the test results in the comments below.
Answers (1)
8/9/2025, 5:10:48 PM
OpenHealth AI
Low ferritin levels, even with normal iron tests, can signal several underlying issues: your body may be facing challenges in iron storage or absorption despite an adequate intake or availability of iron. Given your Celiac Disease diagnosis, it is important to understand how this condition impacts your nutrient absorption.
Explanation:
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Ferritin vs. Other Iron Tests: Ferritin is a protein that stores iron in your body, making it a key indicator of iron levels. It's possible for your body's immediate iron supply (like what your tests show) to appear normal, but ferritin can be low due to inadequate storage, especially in malabsorption conditions like Celiac Disease.
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Connection to Celiac Disease: Celiac Disease can lead to inflammation and damage in the intestines, impairing the absorption of various nutrients, including iron. If you've not strictly adhered to a gluten-free diet, gluten consumption may worsen malabsorption.
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Impacts of Omeprazole: Omeprazole works by reducing stomach acid, which might affect the absorption of certain nutrients, including iron. A low stomach acid level can lead to difficulty in absorbing non-heme iron (the type found in plant foods).
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Symptoms You're Experiencing: Your restless legs syndrome (RLS) and hair thinning could indeed be related to low ferritin levels. Low iron stores are known to contribute to RLS and can be linked to hair loss.
Next Steps:
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Review Your Diet: Ensure you are following a strict gluten-free diet. Consider consulting with a dietitian who specializes in Celiac Disease to optimize your diet and ensure you are obtaining enough iron and other vital nutrients.
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Assess Iron Sources: Focus on iron-rich foods, such as lean meats (if you eat them), beans, lentils, spinach, and fortified cereals. Pair these with Vitamin C-rich foods (like citrus fruits) to enhance iron absorption.
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Monitor Ferritin Levels: Keep track of your ferritin levels and related symptoms. If they are not improving, discuss with your doctor the possibility of iron supplementation. Often, higher ferritin levels require ferritin-targeted supplements, as well as monitoring for appropriate dosages to avoid overload.
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Consider Additional Tests: If you haven’t already, it may be worth discussing further testing for nutrient levels (such as vitamin B12 and folate), as deficiencies in these can also cause similar symptoms.
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Manage Stressors: Address lifestyle factors such as sleep and stress, as they can also contribute to symptoms like RLS and hair thinning.
Conclusion:
Managing your ferritin levels and overall nutrient absorption given your health conditions is crucial. Pay attention to your dietary choices and work closely with healthcare professionals to closely monitor and manage your health effectively. If you have additional test results or further questions, feel free to share those for more tailored advice.
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