Iron/Ferritin

Iron/Ferritin ratio detects inflammation-masked iron deficiency that ferritin alone would miss. Low serum iron combined with disproportionately high ferritin reveals iron sequestration; high iron with low ferritin may indicate hemochromatosis or depleted stores.

Low ratio (sequestration): hemochromatosis, anaemia of chronic inflammation, liver disease, repeated transfusions. High ratio (depletion): iron-deficiency anaemia, poor dietary iron intake, menstrual loss, malabsorption.

Deficiency: fatigue, pallor, shortness of breath, cold extremities, brittle nails, hair loss, restless legs, impaired cognition. Overload: joint pain, hepatomegaly, bronze skin, arrhythmias, diabetes.

Iron-rich foods: red meat (heme iron), dark leafy greens, legumes, fortified cereals. Vitamin C with non-heme iron enhances absorption up to threefold.

Calcium, tannins (tea, coffee), and phytates inhibit non-heme iron absorption — avoid alongside iron-rich meals. Excess iron supplementation drives oxidative stress.