Q. My serum iron levels are consistently high, but I have symptoms of iron deficiency. Why?

Answered by
Dr. Alexander Davis, Md
and medically reviewed by Dr. Lochana
This is a premium question & answer published on Nov 03, 2020

What could cause high serum iron with very low ferritin? I have been consistently getting my iron levels done every few months and the results are very confusing. I have very low ferritin (12) and have been exhibiting classic signs of iron deficiency and even the sclera of my eyes have a blue hue to them. However, my serum iron levels are consistently high (from 170-190) which causes my saturation percentage to be very high. I am not taking any iron supplements.


Thank you for your message. I read your case very carefully and I’m glad that you contacted us. You definitely have to see an endocrinologist because a high transferrin saturation, especially greater than 50%, causes the creation of non-transferrin-bound-iron (NTBI) which is toxic and creates havoc in certain cell types of your body through oxidation processes. When your transferrin saturation is high you must not take any iron supplements, you would poison yourself. Instead you have to take a test for mutations in your HFE Genes (C282Y, H63D, etc.). Please take that seriously because long periods with high transferrin saturation can cause irrevocable damages to certain tissues, like in the heart, brain, etc. Good luck!

The Probable causes:

Iron metabolism disorder

Investigations to be done:

Genetic testing for ALL possible mutation in the HFE Gene

Differential diagnosis:


Probable diagnosis:

H63D Syndrome (to be tested genetically)

Treatment plan:

Stop taking iron supplements!

Preventive measures:


Regarding follow up:

Any time you want.

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