Ferritin often hides in plain sight on lab reports. But if I had to pick a favorite lab value—it would be this one. Why? Because ferritin is a multitasker. It’s one of the few lab values that offers insights into both iron metabolism and inflammation—making it a subtle but powerful indicator of what’s going on beneath the surface.
Ferritin 101: More Than Just an Iron Marker
Ferritin is often billed as a marker of iron stores. True! But that’s like saying your dog is just a pet—it’s also a security guard, emotional support system, and leftover vacuum.
Ferritin also acts as an acute phase reactant, meaning it can spike in response to inflammation. That dual personality makes it incredibly useful—and sometimes a little tricky—in clinical practice.
Let’s look at two very different patients whose ferritin levels pointed us in two very different diagnostic directions.
Case One: The 46-Year-Old Woman with Chronic Fatigue
She came to our clinic with all-too-familiar symptoms: relentless fatigue, poor sleep, and periods that could qualify as an endurance event—six days, heavy every month. A CBC was done elsewhere. Her hemoglobin? Normal. Verdict? “You’re fine.”
But at the Kaplan Center, we don’t settle for “fine.”
We dug deeper. Her ferritin was 9. Single digits. Yikes. We aim for ferritin levels above 50 ng/mL for optimal energy, cognitive function, and restorative sleep.
What’s tricky is that her hemoglobin was still normal—because the body was borrowing from its iron reserves to keep the ‘checking account’ looking normal. But her ‘savings account’—her ferritin—was very low. Like someone covering bills with a dwindling emergency fund, she was running on borrowed resilience. Eventually, those reserves dry up—and that’s when symptoms like fatigue, disrupted sleep, and poor stress tolerance start showing up loud and clear.
Her WatchPAT sleep study also showed no sleep apnea, but she had frequent awakenings, poor sleep efficiency, and trouble maintaining deep sleep. While ferritin doesn’t control sleep stages directly, low iron stores are known to impair energy production, dopamine synthesis, and thermoregulation—all of which can contribute to non-restorative sleep.
Iron isn’t just about oxygen transport. It’s about mitochondrial health, dopamine production, and helping your brain power down at night. So if your labs look “normal” but you feel anything but normal, find someone who will look beyond the surface.
He was a healthy athlete until a tick-borne illness and COVID knocked him flat. Now? Crushing fatigue, post-exertional malaise, and brain fog. He had headaches and saw strange visual patterns. His ferritin level came back at 144 ng/mL.
At first, you might think, “Great iron stores!” But not so fast.
In his case, the elevated ferritin was less about iron, more about inflammation. Ferritin is the body’s way of waving a red flag: neuroinflammation ahead. Using the Kaplan Method, alongside specialized testing, we started him on a personalized comprehensive plan to regain his health so he could return to playing pickleball.
High ferritin can reflect inflammatory stress—something we often see in Long COVID, autoimmune conditions, and chronic infections. It’s part of the body’s acute phase response, kind of like sending in the fire trucks whether it’s a campfire or a five-alarm blaze.
Here’s another reason I love ferritin: it has the power to improve a teen’s cognitive function, academic outcomes, and even self-esteem—especially in adolescent girls (who are recently started menstruating). Most pediatricians only check hemoglobin level, not ferritin- so this is missed.
In the U.S., up to 40% of teenage girls have ferritin levels under 25 ng/mL, often missed because standard labs only check hemoglobin. But research shows that even non-anemic girls with low ferritin (≤12 ng/mL) perform significantly worse on tasks involving verbal learning, memory, and attention.
A randomized controlled trial conducted in Washington, D.C., studied non-anemic adolescent girls with ferritin levels ≤12 ng/mL. Over eight weeks, the group receiving iron supplementation experienced significant improvements in verbal learning and memory scores, while the placebo group showed no meaningful change. Ferritin levels in the treatment group rose from an average of 12 to 27 ng/mL, confirming that iron repletion—not just hemoglobin normalization—was key to improved cognitive performance.
At the Kaplan Center, our integrative model looks at not just what’s “in range,” but what’s optimal for function. We recognize that iron plays a key role in neurotransmitter synthesis, oxygen delivery, and mitochondrial function—all crucial for learning and brain development.
That means when we check ferritin in a tired, struggling teen, and supplement appropriately, we’re not just treating fatigue—we’re helping their brain catch up, their confidence grow, and their future open up.
The Kaplan Method™: Why We Ask “What’s Beneath This?”
At the Kaplan Center, we use ferritin as one of many clues in a larger systems-based, root-cause approach. The Kaplan Method™ integrates immunology, neurology, functional medicine, and decades of clinical insight to understand why symptoms are happening—and how to reverse them.
We do advanced testing. We don’t just treat numbers. We look at patterns. We ask: Is ferritin low due to chronic menstrual loss, poor gut absorption, or chronic infection? Is it high because of oxidative stress and cytokine reactivity? Ferritin doesn’t just give us a number—it gives us a direction.
At the Kaplan Center, we don’t stop at “normal.” We pause, rethink, and investigate.
So there it is. Ferritin is my favorite lab value—because it gives us something priceless: insight. And sometimes, it’s the overlooked clue behind a foggy brain, a sleepless night, or that frustrating feeling when a sharp student just can’t seem to focus, no matter how many flashcards they flip. (Do kids even make flashcards anymore? Either way—low ferritin might be why none of it’s sticking.)
Nidhi Reva, is a Physician Assistant and Director of the Kaplan Center’s Long COVID Clinic and recipient of the Arlington, VA 2021 COVID-19 Hero award.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Callie always knew she wanted to be a nurse. She was a natural nurturer—one of those rare people who truly care about the wellbeing of everyone around them. But somewhere along the way, her dream got derailed.
In her late teens, Callie faced a series of challenges: asthma, a car accident, and then a traumatic event. Still, she pushed forward—doing well in school, focused on her goal, determined to become a nurse. But then her body began to break down.
It started with daily headaches, then widespread pain. And then, something no one expected: her first grand mal seizure.
At the time, she was under immense stress—studying for a major exam, moving apartments, and recovering from a viral illness. She was rushed to the emergency room and started on seizure medications. But the seizures didn’t stop.
Multiple hospital visits and neurology consultations followed. Her tests—including EEGs—were normal. Eventually, she was diagnosed with psychogenic non-epileptic seizures (PNES): episodes that mimic seizures but stem from unresolved distress in the nervous system—not from abnormal brain waves. The diagnosis came with a heavy dose of stigma. At one point, someone even told her she was “making them up.”
Nothing could’ve been further from the truth.
Callie hated the seizures. They lasted anywhere from minutes to hours. They were unpredictable, physically exhausting, and emotionally devastating. Tearfully, she told me: “I wish my brain waves were abnormal—at least then I could take a pill and it would stop.”
By the time she came to our office, her parents were emotionally spent. “She’s in therapy, she’s on medications, we’re doing everything we can,” they said. “But this isn’t just in her head.”
Callie echoed their concern: “If my EEG is normal, maybe everyone’s right. Maybe I am crazy.”
But she also said something more important: “I just want to understand what’s happening inside my body. I want my life back.”
Asking the right questions
This isn’t just a story about seizures. It’s a story about what happens when we stop asking “What’s wrong with you?” and start asking “What happened to you?” That’s when we introduced Callie to the Kaplan Method™.
Our approach begins by recognizing that immune system dysfunction often lies at the root of chronic illness. We look beyond symptoms to understand how early life experiences, family stressors, environmental triggers, and nervous system imbalances shape the body’s ability to heal. Our team—including acupuncturists, psychotherapists, physical therapists, and nutritionists—works together to build individualized plans focused on resilience and recovery.
For Callie, it was the first time someone told her that her seizures weren’t imagined—and they weren’t her fault. I wish I could say there was a magic cure. But we started the process together.
And four months later, Callie came to her visit smiling.
Her seizures haven’t completely resolved—but they’re far less frequent. She’s sleeping better. Her energy is returning. She’s even back to working out. Her parents are hopeful again. And most exciting of all?
This fall, Callie is enrolling in her nursing master’s program. Her dream is back within reach. This is what can happen when we believe someone—and treat the whole person. And Callie’s story is just beginning.
I look forward to the day I’ll work alongside her—not just as a patient, but as one of my future colleagues.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Nidhi Reva, is a Physician Assistant and Director of the Kaplan Center’s Long COVID Clinic and recipient of the Arlington, VA 2021 COVID-19 Hero award.
While avoiding contact with ticks is the only way to prevent contracting a tick-borne disease it is not a reason to avoid outdoor activities. Taking steps to protect yourself from being attractive to ticks is one of the first lines of defense.
Wear light-colored long pants, tucked into socks when outside. This makes seeing the ticks easier and prevents them from crawling up your legs.
Stay on clear paths when in the woods.
Change your clothes immediately when you get home and put the clothes you were wearing in the dryer for 30 minutes.
Most importantly, perform daily tick checks!
While ticks are most commonly found in wooded areas, they can breed and thrive around your home landscape as well. Being vigilant about the practices above will make a difference.
What should you do if you find a tick on you?
Save it!! Testing can be done on ticks to see if they are carriers of Lyme and other tick-borne illnesses (co-infections). If you’re not sure exactly how to remove it, this video shows very clearly how to remove a tick the right way.
Once you pull off the tick, place it inside a sealed zip-lock type plastic bag with a damp (not wet) paper towel. Do not soak in bleach, alcohol or preservative. The tick can be even months old and still be appropriate for testing.
Find a tick lab
There are a number of different labs that will perform tick testing. You can send the tick to a lab directly and do not need a doctor’s order. We use TickReport.com. You can place the order on their site by clicking the “Test A Tick” button. Complete the requested information, choose a test package (we recommend the comprehensive package), provide payment, and then send the tick as instructed. The prices range from $50 to $200.00 depending on the number of tests that you would like done. The results from this lab are received within 3 business days via secure email. Once you receive the results, you can share the information with your physician to guide your treatment.
If you have a known tick bite, do not wait for the results to contact your doctor; the sooner you are treated the better. Adjustments in treatment protocols can be changed if needed once you get the results back.
Ferritin: More Than Iron—A Diagnostic Power Tool
/in Inflammation, Kaplan Links/by Nidhi RevaFerritin often hides in plain sight on lab reports. But if I had to pick a favorite lab value—it would be this one. Why? Because ferritin is a multitasker. It’s one of the few lab values that offers insights into both iron metabolism and inflammation—making it a subtle but powerful indicator of what’s going on beneath the surface.
Ferritin 101: More Than Just an Iron Marker
Ferritin is often billed as a marker of iron stores. True! But that’s like saying your dog is just a pet—it’s also a security guard, emotional support system, and leftover vacuum.
Ferritin also acts as an acute phase reactant, meaning it can spike in response to inflammation. That dual personality makes it incredibly useful—and sometimes a little tricky—in clinical practice.
Let’s look at two very different patients whose ferritin levels pointed us in two very different diagnostic directions.
Case One: The 46-Year-Old Woman with Chronic Fatigue
She came to our clinic with all-too-familiar symptoms: relentless fatigue, poor sleep, and periods that could qualify as an endurance event—six days, heavy every month. A CBC was done elsewhere. Her hemoglobin? Normal. Verdict? “You’re fine.”
But at the Kaplan Center, we don’t settle for “fine.”
We dug deeper. Her ferritin was 9. Single digits. Yikes. We aim for ferritin levels above 50 ng/mL for optimal energy, cognitive function, and restorative sleep.
What’s tricky is that her hemoglobin was still normal—because the body was borrowing from its iron reserves to keep the ‘checking account’ looking normal. But her ‘savings account’—her ferritin—was very low. Like someone covering bills with a dwindling emergency fund, she was running on borrowed resilience. Eventually, those reserves dry up—and that’s when symptoms like fatigue, disrupted sleep, and poor stress tolerance start showing up loud and clear.
Her WatchPAT sleep study also showed no sleep apnea, but she had frequent awakenings, poor sleep efficiency, and trouble maintaining deep sleep. While ferritin doesn’t control sleep stages directly, low iron stores are known to impair energy production, dopamine synthesis, and thermoregulation—all of which can contribute to non-restorative sleep.
Iron isn’t just about oxygen transport. It’s about mitochondrial health, dopamine production, and helping your brain power down at night. So if your labs look “normal” but you feel anything but normal, find someone who will look beyond the surface.
Case Two: The 25-Year-Old Man with Long COVID
He was a healthy athlete until a tick-borne illness and COVID knocked him flat. Now? Crushing fatigue, post-exertional malaise, and brain fog. He had headaches and saw strange visual patterns. His ferritin level came back at 144 ng/mL.
At first, you might think, “Great iron stores!” But not so fast.
In his case, the elevated ferritin was less about iron, more about inflammation. Ferritin is the body’s way of waving a red flag: neuroinflammation ahead. Using the Kaplan Method, alongside specialized testing, we started him on a personalized comprehensive plan to regain his health so he could return to playing pickleball.
High ferritin can reflect inflammatory stress—something we often see in Long COVID, autoimmune conditions, and chronic infections. It’s part of the body’s acute phase response, kind of like sending in the fire trucks whether it’s a campfire or a five-alarm blaze.
Questions? Give Us a Call!
703-532-4892 x2
A Word on Teens, Ferritin & Cognitive Performance
Here’s another reason I love ferritin: it has the power to improve a teen’s cognitive function, academic outcomes, and even self-esteem—especially in adolescent girls (who are recently started menstruating). Most pediatricians only check hemoglobin level, not ferritin- so this is missed.
In the U.S., up to 40% of teenage girls have ferritin levels under 25 ng/mL, often missed because standard labs only check hemoglobin. But research shows that even non-anemic girls with low ferritin (≤12 ng/mL) perform significantly worse on tasks involving verbal learning, memory, and attention.
A randomized controlled trial conducted in Washington, D.C., studied non-anemic adolescent girls with ferritin levels ≤12 ng/mL. Over eight weeks, the group receiving iron supplementation experienced significant improvements in verbal learning and memory scores, while the placebo group showed no meaningful change. Ferritin levels in the treatment group rose from an average of 12 to 27 ng/mL, confirming that iron repletion—not just hemoglobin normalization—was key to improved cognitive performance.
At the Kaplan Center, our integrative model looks at not just what’s “in range,” but what’s optimal for function. We recognize that iron plays a key role in neurotransmitter synthesis, oxygen delivery, and mitochondrial function—all crucial for learning and brain development.
That means when we check ferritin in a tired, struggling teen, and supplement appropriately, we’re not just treating fatigue—we’re helping their brain catch up, their confidence grow, and their future open up.
The Kaplan Method™: Why We Ask “What’s Beneath This?”
At the Kaplan Center, we use ferritin as one of many clues in a larger systems-based, root-cause approach. The Kaplan Method™ integrates immunology, neurology, functional medicine, and decades of clinical insight to understand why symptoms are happening—and how to reverse them.
We do advanced testing. We don’t just treat numbers. We look at patterns. We ask: Is ferritin low due to chronic menstrual loss, poor gut absorption, or chronic infection? Is it high because of oxidative stress and cytokine reactivity? Ferritin doesn’t just give us a number—it gives us a direction.
At the Kaplan Center, we don’t stop at “normal.” We pause, rethink, and investigate.
So there it is. Ferritin is my favorite lab value—because it gives us something priceless: insight. And sometimes, it’s the overlooked clue behind a foggy brain, a sleepless night, or that frustrating feeling when a sharp student just can’t seem to focus, no matter how many flashcards they flip. (Do kids even make flashcards anymore? Either way—low ferritin might be why none of it’s sticking.)
Nidhi Reva, is a Physician Assistant and Director of the Kaplan Center’s Long COVID Clinic and recipient of the Arlington, VA 2021 COVID-19 Hero award.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
“Not All in Her Head”: Callie’s Story of Seizures, Strength, and Starting Over
/in Conditions, Kaplan Links/by Nidhi RevaCallie always knew she wanted to be a nurse. She was a natural nurturer—one of those rare people who truly care about the wellbeing of everyone around them. But somewhere along the way, her dream got derailed.
In her late teens, Callie faced a series of challenges: asthma, a car accident, and then a traumatic event. Still, she pushed forward—doing well in school, focused on her goal, determined to become a nurse. But then her body began to break down.
It started with daily headaches, then widespread pain. And then, something no one expected: her first grand mal seizure.
At the time, she was under immense stress—studying for a major exam, moving apartments, and recovering from a viral illness. She was rushed to the emergency room and started on seizure medications. But the seizures didn’t stop.
Multiple hospital visits and neurology consultations followed. Her tests—including EEGs—were normal. Eventually, she was diagnosed with psychogenic non-epileptic seizures (PNES): episodes that mimic seizures but stem from unresolved distress in the nervous system—not from abnormal brain waves. The diagnosis came with a heavy dose of stigma. At one point, someone even told her she was “making them up.”
Nothing could’ve been further from the truth.
Callie hated the seizures. They lasted anywhere from minutes to hours. They were unpredictable, physically exhausting, and emotionally devastating. Tearfully, she told me: “I wish my brain waves were abnormal—at least then I could take a pill and it would stop.”
By the time she came to our office, her parents were emotionally spent. “She’s in therapy, she’s on medications, we’re doing everything we can,” they said. “But this isn’t just in her head.”
Callie echoed their concern: “If my EEG is normal, maybe everyone’s right. Maybe I am crazy.”
But she also said something more important: “I just want to understand what’s happening inside my body. I want my life back.”
Asking the right questions
This isn’t just a story about seizures. It’s a story about what happens when we stop asking “What’s wrong with you?” and start asking “What happened to you?” That’s when we introduced Callie to the Kaplan Method™.
Our approach begins by recognizing that immune system dysfunction often lies at the root of chronic illness. We look beyond symptoms to understand how early life experiences, family stressors, environmental triggers, and nervous system imbalances shape the body’s ability to heal. Our team—including acupuncturists, psychotherapists, physical therapists, and nutritionists—works together to build individualized plans focused on resilience and recovery.
For Callie, it was the first time someone told her that her seizures weren’t imagined—and they weren’t her fault. I wish I could say there was a magic cure. But we started the process together.
And four months later, Callie came to her visit smiling.
Her seizures haven’t completely resolved—but they’re far less frequent. She’s sleeping better. Her energy is returning. She’s even back to working out. Her parents are hopeful again. And most exciting of all?
This fall, Callie is enrolling in her nursing master’s program. Her dream is back within reach. This is what can happen when we believe someone—and treat the whole person. And Callie’s story is just beginning.
I look forward to the day I’ll work alongside her—not just as a patient, but as one of my future colleagues.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Nidhi Reva, is a Physician Assistant and Director of the Kaplan Center’s Long COVID Clinic and recipient of the Arlington, VA 2021 COVID-19 Hero award.
An Important Reminder From Nurse Nan: Save Your Tick
/in Kaplan Links, Wellness/by Nan Kinder, RNWhile avoiding contact with ticks is the only way to prevent contracting a tick-borne disease it is not a reason to avoid outdoor activities. Taking steps to protect yourself from being attractive to ticks is one of the first lines of defense.
While ticks are most commonly found in wooded areas, they can breed and thrive around your home landscape as well. Being vigilant about the practices above will make a difference.
What should you do if you find a tick on you?
Save it!! Testing can be done on ticks to see if they are carriers of Lyme and other tick-borne illnesses (co-infections). If you’re not sure exactly how to remove it, this video shows very clearly how to remove a tick the right way.
Once you pull off the tick, place it inside a sealed zip-lock type plastic bag with a damp (not wet) paper towel. Do not soak in bleach, alcohol or preservative. The tick can be even months old and still be appropriate for testing.
Find a tick lab
There are a number of different labs that will perform tick testing. You can send the tick to a lab directly and do not need a doctor’s order. We use TickReport.com. You can place the order on their site by clicking the “Test A Tick” button. Complete the requested information, choose a test package (we recommend the comprehensive package), provide payment, and then send the tick as instructed. The prices range from $50 to $200.00 depending on the number of tests that you would like done. The results from this lab are received within 3 business days via secure email. Once you receive the results, you can share the information with your physician to guide your treatment.
If you have a known tick bite, do not wait for the results to contact your doctor; the sooner you are treated the better. Adjustments in treatment protocols can be changed if needed once you get the results back.
The importance of testing the tick
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2