Your research-based read
Your iron stores are running low.
Hemoglobin is still in the normal range, so this isn't anemia yet.
There's nothing to read yet. Head back to step 1 to enter your age, life stage, and at least one lab value.
Start from step 1What we'd suggest instead
Two practical paths forward
- Talk to a clinician who works with trans patients. Iron thresholds for adults on long-term testosterone sit between cis-male and cis-female reference ranges (Wiser 2024), and a clinician familiar with GAHT-specific physiology can interpret your labs against the right baseline.
- Keep your labs — they're still useful. Ferritin, CBC, and iron panel values don't lose meaning. They just need a different reference framework than this tool provides.
- Pattern
- Iron depletion without anemia (Stage 3 — iron-deficient erythropoiesis). Ferritin below threshold, hemoglobin still within range, red cell indices consistent with early iron constraint on erythropoiesis.
- Confidence
- High. Ferritin threshold rests on High quality evidence; supporting markers (TSAT, MCV, RDW) consistent with pattern rather than pointing elsewhere.
- Evidence strength
- Ferritin threshold — High quality. Hemoglobin threshold — Consensus. Symptom associations — mixed, see below.
- Severity tier
- Routine follow-up. Not urgent. Worth raising at your next clinical appointment rather than a same-week visit.
- Next steps
- Bring full iron panel, evaluate underlying causes (menstrual loss, absorption, dietary intake), schedule retest in 3–6 months. Question prompt list below and in your PDF.
Overview
What your labs are telling us
Your ferritin came back at 22 μg/L. For non-pregnant premenopausal women, the research-based threshold for this pattern is < 25 μg/L. The evidence for this threshold is High quality — a large multinational analysis pooling data from women in twelve countries found this threshold holds up consistently, regardless of population or geography.
Your body's iron storage protein is below the level at which iron supply to the bone marrow starts getting constrained. Red blood cell production is still happening, but it's working with less raw material. Hemoglobin often stays within the reference range for months or years at this stage before dropping low enough to flag as anemia. That's why this stage gets missed so often — a standard CBC looks normal.
Per-lab data
Every value, compared to the research
Visual summary — where your two most important values fall
Your value shown as a crimson drop. Segments shaded by severity. Hover any segment to see its label. The table below lists each value you entered alongside the research thresholds we compared it against.
| Marker | Your value | Units | Reference range | Stage threshold | Interpretation | Evidence |
|---|---|---|---|---|---|---|
| Ferritin | 22 | μg/L | 15–150 | < 25 (Stage 3) | Below the threshold where the research documents iron running short for red cell production. Primary driver of the pattern classification. | High quality |
| Hemoglobin | 124 | g/L | 120–155 | < 120 (anemia) | Within the normal range — you are not anemic. Anemia typically develops later in the iron-deficiency progression. | Consensus |
| MCV | 79 | fL | 80–100 | ≤ 82 low-normal | Just below normal. Cells slightly smaller than average — an early morphologic signal of iron constraint. | High quality |
| RDW | 15.2 | % | 11.5–14.5 | ≥ 14.5 elevated | Elevated. Suggests some cells were made under iron constraint while others weren't — a common finding in Stage 3. | Preliminary |
| TSAT | 19 | % | 20–50 | < 20 low | Low. Iron delivery to tissues is reduced. Consistent with the ferritin finding. Points toward nutritional or absorptive cause rather than inflammation. | High quality |
| CRP | — | mg/L | < 5 | ≥ 5 flags inflammation | Not provided. You reported no recent illness, so we're treating ferritin at face value. Adding CRP would strengthen confidence. | Consensus |
Hover any evidence badge to see its citation · hover any severity dot for its label · table rows reflect the values you entered in Step 2. On narrow screens, scroll the table horizontally to see all columns.
Symptom integration
What you told us you're feeling
You reported fatigue and hair shedding. The research documents associations between each of these and ferritin below 30 μg/L.
Confidence
How confident we are in this read
We're confident in this pattern. The ferritin threshold is based on High quality evidence — replicated across multiple countries and validated against bone-marrow iron (the gold-standard test). The other values you entered are consistent with this pattern rather than pointing somewhere else.
Next steps
What to bring to your clinician
Your clinician is the right person to evaluate this pattern for you. We're not diagnosing or recommending treatment — our job is to translate what the research says about values like yours so you can walk into a clinical conversation prepared.
Question prompt list
-
Can we add a full iron panel?
Ferritin is the most informative single marker, but TSAT + serum iron + TIBC together tell a fuller story.
Keep learning
Other possible reads
Patterns this could also be
Bring it with you
Get your personalized PDF
A personalized write-up of your result: the pattern we classified, the thresholds we applied, the research behind each, and a short list of questions you can bring to your doctor.
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