Supplements
ferritin decreases fibromyalgia risk
Part of: • Iron & ferritin
📅 Last reviewed: 2026-07-15 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: Population patterns (Observational)
How the studies fall
What the evidence shows
Low serum ferritin (functional threshold <50 ng/mL) is associated with increased risk of fibromyalgia syndrome — proposed mechanism: iron is the rate-limiting cofactor for tyrosine/tryptophan hydroxylase, so depleted stores throttle dopamine, norepinephrine and serotonin synthesis.
The evidence (7)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Ortancil O, Sanli A, Eryuksel R, Basaran A, Ankarali H 2010 · European Journal of Clinical Nutrition | observational | supports | moderate | Case-control, 46 primary-FMS women vs 46 age-matched healthy women: 'The mean serum ferritin levels in the fibromyalgia (FM) and control groups were 27.3+/-20.9 and 43.8+/-30.8 ng/ml, respectively, and the difference was statistically significant (P=0.003).' Adjusted for age, BMI, smoking, B12 and folate, ferritin <50 ng/ml carried a '6.5-fold increased risk for FMS' (CI not given in abstract). Low ferritin with more FMS — the claim's intended direction. Cross-sectional sampling, so 'risk' is an odds ratio and reverse causation is not excluded. |
| Pervaz H, Rafique A, Khan HHI, Javed R, Arif S, Khaliq SS, Ghazanfar S, Ishfaq A 2026 · Cureus | observational | tested-null | low | n=241 FMS; ferritin lower in neuropathic-pain-FMS vs non-neuropathic-pain-FMS (p=0.005); no healthy-control arm; only FIQR predicted pain in regression |
| Kim H, Ko DS 2024 · J Clin Med | observational | supports | moderate | Two-sample MR: higher iron levels associated with INCREASED chronic widespread pain risk (IVW OR=1.01, 95% CI 1.00-1.01, p=0.029); outcome is CWP not FM diagnosis |
| Zeng W, Hu M, Ma L, Huang F, Jiang Z 2025 · Scientific Reports | observational | supports | moderate | Two-sample Mendelian randomization: genetically higher Fe associated with LOWER FM risk (IVW OR=0.440, 95% CI 0.233-0.834, p=0.011), independent of Cu/Se |
| Goel D, Avinash PR, Shangari S, Srivastav M, Pundeer A 2024 · Journal of family medicine and primary care | observational | tested-null | low | Chronic nonspecific multisite pain (n=243, related overlap syndrome not ACR-diagnosed FM); 59.3% had low ferritin; no control/comparator group |
| Mader R, Koton Y, Buskila D, Herer P, Elias M 2012 · Rheumatol Int | observational | contradicts | moderate | Mader 2012 n=84/87 NO ferritin/iron/sTfR difference vs controls; directional null=contradicts |
| Okan S, Caglıyan Turk A, Sıvgın H, Ozsoy F, Okan F 2019 · Croat Med J | observational | supports | moderate | Ferritin deficiency more frequent in FMS vs controls. |
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