A combined look at iron stores and stress hormone levels to add context to energy and recovery.
The ferritin/cortisol ratio is a calculated value, not a separate blood test. It is ferritin (iron stores and inflammation) divided by cortisol (the main stress hormone). It is an uncommon, mostly research-level combination that pairs an inflammation marker with a stress hormone.
Because it brings together two very different signals, this ratio has no established clinical meaning on its own. It is best understood through its individual parts: ferritin reflecting iron stores and inflammation, and cortisol reflecting stress and adrenal activity. Any interpretation should rest on those two values, not the ratio alone.
Aniva reads your result against research-backed ranges, not just the lab's wide normal. The reference shown below is specific to this biomarker.
There are no established reference thresholds for this ratio. It is not a standardised clinical test, so it should be read only through its individual components.
| Pattern | Interpretation |
|---|---|
| Any value | No validated cut-off; interpret ferritin and cortisol separately |
Source: StatPearls: Ferritin.
Ferritin rises with inflammation and liver injury, while cortisol swings through the day and rises with stress, illness, and steroid medicines. Because both move for unrelated reasons, the ratio is easily distorted and is not reliable on its own.
Best read with its components, ferritin and cortisol, with cortisol interpreted by time of day and ferritin alongside CRP and an iron panel.
What do my results mean? A higher ratio can reflect relatively higher ferritin or lower morning cortisol; a lower ratio the opposite. Look at ferritin and cortisol individually.
Do I need to fast? No. Aim for a consistent early-morning blood draw, as cortisol changes through the day.
What can affect the ratio? Acute illness, hard exercise, iron supplements, steroid medicines, biotin, pregnancy, and sleep or shift changes can all shift results.
How often should I test? If you are adjusting training or iron intake, retesting every few months may help track trends. Follow your clinician’s advice.
How long do results take? Results are usually ready in about 7 days.
What should I discuss with my clinician? Share symptoms, diet and supplements, training load, and medicines. Ask whether a full iron panel or dedicated adrenal testing is useful.
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