Serum Ferritin has been sold to us as reflecting our patients’ iron stores and while we know there are some scenarios where this association is broken e.g. inflammation, how well does it reflect true hepatic iron content for the rest of us? Poorly, is the consensus. Why is this and what do Serum Ferritin results actually speak to then? Well, something quite different, it turns out – and generally as a consequence of this, more is not better! Given Ferritin is routinely reported on for patients with any iron concerns, what value can we still extract from these results then and are we getting closer to being able to describe what desirable results actually look like?