M--
Okay, first things first, YES it could be more it always is more.
Iron definciency is not a disease in itself. You don't get iron deficiency like you do diabetes or cancer or the flu. Iron deficiency is a symptom or result of another disease process. By that, I don't mean that you have another disease, but you have a physical process that is causing you to become deficient in iron.
Now, the good news is that you are not anemic and not even close to being anemic. So, while your ferritin is low, you are still quite robust in the production of red blood cells and getting oxygen to your body.
It's hard to say what could be causing this. I still haven't quite figured out mine. Usually, the doctors don't start doing "workups" until you become anemic. Also, you are on the young side for a GI workup, but it is certainly not unheard of to have a blood loss in that area at your age.
I ended up, surprisingly, having some bleeding in my stomach due to taking Motrin several times a month. Really, I had no clue!! So you need to think about thinks like that.
Other small, but chronic blood losses can deplete you. They could be as simple as bleeding gums when you brush your teeth, to having hemorrhoids.
Another thing you might look at, especially at your age, is malabsorption issues. Many people find out in their 20s that they have Celiac disease. This is an autoimmune response to gluten in the diet. It damages the villi in your small intestine and causes you to not absorb many nutrients. One of the first indicators of this in asymptomatic people is anemia.
You might have a poor diet and you don't know it? Just not intaking enough nutrients? Obviously, when you take supplements you respond so you *can* absorb iron to some degree. Maybe you aren't getting enough in your food.
Also, do you use antacids or medications like Prilosec or Nexium?
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