Ferritin is high but still anemic is associated with ferritin being more sensitive than serum iron during iron supplementation therapy, thalassemia, infection, or hepatitis. High ferritin but still anemia is associated with the following factors: 1. Ferritin is more sensitive than serum iron during iron supplementation therapy: Anemia but high ferritin is mainly caused by iron supplementation drugs because ferritin is more sensitive than serum iron and blood cells reflecting the degree of iron deficiency. It tends to rise rapidly when iron supplementation therapy is given. But a momentary iron supplementation is far from being able to meet the amount of iron deficiency, so there will still be iron deficiency, that is, anemia. 2. Thalassemia: If small cell hypochromic anemia is present, it is necessary to consider the possibility of thalassemia, and the iron in the red blood cells entering the plasma during hemolysis can also cause the elevation of ferritin. Thalassemia screening or thalassemia gene can be done to confirm the diagnosis. 3. Infection or hepatitis: anemia but high ferritin may be the presence of inflammatory infections or hepatitis, with liver disease, liver cell damage can be reduced function, which can cause serum ferritin elevation. Ferritin is very high but still anemia may have other reasons, it is recommended to go to the hospital in time to improve the examination to clarify the cause of the disease, to give targeted treatment or treatment.