By measuring ferritin levels via a blood test it is possible to get a snapshot of the body’s iron reserves. Photograph: Alamy/PA View image in fullscreen By measuring ferritin levels via a blood test it is possible to get a snapshot of the body’s iron reserves. Photograph: Alamy/PA Medical research Explainer ‘Ferritin face’: are social media claims about iron deficiency fact – or fiction? Experts say symptoms such as dark circles under the eyes, grey skin, cracked lips and hair loss can be a warning sign – but there are other factors too
Prefer the Guardian on Google TikTok is rife with influencers warning of “ferritin face”, a term they use to describe the pallor, dark circles, dry skin, and hair loss claimed to indicate low iron stores. But is this based on fact or fiction, and when is it time to head to the GP?
Iron is not made in the body, so typically we consume it in our diet. Ferritin is the protein responsible for storing iron in the body, particularly in the liver, and releasing it in a controlled manner.
By measuring ferritin levels, which can be checked via blood tests, it is possible to get an snapshot of the body’s iron reserves, although experts warn such levels are not always a reliable guide.
Blood ferritin levels of less than 30 micrograms/L indicate an iron deficiency, according to guidelines from the National Institute for Health and Care Excellence .
However “a level below 50 might be a pointer of iron deficiency,” said Sue Pavord, professor of practice in medical haematology at Oxford University hospitals.
View image in fullscreen The symptoms influencers describe include dark circles under the eyes. Photograph: Alamy/PA The symptoms influencers describe, such as dark circles under the eyes, grey skin, cracked lips and hair loss, can be caused by a variety of factors, including genetics, stress and dehydration. But experts say low iron stores can have an effect.
“Iron is needed for every single cell of the body. So if you are iron deficient, you will be very fatigued, have brain fog, your skin will look dull and saggy, you’ll look pale and tired,” said Pavord. “While we can’t diagnose iron deficiency from the face, it might be a suggestion that there is iron deficiency.”
Prof Toby Richards of the University of East London and the Iron Clinic added such changes were particularly pronounced in people with very low iron stores. “They tend to be the really sick patients,” he said.
“Periods and pregnancies are the most common [causes],” said Pavord, but others include not getting enough iron – either from dietary choices or because of poor absorption, as can occur with coeliac disease.
Low ferritin levels can also arise as a result of blood loss linked to gastrointestinal problems, such as gastritis or polyps.
“We also sometimes see it in athletes because of the high demand for iron on their bodies,” she added.
Richards said those who are at high risk of low ferritin – such as people who have heavy periods, are pregnant or have had children, or are vegetarian or vegan – should ask for a blood test, adding that should include a full blood count, ferritin level check, and test for levels of B12 and folate.
“This is a proper disease, and to put it into perspective, it’s the leading cause of disability in women of reproductive ability,” he said.
Pavord also said those who are concerned about their ferritin levels should ask for a blood test, adding it was important to understand the cause of iron deficiency.
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