Ferritin face is going viral, but taking iron supplements without a blood test could be risky

A new viral trend on social media, ferritin face, has put the spotlight on iron deficiency. The trend started on platforms such as TikTok and Instagram, when users started associating their pale or grey-looking skin, dark circles under the eyes, hair shedding, brittle nails and dry lips with low ferritin levels. However, medical experts cautioned that changes in appearance cannot reliably establish whether someone has an iron deficiency. Experts also warn that using these signs to diagnose a deficiency or starting iron supplements without medical advice could be harmful.

What is ferritin face?

Ferritin is a protein that stores iron in the body. Low ferritin levels can thus indicate depleted iron stores, sometimes before haemoglobin levels fall enough for a person to be diagnosed with anaemia. However, “Ferritin face” is not a recognised medical diagnosis. Instead, the term describes appearance changes that some people attribute to iron deficiency.

Dr Aziza Sesay, a GP, told BBC that appearance may offer a clue that something needs investigating, but it cannot establish the cause.


Iron deficiency severe enough to cause anaemia can lead to symptoms such as paleness, fatigue and, in some cases, hair loss and brittle nails. However, these signs are not specific to iron deficiency. Dark circles under the eyes, for example, can also happen due to genetics, allergies, ageing and inadequate sleep. Hair shedding and changes in skin appearance can also be attributed to stress, hormonal changes, nutritional deficiencies and other medical conditions.

Talking to BBC, consultant haematologist Dr Drew Provan emphasised that ferritin levels cannot be determined simply by looking at someone's face. Visual assessments can also be more difficult in people with darker skin tones.

Can ferritin levels be low even when haemoglobin is normal?

A blood ferritin test helps doctors assess the body's iron reserves, which are needed to produce haemoglobin, the protein in red blood cells that carries oxygen. However, iron deficiency can develop before anaemia becomes apparent in routine blood tests. According to UK guidelines from the British Society of Gastroenterology, as reported by BBC, ferritin levels below 15 micrograms per litre generally indicate absent iron stores in otherwise healthy adults, while levels below 30 micrograms per litre often suggest depleted iron reserves. However, doctors interpret results in the context of symptoms, medical history and other test findings. Ferritin can also rise during inflammation, potentially making iron deficiency harder to identify.

Highlighting the distinction between stored iron and haemoglobin, Dr Provan said that a person may have depleted iron reserves while their haemoglobin remains within the normal range. This distinction matters because some people may experience symptoms before they develop iron-deficiency anaemia. Fatigue, weakness and reduced exercise tolerance can have many causes, however, and do not establish an iron deficiency on their own.

Why taking iron supplements without testing can be risky

Doctors advise against starting iron supplements solely because someone identifies with the symptoms described in social media posts.

Although iron supplements are commonly used to treat confirmed iron deficiency, excess iron can be harmful. Unnecessary supplementation can cause side effects, including nausea, abdominal discomfort and constipation. Excessive iron intake can also lead to more serious complications.

Self-treatment also may delay the identification of the underlying cause of a deficiency. For instance possible causes of iron deficiency also include heavy menstrual bleeding, inadequate dietary iron, pregnancy, problems with iron absorption and gastrointestinal blood loss.

Finding the cause is thus particularly important when iron deficiency occurs in men or postmenopausal women.

Iron-rich foods, including meat, beans, lentils, leafy greens and iron-fortified cereals, can contribute to dietary iron intake. However, diet alone may not be sufficient to correct an established deficiency in every case.

When should you get your iron levels checked?

People experiencing persistent fatigue, weakness, breathlessness, palpitations or unusual paleness should discuss their symptoms with a healthcare professional. Persistent hair shedding may also warrant assessment, particularly when accompanied by other symptoms or risk factors.

Doctors may recommend a complete blood count and a ferritin test, alongside other investigations depending on the person's symptoms and medical history. Additional tests may be needed to identify the cause of an abnormal result.