Doctors say low iron cannot be spotted from the face as ferritin videos spread online
Clips claiming that pale skin, dark circles and thinning hair reveal low iron stores have drawn millions of views. A blood test is the only way to find out, and the NHS says the cause matters as much as the result.
Doctors have warned that a person's appearance is no reliable guide to whether they are short of iron, after videos promoting the idea of "ferritin face" gathered millions of views on TikTok and Instagram.
The clips suggest that pale or grey skin, dark circles under the eyes, dry lips, brittle nails and hair shedding are visible signs of low ferritin, the protein that stores iron in the body. GPs and blood specialists told BBC News that these features can go with low iron but can also be caused by many other things, and that only a blood test can show what is going on.
The doctors also said the visual checklist could mislead people with darker skin, in whom changes in skin colour may be harder to see.
Ferritin, haemoglobin and anaemia
Haemoglobin is the protein in red blood cells that carries oxygen. When it falls too low, a person has anaemia. Ferritin is different: it reflects how much iron the body has in reserve.
Iron stores can run down before haemoglobin drops, so it is possible to be iron deficient, and to have symptoms, without being anaemic. UK guidelines from the British Society of Gastroenterology treat a ferritin level below 15 micrograms per litre as showing no iron stores, and below 30 as generally showing low stores, the BBC reported.
The NHS lists tiredness and lack of energy, shortness of breath, a noticeable heartbeat, pale skin and headaches as the main symptoms of iron deficiency anaemia. Less common signs include hair loss, a sore tongue, mouth ulcers, ringing in the ears, spoon-shaped nails and cravings for things that are not food, such as ice.
Why the cause matters
Heavy periods and pregnancy are among the most common reasons for low iron, according to the NHS. Bleeding in the stomach or gut is another, which can be caused by anti-inflammatory painkillers, ulcers or, less often, cancer. For that reason a GP will usually look for the cause as well as checking the level.
A full blood count is the standard first test and needs no preparation. If the reason is not clear, a GP may arrange further tests, such as a stool test that checks for hidden blood, or a referral to a specialist.
Treatment is usually iron tablets, often for around six months. The NHS says tea, coffee, milk and dairy can reduce how much iron the body absorbs, while dark green leafy vegetables, fortified cereals, meat, dried fruit and pulses are good sources. It also warns that iron tablets must be kept away from children, because an overdose can be fatal.
The BBC report said taking iron supplements without a diagnosis can be harmful and that treating yourself could delay the search for what is behind the symptoms. The NHS advises anyone who thinks they may have iron deficiency anaemia to see a GP.
