Can your face reveal low iron?

On social media, pale or grey-looking skin, dark under-eye circles and dry or cracked lips have been grouped under the label ‘ferritin face’. The name refers to ferritin, a protein that stores iron: measuring it in blood helps doctors assess the body’s iron reserves. The online claim is that changes in appearance can reveal when those reserves are low. BBC News (source, opens in new tab)

There is a connection between iron deficiency and some physical changes. Unusual paleness can accompany significant anaemia, while hair shedding and brittle nails may occur with iron deficiency. But these signs can have other causes. Doctors interviewed by the BBC describe the appearance-based signs discussed online as subjective and unreliable: they cannot establish whether someone has low iron.

Part of the confusion is that iron deficiency and anaemia are not the same thing. Anaemia means a low level of haemoglobin, the protein in red blood cells that carries oxygen. Iron stores can become depleted before haemoglobin falls, so someone can have low iron stores without being anaemic. Looking for paleness therefore cannot reliably confirm or rule out iron deficiency.

Blood tests assess what appearance cannot. Guidance from the British Society of Gastroenterology recommends confirming iron deficiency with blood tests that assess iron status. It identifies ferritin as the single most useful marker of iron-deficiency anaemia. Gut (source, opens in new tab)

2 sourcesRead full analysis