‘Ferritin Face’ Is Trending, but Experts Say a Selfie Can’t Diagnose Low Iron

The “ferritin face” trend may be all over TikTok, but close to a third of American adults may actually be low in iron without knowing it. Here’s what to watch for and how new guidelines could help.

There’s a term recently popularized on TikTok called “ferritin face,” named after the protein that stores iron in the body. The term is used by influencers to refer to facial symptoms of iron deficiency, including dark circles under the eyes and pale skin.

And while some influencers claim signs in the face alone can tell if one is iron-deficient, experts say this is not an accurate gauge.

Chloe Casey, a lecturer in nutrition and behavior at Bournemouth University in the United Kingdom, says that while it’s true that severe iron deficiency, especially when it leads to anemia, can make someone look pale, other factors can also contribute to paleness. This includes hormones, poor sleep, stress, dehydration, and not getting enough of other key nutrients. She stresses, “A mirror can’t tell you whether your ferritin is low. Only a blood test can do that.”

Apart from Casey, doctors interviewed by CNN were also skeptical about the accuracy of a selfie diagnosing iron deficiency.

What’s clear, though, is that more people are low in iron than in any other nutrient, according to the American Society of Hematology (ASH). A study in 2024 also found that nearly one-third of U.S. adults may be iron-deficient.

Iron deficiency is common and often overlooked, according to Dr. Ariela Marshall, associate professor of medicine at the University of Minnesota. Its symptoms can include fatigue, brain fog, restless legs, and cravings for things like ice, and they can appear even before iron deficiency leads to anemia. Because standard blood counts don’t detect iron deficiency unless it has progressed to anemia, many people go months or years without being diagnosed.

“The symptoms of iron deficiency can be very subtle, or they can be attributed to many different things,” said Dr. Jacquelyn Powers, section chief of hematology at Texas Children’s Hospital.

In September, ASH released new guidelines to help doctors diagnose iron deficiency earlier. They recommend using a ferritin test, which is the gold standard for checking the level of iron in the body. The guidelines also set clear cutoffs for what counts as low, with higher thresholds for people with certain risk factors.

People at greater risk of iron deficiency include women with heavy periods, pregnant people, children, endurance athletes, and people with digestive conditions like celiac disease.

According to Powers, one way to decide whether you need to check your ferritin levels is if you’re eating and sleeping well but still experience fatigue. “It’s an easy test, and there’s an easy intervention,” she also assures.

If a test shows you’re low in iron, a doctor may recommend supplements. Casey warns of supplement marketing on social media that may be mistaken for medical advice. Too much iron can be harmful, causing nausea and diarrhea. With very high doses, it can also cause your blood pressure to drop dangerously low and even cause liver failure.

There are many possible reasons why you’re low in iron, so it’s also important to find out why. Causes can range from heavy periods to digestive issues, Marshall said.

If you’re wondering whether your symptoms are signs of iron deficiency, skip the selfie and ask your doctor about a blood test.