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Can you tell from my face if my ferritin levels are low? Here’s what dark circles, a pale complexion and chapped lips reveal

The team of doctors and fact-checking experts from the National Medical Association addresses the main health concerns

6 November 2026

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3' min read

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Key points

What is ferritin and how is it measured?
What does this have to do with anaemia?
Are a pale complexion, dull skin and dark circles under the eyes a reliable sign of low ferritin levels?
When is it a good idea to take exams?
If ferritin levels are low, does iron help with tiredness?

3' min read

Translated by AI

Versione italiana

Dark circles under the eyes, pale or dull skin, chapped lips, brittle hair: on social media, particularly TikTok, there are many videos circulating that attribute these signs to low ferritin levels in the blood and refer to them as ‘ferritin face’. The ‘ferritin face’ has even made it into several British and Italian newspapers. But be warned: it is not a medical term and, according to specialists, you cannot diagnose an iron deficiency just by looking at someone’s face. So let’s see what the research says and when it makes sense to have a blood test.

What is ferritin and how is it measured?

It is the protein that stores iron in our bodies – a sort of storehouse. It is measured by a standard blood test: if the level is low, our iron stores are probably running low.

What does this have to do with anaemia?

Iron is needed to produce haemoglobin, the protein that binds oxygen and carries it throughout the body via the red blood cells. If there is a lack of iron, the body produces less haemoglobin and iron-deficiency anaemia may develop. Anaemia can cause extreme tiredness, weakness, shortness of breath, headaches and paleness, but in the early stages it is so mild that it may go unnoticed. There are several types of anaemia: iron-deficiency anaemia is the most common. Anaemia is diagnosed by a complete blood count, a blood test that measures, amongst other things, haemoglobin levels.

Ferritin and haemoglobin, however, do not always fall at the same time: iron ‘stores’ can be depleted before haemoglobin levels drop. It is therefore possible to have an iron deficiency without being anaemic, and still experience symptoms. Iron deficiency can cause, for example, tiredness, weakness and difficulty concentrating.

Finally, ferritin levels must be interpreted with care: in the presence of inflammation, they can rise and make an actual deficiency appear to be within the normal range. This is why your doctor assesses them alongside other blood tests.

Are a pale complexion, dull skin and dark circles under the eyes a reliable sign of low ferritin levels?

No, these signs alone are not enough. A pale complexion may appear when iron deficiency has led to anaemia, and it is one of the symptoms listed. Recognising it by sight, however, is not straightforward: a review of studies conducted mainly on young children concluded that no sign of paleness – whether on the palms of the hands, the nails or the inner eyelids – allows anaemia to be identified with great accuracy. A dull complexion, greyish skin, dark circles under the eyes and chapped lips can also be caused by genetics, stress and dehydration; dark circles can also be caused by a lack of sleep.

When is it a good idea to have tests?

When symptoms are present, it is less about the appearance of the face and more about, for example, persistent tiredness, weakness, shortness of breath or cold hands and feet. We have discussed the cold and its possible causes in the factsheet “Are some people more sensitive to the cold than others?”. Ferritin is not generally included in routine blood tests: your GP will request it when the clinical picture warrants it. However, the risk of deficiency is higher in those with heavy periods, during pregnancy, or those following a vegetarian or vegan diet. In these cases, your GP may prescribe the necessary blood tests. If a deficiency is confirmed, it is important to investigate the cause as well. As for diet, we’ve discussed this in the factsheet “If I’m iron-deficient, do I need to eat lots of spinach?”.

If ferritin levels are low, does iron help with tiredness?

It may reduce it, but the proven benefits are limited. A review of studies on adults with iron deficiency but without anaemia found that iron reduces self-reported fatigue, but does not improve measured physical performance. In a study of women with fatigue of no clear cause and without anaemia, improvement was seen mainly in those with low or borderline ferritin levels. However, the studies are few in number and of short duration. Furthermore, in women of childbearing age, daily iron supplementation was more likely to cause stomach and bowel problems, such as constipation and diarrhoea.

In practice: Photos and lists of symptoms on social media are no use in determining whether you have low iron levels: to find out, you need blood tests prescribed by your doctor; if you have persistent tiredness, shortness of breath or other symptoms, speak to your GP; do not take iron supplements ‘just in case’: they can cause side effects and should only be taken once you have confirmed that you actually have a deficiency and, where necessary, identified the cause.

Read the full article on the dottoremaeveroche website, run by Fnomceo