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“Maybe you’re not depressed and unmotivated … maybe you just have low ferritin,” says Elizabeth Orringo, a wellness influencer and host of The Wellness Process podcast, in an Instagram reel. The caption then prompts viewers to comment “Iron” to get a link to her Substack, which details how she raised her ferritin from 16 to 142, making her body “feel like a new person.” The video has 244,000 views and nearly 5,000 “Iron” comments. But what is ferritin, how does it relate to iron, and why do thousands of women online care?
Ferritin and iron aren’t synonymous, but they are closely linked. “Ferritin is a protein that stores iron in your body, and iron is essential for producing hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body,” says Pooja Gidwani, a Los Angeles–based internist and longevity expert. “Ferritin is one of the best markers we have to assess how much iron your body has stored, rather than just how much is circulating in your blood at a given time.”
Iron has had its moment in the wellness world, but ferritin is just getting started; it stores iron for later use, so the less you have, the less iron supply your body has in times of need, like during increased blood loss, growth stages, and life in general. “I like to think of serum iron as your checking account and ferritin as your savings account,” says Amanda Kahn, a New York–based internist and longevity specialist. “You can have enough money to cover today’s expenses while your savings are becoming depleted.” While iron gets most of the spotlight, Kahn says ferritin often gives a clearer picture of the body’s iron reserves and can more efficiently identify iron deficiency before it progresses to anemia and other problems.
Even without a blood test, people often notice iron deficiency through low energy, hair loss, and fatigue, which can also be side effects of low ferritin. But another marker of low ferritin that has taken social media by storm is “ferritin face.”
“While ‘ferritin face’ isn’t a recognized medical condition, the broader connection between iron status, energy, and overall well-being is worth understanding,” Kahn explains. “Social media has introduced terms like ‘ferritin face,’ bringing attention to the relationship between iron stores, energy, and appearance.”
According to Google Search, searches for “ferritin face” are up 450 percent in the last three months and 5,000 percent year over year. Ferritin face refers to the more visible hallmarks of low ferritin, like pale skin, dark, hollow under-eyes due to lack of color, and puffiness as a result of inflammation. In a beauty landscape where going under the knife is often the first line of defense, “ferritin face” offers another explanation that plastic surgery can’t fix. “When iron is in short supply, the body deprioritizes skin and hair and redirects it to support vital organs, which is why it shows up visibly first,” says Tiffany Lester, an integrative medicine physician and women’s health medical director at Function.
Just because you have dark circles or look pale doesn’t mean you have low ferritin—and vice versa; someone without “ferritin face” can still have low ferritin. The first step is a blood-work panel that covers both iron and ferritin levels, since iron levels can be normal while ferritin can be low. “If your iron levels read normal, but you have low ferritin, which means your body may still have enough circulating iron to meet its immediate needs, but its stored iron is depleted,” says Gidwani.
However, experts point out that laboratories often have different ideal ranges for ferritin levels, and a “healthy” ferritin level can be hard to pinpoint. “Reference ranges reflect a population average, not your optimal baseline,” Lester explains. This means that an adequate level for you may not be normal for someone else. “A lab may tell a woman that a ferritin of 16 nanograms per liter is ‘normal,’ while another woman has a ferritin of 100 nanograms per liter and is also considered normal. I often ask, ‘How could women possibly feel the same across such a wide range?’” says Kahn.
Doctors agree that ferritin below 15 nanograms per milliliter and iron below 30 nanograms per milliliter indicate a deficiency. However, Kahn points out that ferritin levels that are too high aren’t good either. “I also pay close attention to women with ferritin between 30 and 50 nanograms per liter, particularly when they’re experiencing fatigue, exercise intolerance, or hair shedding,” she says. This isn’t to say levels in the 100s are unhealthy. “Reference ranges reflect a population average, not your optimal baseline,” Lester adds.
There is no one-size-fits-all approach to improving your ferritin levels, but you can follow the same protocol you’d use to increase iron and ferritin, since more iron means more for ferritin to store. You can’t pinpoint the causes of the deficiency, but the best place to start is diet. “Diet is often assumed to be the cause, but menstrual blood loss, gastrointestinal blood loss, and impaired absorption are important considerations,” says Gidwani. Historically, the best food sources of iron have been animal sources like red meat, which contains heme iron, generally absorbed more efficiently than the nonheme iron found in plant foods like lentils, beans, and spinach, Gidwani adds. “Pairing plant-based iron sources with vitamin C, such as citrus fruits or bell peppers, can improve absorption.”
Habits are important too, Lester explains. Your daily coffee or tea with breakfast may be affecting your iron and ferritin levels. “Caffeine blocks gut absorption of the iron-rich foods we are consuming,” she adds. Consider having your morning caffeine an hour or two before or after you eat.
The same goes for supplements—experts say to avoid drinking caffeine when you take an iron supplement. “Oral iron is usually the first treatment, and alternate-day dosing can improve absorption and sometimes tolerability,” Gidwani says. “IV iron may be appropriate when oral iron isn’t tolerated, isn’t effective, or absorption is impaired.” Experts also recommend pairing an iron supplement with a vitamin C supplement, similar to the aforementioned food pairings, because vitamin C helps iron absorption.
If ferritin remains low despite consistent supplementation, it may be worth looking into why the iron isn’t being absorbed. Popular culprits are gut conditions like celiac disease, autoimmune gastritis, SIBO, and IBS, as they all interfere with iron absorption. Even poor stomach acid can affect absorption.
Bragging about your TikTok followers may not be the most socially appropriate thing, but bragging about your ferritin levels certainly is. However, more isn’t always better. “I always remind my patients that we need to look at the entire physiological picture, and there is also a meaningful difference between treating a genuine deficiency and simply trying to push a laboratory value higher,” Kahn emphasizes.
“My philosophy is that laboratory values should be interpreted in the context of the individual, not just whether a number falls inside a ‘normal’ reference range,” she adds. “The goal isn’t to chase a perfect ferritin number. It’s to identify deficiencies, understand why they’re occurring, and help women feel and function their best.”
