Why does everyone brag about their ferritin levels?

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“Maybe you’re not depressed and unmotivated…maybe you just have low ferritin,” Elizabeth Orringo, wellness influencer and host of The Wellness Process podcast, says in an Instagram Reel. The caption then invites viewers to comment on “Iron” for a link to her sub-stack, which details how she increased 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 are not synonymous, but they are closely related. “Ferritin is a protein that stores iron in your body, and iron is essential for the production of hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body,” says Pooja Gidwani, an internist and longevity expert based in Los Angeles. “Ferritin is one of the best markers we have for assessing how much iron your body is storing, rather than how much is circulating in your blood at any given time.”

Iron has emerged in the wellness world, but ferritin is just getting started; it stores iron for later use, so the less you have, the less iron your body has when needed, such as 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, an internist and longevity specialist based in New York City. “You can have enough money to cover today’s expenses while your savings dry up.” While iron is the center of attention, Kahn says ferritin often gives a clearer picture of the body’s iron stores and can more effectively identify iron deficiency before it progresses to anemia and other problems.

Even without a blood test, people often notice iron deficiency through lack of energy, hair loss, and fatigue, which can also be side effects of low ferritin levels. But another marker of low ferritin that has taken social media by storm is the “ferritin face.”

“While facial ferritin is not a recognized medical condition, the broader connection between iron status, energy, and overall well-being is worth understanding,” says Kahn. “Social media has introduced terms like ‘ferritin face,’ drawing attention to the relationship between iron stores, energy and appearance.”

According to Google Search, searches for “ferritin face” increased 450% in the last three months and 5,000% year-over-year. Ferritin face refers to the most visible characteristics of low ferritin, such as pale skin, dark, sunken eyes due to lack of color, and swelling due to inflammation. In a beauty landscape where going under the knife is often the first line of defense, the “ferritin face” offers another explanation that plastic surgery can’t solve. “When iron is scarce, the body deprioritizes skin and hair and redirects it to supporting vital organs, which is why it visibly shows up first,” says Tiffany Lester, an integrative medicine physician and medical director of women’s health at Function.

Just because you have dark circles or look pale doesn’t mean your ferritin levels are low, and vice versa; a person without a “ferritin face” may still have low ferritin levels. The first step is a blood test that covers both iron and ferritin levels, as iron levels may be normal while ferritin may be low. “If your iron levels are normal, but your ferritin levels are low, this means that 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 labs often have different ideal ranges for ferritin levels, and a “healthy” ferritin level can be difficult to identify. “Reference ranges reflect a population average and not your optimal reference,” says Lester. This means that a level that is adequate for you may not be normal for someone else. “One lab may tell one 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 feel the same way over such a wide range?'” Kahn says.

Doctors agree that ferritin below 15 nanograms per milliliter and iron below 30 nanograms per milliliter indicate a deficiency. However, Kahn points out that too high ferritin levels are not good either. “I also pay special attention to women whose ferritin is between 30 and 50 nanograms per liter, especially when they are experiencing fatigue, exercise intolerance or hair loss,” she says. This is not to say that levels in the 100s are unhealthy. “Reference ranges reflect a population average and not your optimal reference,” adds Lester.

There is no one-size-fits-all approach to improving your ferritin levels, but you can follow the same protocol you would use to increase iron and ferritin, because more iron means more ferritin to store. You cannot pinpoint the causes of this deficiency, but the best place to start is diet. “It’s often assumed that diet is the cause, but menstrual blood loss, gastrointestinal blood loss, and poor absorption are important considerations,” says Gidwani. Historically, the best dietary sources of iron have been animal sources like red meat, which contains heme iron, which is generally absorbed more efficiently than non-heme iron found in plant foods like lentils, beans and spinach, Gidwani adds. “Pairing plant-based sources of iron with vitamin C, such as citrus fruits or peppers, may improve absorption.”

Habits are also important, says Lester. Your daily coffee or tea at breakfast can affect your iron and ferritin levels. “Caffeine blocks the intestinal absorption of the iron-rich foods we eat,” she adds. Consider taking your morning caffeine an hour or two before or after eating.

The same goes for supplements: Experts advise avoiding drinking caffeine when taking an iron supplement. “Oral iron is usually the first treatment, and dosing over two days can improve absorption and sometimes tolerance,” says Gidwani. “IV iron may be appropriate when oral iron is not tolerated, is not effective, or when absorption is impaired.” Experts also recommend pairing an iron supplement with a vitamin C supplement, similar to the aforementioned food pairings, because vitamin C promotes iron absorption.

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If ferritin remains low despite consistent supplementation, it may be worth investigating why iron is not being absorbed. The most common culprits are intestinal diseases 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 might not be the most socially appropriate thing, but bragging about your ferritin levels certainly is. However, more is not always better. “I always remind my patients that we need to look at the whole physiological situation and that there is also a significant difference between treating a true deficiency and simply trying to increase a laboratory value,” Kahn emphasizes.

“My philosophy is that lab values ​​should be interpreted in the context of the individual, not just whether a number falls within a ‘normal’ reference range,” she adds. “The goal isn’t to chase a perfect ferritin reading. It’s about identifying deficiencies, understanding why they occur, and helping women feel and function at their best.”

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