Does low iron really make you “ugly“?
Well, according to TikTok, yes.
And now the BBC are adding their input.
Well, the answer is yes and no.
The photo above, is before after low iron as per a ferritin test. But it is also before with shadows across the face (and possibly some make-up too) and after, without, so it’s slightly hard to be sure.
Regardless, there are some things we can look for that might be clues to low iron, and yes iron might make you look less than your best.
I am currently eyeballs deep writing ACN’s functional blood chemistry analysis course, and I can tell you the thyroid is a funny old organ.
It makes mostly T4 (80%) and some T3 (20%), and the number relates to the amount of iodine added to a tyrosine molecule.
Iodide comes into the cell and then an enzyme called TPO or thyroid-peroxidase to their friends, and it must be converted into a special form of iodine that will react with tyrosine to make T1 and T2.
And TPO is 100% IRON DEPENDENT.
Then, once T1 and T2 are made, TPO then chemically bonds them together to make T4 and T3 and viola, you have thyroid hormone driving your metabolism.
And one feature of overt low thyroid is fluid retention (that is why they can put on weight, it is mostly fluid), and that can lead to puffiness, especially around the eyes.
Below is a before and after thyroxine:
So could the influencers with low ferritin also potentially have some sub-optimal thyroid function?
Yes, that is 100% possible. Check her photo again, the eyes do look different:
Hair loss is another symptom mentioned and with good reason as there is solid research to back this up.
In this study, ladies with hair loss had an average ferritin of 16.3 ng/ml, versus controls with 60.3.
Remember your ferritin ranges:
What about dark circles under the eyes?
One study found a prevalance of 50% anaemia a this subgroup of patients, a very high number relative to general population (though I should point out this was in India where iron deficiency and thus anaemia is higher than UK).
They also note: ” Many patients reported improvement of dark circles on correction of anemia. In these patients dark circles may be either because enough oxygen is not reaching the periorbital tissues or due to facial pallor which makes the periorbital region look comparatively darker.”
Remember low iron in UK is common, especially in younger groups and even more so in females, as high as 55% in teens.
We talked about that here:
Re-read it 👇️
So this is one to consider, but not dark circles are more often related to allergies affecting the nose.
They are often referred to as “allergic shiners”.
Here vs controls, they have darker circles and bigger areas relatively.
So it’s worth checking if they can nose breath, and if they have allergies such as house dust or animal hair.
In that situation, the offending allergen would be removed or minimised, and then you might consider a trial of DAO to remove histamine.
We talked about that here 👇️
And of course, foods, which in this case will be more likely to be IgA/G not true allergy of IgE.
Low hanging fruit here is always gluten, dairy, eggs and nuts. Short trial of 2 weeks to assess response.
Also, patients with persistent itch without a rash should be checked for iron according to the British dermatological society.
“In all cases of generalized pruritus without rash (GPWOR), but especially where iron loss is suspected, it is important to enquire about diet (vegetarian or vegan), potential sources of blood loss and gastrointestinal symptoms. Iron replacement leads in some cases to complete cessation of pruritus very shortly after commencement of therapy.”
“A prospective case–control study showed that the mean serum iron levels in the population of patients with pruritus was significantly lower than that in the control group, with no median age difference between the two groups. Furthermore, the most common cause of generalized pruritus in patients with underlying systemic disease was found to be iron deficiency anaemia, which responded to iron replacement (25% of all patients with pruritus with systemic disease). Therefore, we recommend that full blood count and ferritin levels should be checked in all patients with chronic itch. Note that ferritin is an acute-phase protein and may be elevated in a situation of iron deficiency”
I would also mention that I have seen a number of patients with liver disease that presented with itching (without jaundice).
How about pica, which is the compulsive eating of non-foods, such as soil, or paper.
But in the case of iron, they specifically eat ice, known as pagophagia.
Pica was reported in 11% of patients with iron deficiency. And many found this resolved or massively improved with iron repletion.
Note in that same study, 16% of iron deficient patients had restless syndrome. Something we have talked about before:
Re-read it 👇️And note in RLS you need to aim for 100 ng/ml ferritin.
