Mother-of-two Ruth Bradford experienced severe exhaustion, dizziness, anxiety, heart palpitations, and brain fog that left her struggling through daily life. The 44-year-old from Wiltshire initially blamed the stress of parenting young children and running a business before a 2024 blood test revealed low ferritin.
"It was like looking at life through a fog that wouldn't clear, like when you've taken drowsy medication," she said. "I felt like I'd been tranquillised, a zombie walking through life. It was rock bottom."
Ferritin stores iron in the body and releases it when needed. Low levels point to an iron shortage, which can cause fatigue, hair loss, brain fog, low mood, and breathlessness. Viral social media videos recently highlighted "ferritin face," pointing to dull skin, dark circles, and cracked lips as warning signs.
Government figures indicate that 13% of British women aged 35 to 49 have ferritin levels below 15 micrograms per litre, showing severely depleted iron stores. Bradford's level dropped even further to 8 micrograms per litre.
"This issue affects so many people yet it's so trivialised," she said. "Thousands of women are blaming their symptoms on age, busy lives, and stress, when it's actually physiological and potentially preventable. It feels like there's this black hole of knowledge."
Dr Andrew Fletcher, a consultant at NHS Blood And Transplant, explained that iron deficiency occurs more frequently in women of childbearing age due to menstruation. Pregnancy also increases the risk because unborn babies draw nutrients from their mothers, while vegetarians and vegans may struggle to meet their body's iron demands. Coeliac disease acts as another risk factor, and untreated deficiency can progress to anaemia, raising the risk of illness, heart and lung problems, and pregnancy complications.
Ferritin levels under 30 micrograms per litre can signal iron deficiency, while measurements of 15 and below point to critically low stores.
Bradford, who runs The Little Black & White Book Project, had normal haemoglobin levels despite her low ferritin, meaning she lacked iron without being anaemic. Her GP prescribed iron supplements, raising her ferritin to 24, though she is considering discussing iron infusions with her doctor. Infusions deliver liquid iron directly into the bloodstream through a drip and are sometimes offered when tablets fail or cause side effects.
"I was being a rubbish mum and missing out on so much life," Bradford said. "There's being a tired parent, and then there's bone-crushing fatigue that makes you feel like you aren't in your own body. Women are crawling through their 30s and 40s on their knees. We shouldn't have to hit rock bottom before we get the help we need."
Amanda Ashworth, a 43-year-old mother of three, similarly mistook her exhaustion and brain fog for normal signs of aging. Operating between Cambridge, Goa, and Dubai as founder of Worldschooling Hub Goa, she blamed stress and perimenopause before a £100 private blood test showed a ferritin level of 21. Her doctor considered this normal, and her haemoglobin was also normal, leaving her without a medical plan.
"It was so frustrating," she said. "I didn't feel well but I wasn't anaemic, so I wasn't given any plan or further investigation. I just had to do my own research."
Medical benchmarks for low ferritin can vary across practices and laboratories, and doctors evaluate results alongside overall health and symptoms. Ashworth eventually started taking an iron supplement and felt improvements within weeks.
"I'm already feeling so much better," Ashworth said. "My energy has improved, I feel mentally clearer and far more like myself again. It's vital to listen to your body. Don't automatically assume that constant exhaustion is simply part of being a parent, working, ageing, stress, or perimenopause."
Hair-raising
Hair loss remains a primary symptom of low ferritin. Hannah Leathers, a 47-year-old PR worker and mother of three from Fulham in west London, lost fistfuls of hair daily and found huge amounts in the shower.
"I was scared to brush it," she said. "It was awful. I genuinely thought I was going bald. I bought hair serums, supplements, and even a special brush, but nothing did the trick."
Leathers started wearing headbands every day to conceal her hairline.
"They became my armour," she said. "I felt incredibly vulnerable without them. My self-esteem plummeted and I didn't want to go out. I was so embarrassed. Family trips to the beach were horrible as I couldn't wear my headband. I was having nightmares about losing all of my hair. It made me cry a lot."
Like the others, she initially blamed stress or perimenopause, and her GP dismissed it. After paying for a trichologist and further tests, she learned her ferritin was only 12 micrograms per litre. Supplements and a scalp treatment helped her hair grow back within months.
"I wish I'd shouted a little louder," Leathers said. "Not every symptom for women in their 40s means perimenopause. It has become such a cover-all."
THE SYMPTOMS TO KNOW ABOUT
Speak to a GP if you have these:
- Fatigue
- Hair loss
- Weakness
- Dizziness
- Headaches
- Pale skin
- Poor concentration
- Shortness of breath
- Heart palpitations
- Brittle or spoon-shaped nails
- Restless legs
Patients require supplements to correct deficiencies. "With intravenous iron infusion, people can feel better within two to three weeks," said Dr Sue Pavord, consultant haematologist at Oxford University Hospitals NHS Foundation Trust.
"It can take longer with pills, as the dose is lower. To ensure maximum absorption, take iron tablets in the morning on an empty stomach with water or vitamin C."
"Both tablets and IVs carry side effects, including bone pain and constipation, so always speak to a doctor. And don't take more than recommended, as this can cause stomach pain and diarrhoea."
"You can also top up levels with iron-rich foods including red meat, pulses, nuts, dried fruit and green veg. Citrus fruits and peppers can improve absorption, but wait two hours to have tea, coffee, dairy products and wholegrain cereals."
