For those of you who have never heard, ferritin is a protein that stores iron for the body to use when there is not enough of this element available in the bloodstream from food.
Low ferritin is very rarely a problem for men, unless they have experienced severe loss of blood.
Loss of blood – yes, you got it – low ferritin is a massive problem for women who lose blood every month and the first symptoms of low ferritin stores in them can occur very early after the first period.
In my case, it was less than two years after that milestone when I started experiencing something worrying – my hair was shedding like mad. It got me freaked out obviously. I thought I was going bald.
It was the late 1990s, post-communist Czechoslovakia, and everyone including my mother (well, my mother in the first place), just kept telling me that I was being paranoid and that I had plenty of hair.
I did have plenty of hair, a tonne of hair, everyone used to comment on how beautiful my hair was – but it wasn’t meant to last.
In the years that followed, the quality of my hair would change drastically and I had to go with shorter and shorter cuts. Gone were the days when I could wash my hair every two weeks and cut it every two years and it would look great at every stage.
No one would believe me that I had a problem (including dermatologists) because they clearly had no recollection of how my hair used to look like in the first place.
It took me something like 17 years to figure out what was going on and reversing the problem has by no means been a straightforward journey.
GPs have no clue
The range of ferritin levels considered normal by the general medical practitioners is rather broad: 14 to 148 milligrams per litre of blood in pre-menopausal women. And that’s the problem. You come to your GP. Your level is 30, which means you are not severely anaemic but your hair is not happy. And you are told to go home and not bother them.
I am not sure whether there is scientific consensus on this but one theory says that hair follicles actually store ferritin and that this is the first place from where the body takes it if you don’t have enough iron in your diet (makes sense right? Gorgeous hair is not essential for survival, red blood cells are.)
So what happens? Your body is using up the ferritin and you start shedding hair. The growth cycle gets shorter and shorter, the follicle gets smaller and smaller and the hair gets thinner and thinner. While in the past you used to have most of the hair in the same and pretty decent length, now it’s all different lengths, lot of short hairs sticking out and most of it falls out before reaching the length you want. It’s called chronic telogen effluvium and it’s by far the single most common cause of hair thinning in women.
So please, don’t ask your GP to interpret your ferritin results for you. He will tell you that it’s OK. Trichologists know that for healthy hair growth, your ferritin levels need to be at around 70 preferably 100 milligrams per litre.
Fatigue in early thirties? IT’S NOT AGING!
And hair loss is not the only way low ferritin makes your life miserable. You have accepted the shedding. You see that you are actually not getting bald. Your hair is just not what it used to be. You accepted that this is what happens with age (with age? Really? At 20? Or 25?). You continue to have periods. You continue eating the way you always have. You don’t really pay that much attention to how much of what you consume because you believe that your diet is balanced, sort of. You are not starving like children in Africa, are you? So why should you worry?
You hit your early 30s and you notice that most of the time you feel drained, you struggle to focus and the only thing you like doing is lying in front of the TV or napping. Coffee is your best friend. ‘Aging’, you think. ‘Or maybe the strains of juggling a family and a full time job?’
Well… not really. There is no reason for life to be over by the mid-30s and you can actually have more energy in your mid-30s than in your mid-20s if you get your nutrition and ferritin levels right.
My journey towards fixing my ferritin stores has by no means been straightforward. I was 31 when I finally learned the truth about ferritin after visiting a trichologist and doing a lot of online reading. My ferritin levels were at around 30 at that time – enough for a GP but clearly not enough for my hair (there were other problems such as low Vitamin D but I will leave that out for now). Over the next years, I would trial various approaches with various results and do a lot of reading to finally elevate my ferritin levels to above the 70 miligramms per litre mark.
The trichologist prescribed florisene iron tablets for me to take three times a day. Florisene contains what the maker describes as a golden mix of iron, vitamin C and the amino acid L-lysin, which is supposed to optimise the absorption of iron and creation of ferritin. After four months, I was supposed to have my ferritin levels re-checked, which I had, only to learn that they increased to barely 40. But the trichologist told me the process of increasing ferritin is slow so I continued. I started eating red meet regularly. Before that I had been vegetarian for about five years and I knew that was a thin ice for the body’s iron stores.
I had another blood test done in about a year and the situation was pretty much the same. I was still taking the tablets.
Beware of green tea and other iron absorption blockers
It wasn’t making sense to me. Why wasn’t my ferritin going up despite the massive amounts of iron I was consuming in those pills? At about this time, a friend of mine mentioned a study that found that green tea blocks the absorption of iron and can even lead to anaemia. I was drinking about five cups of green tea per day at this stage.
I looked into it further and found that quite many foods and beverages do contain chemicals that prevent iron absorption. It’s very well described in this article on the website of the Iron Disorders Institute.
It’s not only green tea, black tea and most herbal teas such as mint contain polyphenols that block the absorption of iron and should not be consumed within two hours from your iron-reach meal or tablet. The same goes for coffee and cocoa.
Calcium also blocks the absorption of iron and so do eggs. Spinach, the alleged vegetable iron champion contains oxalates that largely prevent absorption. Soy has the same problem due to the presence of phytates.
That also makes you see why vegetarians tend to have low ferritin levels.
Levels finally up, too up
I ditched green tea and other teas and continued taking my tablets, eating red meet and liver and occasionally black strap molasses. If you think I was eating a lot of iron, you are right. About six months after quitting green tea, I had another test. My ferritin went up to 66. Still a bit below my 70 milligrams per litre goal but close enough.
Beware of iron overload – no more pills
But there was another problem – my iron serum levels were too high and my transferrin saturation index was 90 per cent (40 per cent is the upper limit for what is considered normal).
Such a situation is called iron overload and is not good for your health either. Iron in large amounts is toxic and can harm many organs including the liver and the heart (oops… yes, my journey towards health wasn’t straightforward)
I ditched the pills. I saw that if I focus on fine-tuning my diet towards iron absorption and eat the right combinations of food, my ferritin would most likely achieve optimum levels naturally.
My current ferritin protocol
Since I embarked on the holistic healing journey three years ago, many things in my body have changed. I have managed to heal my endometriosis-related cysts and my periods have generally gotten lighter and shorter, which means losing less blood and less iron by that matter.
I am still concerned about my iron intake. I take one tablespoon of blackstrap molasses every morning together with a vitamin C tablet. Many people in the female hairloss community swear by blackstrap molasses. Some say it can even reverse hair greying. 100 grams of blackstrap molasses contains 730 per cent of the recommended daily dose of iron, 760 per cent of the recommended daily dose of calcium, 1000 per cent of the recommended daily dose of chromium and 390 per cent of the recommended daily dose of copper. Since it contains both calcium and iron it is highly likely that not all of this iron gets absorbed. As I mentioned above, calcium is a known iron-absorption blocker. But even if just 30 per cent of that iron makes it into the bloodstream, that would still be good enough.
My iron insurance policy is organic chicken liver. I buy a 400-gram pack from Waitrose every two weeks. It’s pretty cheap and lasts me for three days. I don’t think that eating liver more often would be safe due to not only the high content of iron but also the high content of vitamin A, which also can be toxic in high amounts.
I have reduced my green tea consumption to one cup a day (bar those miserable days when I haven’t had enough sleep) and I make sure there is a substantial gap between my cup of green tea and my chicken liver and blackstrap molasses.
After six months on this regime my ferritin increased to 73 (hooray) and my serum iron levels and my transferrin saturation index dropped to almost within normal.
While I am still shedding more hair than I should, it has certainly improved. I am not saying that is is just because of the ferritin. What I can say for sure is that I do have much more energy than I used to have in my twenties and most likely even in my teens. I have perfected my lifestyle on many levels over the past few years but I do think that my increased iron intake has certainly helped together with the rest of my diet and my stress management practice.
Risk factors for low ferritin
While all women have periods not all women start losing hair and not all suffer from low ferritin and fatigue by their early 30s.
Women with hormonal imbalances and related conditions such as endometrioses and fibroids (I had/have both) are more likely to develop problems since their periods are heavier. They lose blood faster and unless they pay close attention to their dietary intake of iron they are bound to deplete their reserves.
Disclaimer: I am not saying that if you fix your ferritin, your hair will immediately stop shedding (mine has not, although it has improved). There are many other variables at play such as adequate protein intake, stress and the overall hormonal health.
Low-glycaemic diets with sufficient protein intake are believed by some to be able to reverse hair loss even in men so following an advanced dietary protocol such as Wahls might be a good thing. Not only for your hair but also for everything else.
And I would for sure recommend having a blood test done before even thinking of starting to take iron pills, which I don’t think is necessary in the first place.