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Iron studies

Evaluation of the body's iron depends on the results of three lab tests. To reach a diagnosis the three results should be interpreted together (see table below).

Serum iron

Serum iron measures the amount of iron in the blood.

Total iron binding capacity

A test that measures indirectly the transferrin level in the bloodstream. Transferrin is a protein that carries iron in the body.

Normal values are 240 to 450 mcg/dl.

Lower than normal TIBC may indicate:

• Cirrhosis
• Sickle cell anemia
• Hypoproteinemia
• Pernicious anemia
• Hemolytic anemia

Greater than normal TIBC can be seen in:

• Iron deficiency anemia
• Late pregnancy
• Polycythemia vera
• The use of birth control pills can lead to increased TIBC measurements.

Ferritin

Serum ferritin measures the amount of ferritin in the blood. This is a better estimate of total body iron than the serum iron test.

Normal Values:

• male: 12-300 ng/ml
• female: 12-150 ng/ml

Lower than normal levels may indicate:

• chronic gastrointestinal bleeding
• heavy menstrual bleeding
• iron deficiency anemia

Higher than normal levels may indicate:

• alcoholic liver disease
• hemochromatosis
• hemolytic anemia
• Hodgkin's lymphoma
• megaloblastic anemia
• Any inflammatory disorder can raise the ferritin level.

Table 1: Interpretation of iron studies in various diseases.

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