Ferritin, iron and either iron binding capacity or transferrin are useful in the differential diagnosis of iron deficiency, anemia, and for iron overload conditions.Ferritin and iron/TIBC (or transferrin) are affected by acute and chronic inflammatory conditions, and in patients with these disorders, tests of iron status may be difficult to interpret. Transferrin and ferritin belong to a group of serum proteins known as acute phase reactants, and are increased in response to stressful or inflammatory conditions and also can occur with infection and tissue injury due to surgery, trauma or necrosis. Serum ferritin can be useful for both initiating and monitoring treatment for iron overload. In these conditions the iron is elevated, the TIBC and transferrin are within the reference range or low, and the percent saturation is elevated. High concentrations are found in hemosiderosis (iron overload without associated tissue injury) and hemochromatosis (iron overload with associated tissue injury). Low concentrations are associated with iron deficiency and are highly specific.
The percent saturation represents the ratio of iron to the TIBC.Īssays for ferritin are also useful in assessing iron balance. TIBC and transferrin may be decreased in malabsorption syndromes or in those affected with chronic diseases. TIBC and transferrin are elevated in iron deficiency, and with oral contraceptive use, and during pregnancy. TIBC quantifies transferrin by the amount of iron that it can bind. Total iron binding capacity (TIBC) is an indirect measure of transferrin, a protein that binds and transports iron. Serum iron may also be altered in acute and chronic inflammatory and neoplastic conditions.
High doses of supplemental iron may cause the serum iron to be elevated.
In adults, iron deficiency is usually the result of blood loss and is only occasionally secondary to dietary deficiency or malabsorption.įollowing major surgery the patient may have iron deficient erythropoiesis for months or years if adequate iron replacement has not been given. In young children on a milk diet, iron deficiency is often secondary to dietary deficiency. Iron deficiency is the most common cause of anemia. Iron studies are best performed when the patient is fasting in the morning and has abstained from medications that may influence iron balance. Serum iron studies are useful in the evaluation of disorders of iron metabolism, particularly iron deficiency and iron excess.
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