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Iron is (quite literally) the central component of the blood cells, especially the red blood cells. Remember hemoglobin? I’ve talked about it more in my first post here. The heme group has iron sitting right in the middle, like so:
So we now know that iron is very important in blood formation. Let’s now discuss the commonly ordered iron studies.
a) Serum iron
b) Ferritin
c) Total iron binding capacity/transferrin
d) Percentage saturation a.k.a transferrin saturation
Let’s now look at each of these individually
Test | Description |
|---|---|
Serum iron | This test measures the amount of circulating iron in the blood. It is can vary from day-to-day and with dietary changes |
Ferritin | The ferritin is the measure of the total amount of storage iron in the body. This is the most important number that is looked at to guide repletion in case of iron deficiency. However, a high ferritin does not necessarily indicate iron overload. A high ferritin can be commonly seen in clinical conditions that cause inflammation such as autoimmune disease, acute infection etc. |
Total iron binding capacity (TIBC)/transferrin level | Transferrin is the protein in the blood that carries iron and transports it from one place to another. This test measures how much iron can the body is able to absorb iron from the diet. The TIBC is high when the body is deficient in iron, i.e, the body ramps up its ability to bind iron when it senses that there is not enough circulating in the blood |
Percentage saturation or transferrin saturation | This test tells us how much iron is present on the transferrin molecule. A low % saturation indicates that there is not enough circulating iron in the body that is available to bind to transferrin |
The above tests are commonly ordered as a panel to help get a clearer picture of what might be going on in the body. It is not recommended to get these tests in isolation as they can be difficult to interpret
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