Iron Studies Max
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Iron, TIBC, Transferrin, Ferritin
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🩸 Iron Panel Tests: Explanation & Interpretation
Test | Fasting Required | Main Organs Involved | What It Measures |
|---|---|---|---|
Iron (Serum) | ✅ Yes (8–10 hours) | Blood, liver, bone marrow | Circulating iron bound to transferrin |
TIBC | ✅ Yes | Liver, blood plasma | Blood’s total capacity to bind iron via transferrin |
Transferrin | ✅ Yes | Liver | Main iron-binding protein produced by liver |
Ferritin | ✅ Yes | Liver, spleen, bone marrow | Stored iron in tissues; also rises with inflammation |
1. Serum Iron
- 🧪 Measures: Iron bound to transferrin (circulating form)
- 📉 Low in: Iron deficiency, chronic disease, poor diet, bleeding
- 📈 High in: Hemochromatosis, excess supplementation, liver disease
- 🔄 Fluctuates daily — should always be interpreted with TIBC and ferritin
2. TIBC (Total Iron Binding Capacity)
- 🧪 Measures: The blood’s potential to bind iron (mainly via transferrin)
- 📈 High TIBC: Body is trying to absorb more iron → iron deficiency
- 📉 Low TIBC: Seen in inflammation, liver disease, hemochromatosis
3. Transferrin
- 🧬 A protein that binds and transports iron in the blood
- 🧪 % Saturation = (Serum Iron / TIBC) × 100
- 📉 Low transferrin saturation = iron deficiency
- 📈 High transferrin saturation = iron overload
4. Ferritin
- 🧪 Storage form of iron – reflects iron stores in liver, bone marrow, and spleen
- 📉 Low Ferritin = Earliest indicator of iron deficiency
- 📈 High Ferritin = Can indicate iron overload OR inflammation (acute phase reactant)
- ⚠️ Always interpret ferritin with CRP or ESR to rule out false elevation due to inflammation
📋 Summary Table
Condition | Iron | TIBC | Transferrin Sat% | Ferritin |
|---|---|---|---|---|
Iron Deficiency Anemia | ↓ | ↑ | ↓ | ↓ |
Chronic Disease Anemia | ↓ | ↓/N | ↓ | N/↑ |
Hemochromatosis | ↑ | ↓/N | ↑ | ↑↑ |
Inflammation or Infection | ↓/N | ↓ | ↓ | ↑ |
🔗 Ideal Complementary Tests
Goal | Additional Tests Recommended |
|---|---|
Diagnose iron deficiency | CBC (for anemia), Reticulocyte Count, CRP (inflammation check) |
Rule out chronic disease | ESR, CRP, Serum protein electrophoresis |
Detect iron overload | Genetic testing (HFE gene), Liver function tests, MRI (liver) |
✅ Clinical Use Cases
Clinical Scenario | Most Relevant Markers |
|---|---|
Fatigue, pallor, dizziness | Iron, Ferritin, CBC |
Chronic infections or arthritis | Ferritin + CRP + TIBC |
Menstrual loss / GI bleeding | Ferritin + Iron + FOBT |
Suspected hemochromatosis | Ferritin + Transferrin Saturation + HFE gene |
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