Anemia is a common clinical condition with multiple causes, and a thorough lab workup is crucial for accurate diagnosis. Among the most important parameters are serum ferritin and iron studies, including serum iron, TIBC (Total Iron Binding Capacity), and transferrin saturation. These tests help differentiate between types of anemia such as iron deficiency anemia, anemia of chronic disease, and iron overload disorders.
🧪 Components of Iron Studies
- Serum Iron: Measures circulating iron bound to transferrin.
- TIBC: Reflects total capacity of transferrin to bind iron.
- Transferrin Saturation: Calculated as (Serum Iron ÷ TIBC) × 100; indicates how much transferrin is saturated with iron.
- Serum Ferritin: Indicates iron stores in the body; also an acute phase reactant.
📊 Reference Ranges
| Parameter | Normal Range |
|---|---|
| Serum Iron | 60–170 µg/dL |
| TIBC | 240–450 µg/dL |
| Transferrin Saturation | 20–50% |
| Serum Ferritin (M) | 20–500 ng/mL |
| Serum Ferritin (F) | 20–200 ng/mL |
🔍 Ferritin and Iron Studies in Various Anemias
1. Iron Deficiency Anemia (IDA)
- ↓ Serum iron
- ↑ TIBC
- ↓ Transferrin saturation
- ↓ Serum ferritin (most specific marker)
2. Anemia of Chronic Disease (ACD)
- ↓ Serum iron
- ↓ or normal TIBC
- ↓ Transferrin saturation
- Normal or ↑ ferritin (due to inflammation)
3. Iron Overload (e.g., Hemochromatosis)
- ↑ Serum iron
- ↓ TIBC
- ↑ Transferrin saturation (>60%)
- ↑ Serum ferritin
📈 Interpretation Chart
| Condition | Iron | TIBC | Sat% | Ferritin |
|---|---|---|---|---|
| Iron Deficiency | ↓ | ↑ | ↓ | ↓ |
| Chronic Disease | ↓ | ↓ or N | ↓ | ↑ |
| Iron Overload | ↑ | ↓ | ↑ | ↑ |
🧾 When to Order Iron Studies?
- Microcytic anemia (MCV <80 fL)
- Fatigue, pallor, or unexplained weakness
- Suspected chronic disease with anemia
- Monitoring response to iron therapy
🔗 Related Articles
- Vitamin B12 and Folate Deficiency: Lab Diagnosis
- Role of Reticulocyte Count in Anemia
- Hemoglobin Electrophoresis and Thalassemia
❓ Frequently Asked Questions
1. Is ferritin a reliable test?
Yes, it is the most specific indicator of iron stores. However, it may be falsely elevated in infection or inflammation.
2. What is the earliest indicator of iron deficiency?
A fall in serum ferritin is the earliest biochemical change before anemia develops.
3. Can you have normal ferritin and still be iron deficient?
Yes, especially in chronic inflammatory states where ferritin is falsely elevated.
✅ Conclusion
Serum ferritin and iron studies are fundamental tools in diagnosing and managing different types of anemia. Their accurate interpretation guides effective treatment, whether it's iron supplementation or managing chronic disease.
Tags: Anemia, Ferritin, Iron Deficiency, Iron Studies, TIBC, Transferrin Saturation, Clinical Pathology, Hematology
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