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These examples demonstrate that to properly understand a value for TIBC, one also must know the serum iron, the percent transferrin saturation, and the individual clinical situation. In modern laboratory testings, serum ferritin levels are generally accepted as reliable single indicators of the presence of iron deficiency.
Transferrin saturation (TS), measured as a percentage, is a medical laboratory value. It is the value of serum iron divided by the total iron-binding capacity [1] of the available transferrin, the main protein that binds iron in the blood, this value tells a clinician how much serum iron is bound. For instance, a value of 15% means that 15% of ...
IRON PANEL Serum iron Transferrin and TIBC Transferrin saturation Ferritin Transferrin receptor Related tests Hb MCV Iron deficiency anemia: Iron overload (hemochromatosis) * Normal Anemia of chronic disease * * Porphyria cutanea tarda (PCT) Normal Thalassemia Sideroblastic anemia * Megaloblastic anemia: Hemolytic anemia * * * *
When plasma transferrin levels rise, there is a reciprocal decrease in percent transferrin iron saturation, and a corresponding increase in total iron binding capacity in iron deficient states [22] A decreased plasma transferrin level can occur in iron overload diseases and protein malnutrition.
Serum iron is a medical laboratory test that measures the amount of circulating iron that is bound to transferrin and freely circulate in the blood. Clinicians order this laboratory test when they are concerned about iron deficiency, which can cause anemia and other problems. 65% of the iron in the body is bound up in hemoglobin molecules in red blood cells.
Total iron-binding capacity increases when iron deficiency exists. [4] Serum ferritin levels reflect the iron stores available in the body. [4] The normal range is 20 to 200 nanograms per milliliter (ng/mL) for men and 15 to 150 ng/mL for women. [8] Low levels (< 12 ng/mL) are specific for iron deficiency. [4]
Iron-deficiency anemia is confirmed by tests that include serum ferritin, serum iron level, serum transferrin, and total iron binding capacity. [59] A low serum ferritin is most commonly found. However, serum ferritin can be elevated by any type of chronic inflammation and thus is not consistently decreased in iron-deficiency anemia. [23]
Transferrin saturation of greater than 45% combined with an elevated ferritin level is highly sensitive in diagnosing HFE hemochromatosis. [7] Total iron binding capacity may be low in hemochromatosis, but can also be normal. [37]
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