Iron Panel: What Each Test Shows
| Test | Normal Range | Role |
|---|---|---|
| Ferritin | Women: 15–200 μg/L; Men: 30–300 μg/L | Iron stores — best single test for deficiency |
| Serum iron | 10–30 μmol/L | Circulating iron level (fluctuates day-to-day) |
| TIBC (total iron-binding capacity) | 45–72 μmol/L | Iron-carrying capacity of transferrin |
| Transferrin saturation | 20–50% | % of transferrin bound to iron |
| Soluble transferrin receptor (sTfR) | <1.76 mg/L | Rises in deficiency; unaffected by inflammation |
Pattern Recognition
| Pattern | Ferritin | Iron | TIBC | Diagnosis |
|---|---|---|---|---|
| Iron deficiency | Low | Low | High | Iron deficiency anaemia |
| Anaemia of chronic disease | Normal/High | Low | Low/Normal | Chronic disease, inflammation, cancer |
| Haemochromatosis | Very high | High | Low | Iron overload |
| Haemolysis | High (acute) | High | Normal | RBC destruction |
Ferritin Is an Acute Phase ReactantFerritin rises with inflammation, infection, or liver disease — even when iron stores are actually low. A ferritin of 80 μg/L in a patient with active CRP 100 may still mask iron deficiency. Check CRP alongside ferritin.
What ferritin level is considered iron deficiency?
Ferritin <15 μg/L confirms iron deficiency. <30 μg/L is suggestive if symptoms are present. In inflammatory states (raised CRP), a higher ferritin threshold (up to 100 μg/L) may still reflect functional deficiency.
Why is my iron low if I eat meat?
Causes of iron deficiency despite adequate diet: blood loss (heavy periods, GI bleeding), poor absorption (coeliac disease, post-gastric surgery), or increased demand (pregnancy). Investigate the cause.
What is haemochromatosis?
A genetic condition (usually HFE gene mutations) causing excessive iron absorption and accumulation in organs — liver, heart, pancreas, joints, skin (bronze pigmentation). Treated with regular venesection (phlebotomy).
How long does it take to correct iron deficiency?
Oral iron supplementation typically raises haemoglobin within 4–8 weeks. Iron stores (ferritin) take 3–6 months to replenish. IV iron works faster and is used when oral iron is not tolerated or absorbed.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.