What are Iron Studies?
Iron studies are a panel of blood tests that measure different aspects of how your body handles iron. The panel typically includes: Serum Iron (iron in the blood right now), TIBC (Total Iron Binding Capacity — the maximum amount of iron your blood can carry), Transferrin Saturation (% of TIBC that is actually carrying iron), and often Ferritin (iron stores). Together, these tests tell your doctor whether you have iron deficiency, iron overload, or anaemia of chronic disease.
Iron Studies Normal Range
| Test | Normal Range (Adults) |
|---|---|
| Serum Iron — Men | 65 – 175 µg/dL |
| Serum Iron — Women | 50 – 170 µg/dL |
| TIBC | 250 – 370 µg/dL |
| Transferrin Saturation | 20 – 50% |
| Ferritin — Men | 24 – 336 ng/mL |
| Ferritin — Women | 11 – 307 ng/mL |
Iron Deficiency Pattern
LOW Iron deficiency anaemia pattern
Low serum iron + High TIBC + Low transferrin saturation (below 16%) + Low ferritin = Classic iron deficiency anaemia. Your body is starving for iron. TIBC is high because your blood is producing extra "carriers" desperately trying to grab any available iron. This pattern is the most common cause of anaemia in India, especially in women and children.
Anaemia of Chronic Disease Pattern
Anaemia of chronic disease (ACD) pattern
Low serum iron + Low TIBC + Low/Normal transferrin saturation + Normal or HIGH ferritin = Anaemia of chronic disease. This occurs in chronic infections (TB, HIV), autoimmune diseases, kidney disease and cancer. Iron is trapped inside cells and cannot be used — even though stores are adequate. Treating the underlying condition (not giving iron supplements) is the right approach here. Giving iron supplements in ACD is usually unhelpful and sometimes harmful.
Iron Overload Pattern
HIGH Iron overload (haemochromatosis) pattern
High serum iron + Low TIBC + High transferrin saturation (above 60%) + Very high ferritin = Iron overload. In hereditary haemochromatosis, the body absorbs too much iron and deposits it in organs (liver, heart, joints, pancreas). Treatment is regular blood donation (phlebotomy) to reduce iron. Very high transferrin saturation (above 45%) in otherwise healthy person should prompt a ferritin test and possibly genetic testing for HFE gene mutation.
Questions to ask your doctor
- Is this iron deficiency anaemia or anaemia of chronic disease?
- What is the underlying cause of my iron deficiency — diet, periods or gut bleeding?
- Do I need IV iron or are tablets sufficient?
- When should I recheck iron studies after starting treatment?