Iron deficiency anemiaDecreaseIncreaseDecrease
Anemia of chronic diseaseDecreaseDecreaseIncrease
HemochromatosisIncreaseDecrease / NormalIncrease
Chronic hemolysisIncreaseDecreaseIncrease
Sideroblastic anemiaIncreaseNormalIncrease

Iron studies

Evaluation of the body's iron depends on the results of three lab tests. To reach a diagnosis the three results should be interpreted together (see table below).

Serum iron: normal 60-170 mcg/dl

Lower than normal levels may indicate:
  1. chronic gastrointestinal blood loss
  2. chronic heavy menstrual bleeding
  3. inadequate absorption of iron
  4. insufficient dietary iron
  5. pregnancy
  6. anemia of chronic disease
Higher than normal levels may indicate:
  1. hemochromatosis
  2. hemolysis
  3. hemolytic anemias
  4. hemosiderosis
  5. hepatic (liver) necrosis (tissue death)
  6. hepatitis
  7. vitamin B-12 deficiency, vitamin B-6 deficiency
  8. iron poisoning
  9. multiple blood transfusions
TIBC: normal 240 to 450 mcg/dl

Measures indirectly the blood transferrin level. Transferrin is a protein that carries iron in the body.

Lower than normal TIBC may indicate:
  1. Cirrhosis
  2. Sickle cell anemia
  3. Hypoproteinemia
  4. Pernicious anemia
  5. Hemolytic anemia
Greater than normal TIBC can be seen in:
  1. Iron deficiency anemia
  2. Late pregnancy
  3. Polycythemia vera
  4. The use of birth control pills can lead to increased TIBC measurements.
  5. Ferritin

Serum ferritin measures the amount of ferritin in the blood. This is a better estimate of total body iron than the serum iron test.

Normal Values: male: 12-300 ng/ml, female: 12-150 ng/ml

Lower than normal levels may indicate:
  1. chronic gastrointestinal bleeding
  2. heavy menstrual bleeding
  3. iron deficiency anemia
Higher than normal levels may indicate:
  1. alcoholic liver disease
  2. hemochromatosis
  3. hemolytic anemia
  4. Hodgkin's lymphoma
  5. megaloblastic anemia
  6. Any inflammatory disorder can raise the ferritin level.