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Iron Status Profile

What is an Iron Status Profile?

The body needs the mineral iron for normal growth and development. Iron is required by the body to produce haemoglobin, a protein found in red blood cells. Haemoglobin functions to carry oxygen from the lungs to the cells of all organs of the body. Iron is also required by other tissues of the body to function properly. These include the bone marrow where different types of blood cells are produced, the muscles, and the connective tissues that provide support for the organs. It is necessary for development of the brain and immune (defence) system, as well as for making some hormones.

Three substances found in the blood - mineral iron, and the proteins transferrin and ferritin - are used to generate the Iron Status Profile. Transferrin is made in the liver and is important for regulating the amount of iron in the blood. Iron bound to transferrin is transported all around the body in the blood. Ferritin is produced in blood cells and cells of other tissues. The function of ferritin is primarily iron storage within cells of the body, where iron is stored bound to ferritin; it is essential to maintaining iron balance.

The Profile then reports serum iron level and three other parameters of the blood that are important to iron status, the Total Iron Binding Capacity (TIBC), the Ferritin level, and the Transferrin Saturation. The TIBC is the amount of the transferrin in your blood that is available to attach to iron. Transferrin saturation refers to the amount of iron in the blood that is bound to transferrin.

Buy Iron Status Profile test

Iron Status Profile Test £39.95

The test is very easy-to-use and results are available 1 day after your sample is received at our laboratory.

What tests are done for an Iron Status Profile?

Tests included in this Iron Status Profile are serum iron test, TIBC, ferritin, and transferrin saturation.

The iron test evaluates the amount of iron in the blood; the TIBC test measures the total ability of transferrin to bind to iron and indicating iron stores in the body; the ferritin measures the level of iron stored in the body; and transferrin saturation measures how much iron in the blood is attached to transferrin. Taken together, these measurements give an overall picture of your iron status.

Why is an Iron Status Profile important?

An Iron Status Profile contains all the necessary tests to ensure that your iron levels are not either too low or too high, but are adequate for good health and functioning.

An Iron Status Profile may be needed for several different reasons, which include:

  • Screening for or diagnosing conditions characterised by abnormal iron levels, such as iron-deficient anaemia, other kinds of anaemia, haemochromatosis (iron-overload), and liver disorders/disease
  • Monitoring a long-term medical condition, such as inflammatory bowel disease, an autoimmune disease, intestinal bleeding, kidney disease, and cancer
  • Haemoglobin level and/or haematocrit are low during a routine blood test
  • A woman with heavy menstrual bleeds, is pregnant or is breast feeding
  • Malnutrition, when insufficient consumption of iron in the diet is suspected
  • Determining whether an iron treatment is working
  • Assessing iron poisoning, such as in cases of swallowing too many iron supplements.

Who should have their Iron Status Profile tested?

Certain signs and symptoms may indicate that you have problems with the level of iron in your body. The tests conducted in an Iron Status Profile may be required to confirm whether your iron level is below or above the normal range.

Common signs and symptoms of an iron deficiency are lack of energy, fatigue, weakness, dizziness, breathlessness, pale skin, increased heartbeat, and frequent infections. Common signs and symptoms of an iron overload are loss of energy, fatigue, weak limbs, pain in the joints and/or stomach, irregular heartbeat, jaundice, liver damage, and lack of sex drive, and early menopause or impotence.

How to test for Iron Status?

A sample of blood is required to evaluate your Iron Status Profile. The blood sample, which is only 600 microlitres, is collected by you in your own home. The sample collection tubes are designed for blood collected from pricking the skin. While you may not have collected your own blood sample before, instructions on what to do are given in the test kit pack along with everything you need. The best samples are collected by people who read these instructions, and who collect enough blood for one collection tube (that is up to the upper line indicated on the tube). The test kits are given to you by your doctor, the labelled blood samples with the request form are posted by you to the laboratory, and the results are then sent to your doctor. You can ask your doctor to explain your results and whether other tests are needed.

What are normal Iron Status Profile test results?

The reference range for iron is required to evaluate whether your test results are within the 'normal' range. Reference ranges may vary with age, sex, medical history, and laboratory. This means that a result outside of the normal range may be that person's 'normal'.

Iron, ferritin, TIBC and transferrin saturation can change relative to each other. Mild iron depletion means that the body's iron level is sufficient to functioning, but that there are no additional iron stores; thus,

  • serum iron level may be normal and
  • ferritin level is low.

With worsening iron deficiency (and in iron-deficiency anaemia), the body uses up its stored iron and increases transferrin production to increase transport of iron; thus,

  • serum iron and ferritin are low
  • transferrin and TIBC are high
  • transferrin saturation is low
  • fewer red blood cells are produced and some may be small and pale.

Conversely, acute iron overload results in:

  • high iron levels
  • normal ferritin and TIBC
  • high transferrin saturation.

In chronic iron overload, such as in hereditary haemochromatosis,

  • iron and ferritin levels are high
  • transferrin and TIBC are low
  • transferrin saturation is high.

A low iron level may indicate:

  • Iron-deficiency anaemia (e.g., from a poor diet, heavy menstrual periods, during pregnancy or breast feeding, in rapidly-growing children, surgery, chronic disease, and infections)
  • Other types of anaemia (e.g., 'functional iron deficiency' because of an inflammatory disease where iron use is inefficient in red blood cell production)
  • Long-term blood loss (e.g., due to poor intestinal absorption or bleeding in the intestine).

A high iron level may indicate:

  • Iron overload, (e.g., from hereditary hemochromatosis)
  • Liver damage or disease
  • Haemolytic anaemia that causes early destruction of red blood cells
  • Iron-replacement therapy.
  • Recent or frequent blood transfusions
  • Iron or lead poisoning (e.g., from too many iron supplements)

How to maintain a normal Iron Status Profile

Having a varied balanced diet can provide sufficient iron to keep your iron levels, as well as your TIBC, ferritin, and transferrin saturation, healthy. Particular care should be taken by women at the time of their menstrual period, and by vegans or vegetarians. The best iron sources come from animal products such as red meat and liver, and shellfish; plant sources are green leafy vegetables, pulses, nuts and seeds, fortified cereals, and dried fruit. Iron absorption can be increased by vitamins A and C, but decreased by tannins (in tea) and calcium. Alcohol can increase iron storage, especially in the liver, so should be consumed in moderation and not at all in people with liver disease.

Reviewed by: Dr Loraine Haslam MBBS, DRCOG, DFSRH, LoC SDI, LoC IUT, MRCGP
GMC registration number: 4524038
Date: 27 March 2023
Next review: 26 March 2025
All UK registered doctors can have their registration checked on
The Medical Register at the GMC website.
 
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