Iron with TIBC, Serum

Serum iron, total iron-binding capacity (TIBC) along with transferrin tests and transferrin saturation are used to assess how much iron is being carried in the blood. These tests are used together helps to diagnose iron deficiency or iron overload (example: Hemochromatosis which is an inherited condition associated with excessive iron storage). Serum iron, TIBC also help to determine the cause of anemia. Serum iron and TIBC are done to screen for iron poisoning and hereditary disorders like hemochromatosis. Once the dietary iron enters the body, it is carried throughout the bloodstream by a protein called transferrin. Transferrin is produced by the liver. The TIBC test evaluates the iron carrying capacity of transferrin in the blood. Serum iron along with TIBC test is advised when there are non specific symptoms and signs of iron deficiency anaemia such as pallor, weakness, easy fatiguability, breathlessness on exertion, tachycardia, nail changes, and systolic heart murmur. Serum iron along with TIBC test is also done when suspecting hemochromatosis with symptoms like Joint pain, abdominal pain, fatigue, weakness etc. TIBC reflects the amount of transferring in circulation. TIBC is increased in iron deficiency anemia and decreased in chronic infections. Serum iron levels are slightly lower in women, Iron deficiency anemia, chronic inflammation and malignancies. Alteration in serum iron and TIBC occur after depletion of storage iron and are thus normal in early stage of disorders.

1. What foods can increase iron in the diet?

Meat, egg, green leafy vegetables (such as spinach, collard greens, etc.), wheat germ, whole grain breads and cereals, raisins etc., are rich sources of iron.

2. When are iron supplements required?

Iron supplements are required in pregnancy, those with or suspected iron deficiency, Young women who are anemic due to poor dietary intake and have excessive bleeding during menstrual cycle may require iron supplements.

3. Does iron deficiency manifest quickly or slowly?

Iron deficiency anemia manifests gradually. Iron stores are slowly used up, when the rate of iron loss exceeds the amount absorbed from the gut. At this initial stage, ferritin levels will be low, but serum iron and TIBC remain normal and there are no signs and symptoms of anemia. In the later stages, serum iron levels decrease, TIBC and transferring levels increase and signs and symptoms of anemia appear along with decreased haemoglobin, decreased RBC indices and change in RBC size.

4. Does blood donation affect iron levels?

Yes. Every time one unit of blood is donated, the body loses approximately 250 mg of iron. Serum ferritin level dereases with each donation and then returns to normal over time. However other tests such as serum iron and TIBC remain unchanged.

5. When is an iron profile done after iron supplementation?

To check for iron absorption from the gut. However iron profile still remains abnormal in malabsorption which requires treatment.