Iron studies interpretation
What it means
Iron deficiency: ↓ferritin, ↑TIBC/transferrin, ↓transferrin saturation. Anaemia of chronic disease: ↓/normal iron, ↓TIBC, normal/↑ferritin (acute-phase). Haemochromatosis/overload: ↑↑ferritin, ↑↑transferrin saturation (>45%). Ferritin is an acute-phase reactant — <30 µg/L confirms iron deficiency in any adult, but a normal ferritin doesn't exclude it in inflammation.
Worked example
Microcytic anaemia, ferritin 12, transferrin saturation 8%, raised TIBC → iron deficiency — find the source.
In the exam
A menstruating woman has a microcytic anaemia with ferritin 11, raised total iron-binding capacity and a transferrin saturation of 8%.
What settles it
Iron deficiency: low ferritin, HIGH TIBC; anaemia of chronic disease: normal/high ferritin, LOW TIBC.
Classically confused with
B12 & folate deficiency
Source: NICE CKS / BSH iron-deficiency