Laboratory tests used to evaluate iron status
| Test . | Sex . | Reference interval . | Comments . |
|---|---|---|---|
| Serum ferritin | M | 30-500 ng/mL | A low value indicates absolute iron deficiency. In a patient with liver disease or inflammation (eg, cancer), a normal or increased value does not exclude iron deficiency. |
| F | 12-240 ng/mL | ||
| TSAT | 20%-50% | Low values indicate iron-restricted erythropoiesis and iron deficiency. A low ferritin and low TSAT indicate absolute iron deficiency. A normal or elevated ferritin and low TSAT indicate iron sequestration. | |
| Serum iron | M | 50-170 μg/dL | |
| F | 30-160 μg/dL | ||
| TIBC | 240-450 μg/dL | ||
| ZPP | <70 μmol/mol heme | Elevated levels are also seen in lead poisoning, sideroblastic anemia, and other disorders. | |
| sTfR | M | 2.2-5.0 mg/L | sTfR is unaffected by inflammation, but the test has poor predictive value in the cancer population. |
| F | 1.9-4.4 mg/L | ||
| Hepcidin | Optimal threshold for response yet to be defined; it is likely <64.3 ng/mL (baseline) based upon currently available data | Baseline hepcidin level seems to strongly correlate with response to IV iron in FIDA; however, this test is not routinely available. | |
| MCV | M | 83-98 fL | Not sensitive or specific for iron deficiency. Affected by drugs, liver disease, and other factors. |
| F | 85-98 fL* | ||
| Reticulocyte hemoglobin content | Not routinely available | May be helpful in determining when patients will benefit from IV iron. |
| Test . | Sex . | Reference interval . | Comments . |
|---|---|---|---|
| Serum ferritin | M | 30-500 ng/mL | A low value indicates absolute iron deficiency. In a patient with liver disease or inflammation (eg, cancer), a normal or increased value does not exclude iron deficiency. |
| F | 12-240 ng/mL | ||
| TSAT | 20%-50% | Low values indicate iron-restricted erythropoiesis and iron deficiency. A low ferritin and low TSAT indicate absolute iron deficiency. A normal or elevated ferritin and low TSAT indicate iron sequestration. | |
| Serum iron | M | 50-170 μg/dL | |
| F | 30-160 μg/dL | ||
| TIBC | 240-450 μg/dL | ||
| ZPP | <70 μmol/mol heme | Elevated levels are also seen in lead poisoning, sideroblastic anemia, and other disorders. | |
| sTfR | M | 2.2-5.0 mg/L | sTfR is unaffected by inflammation, but the test has poor predictive value in the cancer population. |
| F | 1.9-4.4 mg/L | ||
| Hepcidin | Optimal threshold for response yet to be defined; it is likely <64.3 ng/mL (baseline) based upon currently available data | Baseline hepcidin level seems to strongly correlate with response to IV iron in FIDA; however, this test is not routinely available. | |
| MCV | M | 83-98 fL | Not sensitive or specific for iron deficiency. Affected by drugs, liver disease, and other factors. |
| F | 85-98 fL* | ||
| Reticulocyte hemoglobin content | Not routinely available | May be helpful in determining when patients will benefit from IV iron. |
Reference intervals are taken from ARUP Laboratories; zinc protoporphyrin (ZPP) from Mayo Clinic Laboratories.
F, female; M, male; sTfR, soluble transferrin receptor; TIBC, total iron binding capacity.
MCV reference intervals are from Wakeman et al.32