Interpreting Haematinics

Related Subjects: | Ferritin | CEA | ESR | CRP | ALP | LDH | HbA1c | Alpha Fetoprotein | Anti-Hu ab | Anti-Yo ab | Biochemical Lab values

Fe def anaemia : ferritin low, TIBC normal/high, Transferrin normal/high.
AOCD ferritin normal, low iron, low TIBC, low transferrin

Ferritin

• Intracellular storage form of Iron and Each molecule holds 4500 atoms of Fe
• High Ferritin: Acute Phase reactant. Consider Haemochromatosis if > 1000 ug/L
• Normal: Adequate iron levels or may be elevated as APR
• Low: Suggests Iron deficiency if Ferritin <15 ug/L (some say 30 ug/L)

Total serum iron: Considerable variation even in day so not very useful

• Refers to ferric ions (Fe3+) bound to serum transferrin
• A poor marker of Iron status as Serum iron concentration is highly variable
• Affected by dietary iron intake, inflammation, and infection.
• Levels < 10 micromol/L suggest low iron stores
• Levels > 30 micromol/l suggest high stores

Transferrin

• Carrier protein (apotransferrin) bound to one or two iron atoms
• High in iron deficiency to maximize utilization of available iron.
• Low in Hepatic disease, Inflammatory states

Transferrin saturation

• Calculated from serum iron and either TIBC or transferrin measurements.
• Normal is 30% saturated with iron.
• Transferrin saturation rises in iron overload and falls in iron deficiency
• Levels < 16 % suggest low iron stores
• Levels > 45% suggest high iron stores
• Levels > 55% in males an 50% in females consider screening for Haemochromatosis

Total iron binding capacity

• Alternative test to transferrin
• Reflects the availability of iron binding sites on transferrin.
• High in iron deficiency > 70 umol/L
• Low in iron overload. < 45 mol/L

Iron Deficiency Anaemia

• Ferritin <15 ug/L (some say 30 ug/L)
• Transferrin saturation <16%
• Hb increase of 1 g/dL after 2 months of iron supplementation (values vary with ethnicity and pregnancy)
• Hb <120 g/L in women and <130 g/L in men (15 years of age and above).