Iron, Ferritin, Transferrin, TIBC
Test ID: A901
Measurement of iron levels in blood are useful for the evaluation of iron status, including red blood cell production and destruction, iron metabolism, and iron transport. Increased iron concentrations occur in haemolytic anemias, hemochromatosis, and acute liver disease. Decreased iron concentrations are seen in iron deficiency and anemia of chronic disease, with major causes of iron deficiency including gastrointestinal bleeding and menstrual bleeding.
Ferritin analyses provide a sensitive, specific, and reliable measurement for determining iron deficiency at an early stage, and are also useful for monitoring the reaccumulation of iron stores in iron-deficient individuals who are taking iron supplements. Ferritin analyses are also beneficial for determining iron overload and response to iron chelating agents.
Transferrin is the main protein that binds to and transports iron around the body. Transferrin levels provide an indication of nutritional status, with increased levels associated with iron deficiency anemia.
Total iron-binding capacity (TIBC) and transferrin saturation are two calculations to determine the blood’s capacity to bind iron with transferrin. In low iron states, TIBC is increased, while transferrin saturation is decreased.
How to order a test
What is Included?
Measurement of iron levels in a blood sample by colorimetric (ferene) methodology.
Measurement of ferritin levels in a blood sample by chemiluminescent microparticle immunoassay.
Measurement of transferrin levels by immunoturbidimetric assay.
Calculation of transferrin saturation, using measured values for serum iron and serum transferrin.
Calculation of total iron binding capacity (TIBC), using the measured value for serum transferrin.
1 – 3 business days
The turnaround time is not guaranteed. The average turnaround time is 1 – 3 business days from the date that the sample arrives at the laboratory. Shipping time for the sample is not included. Additional time is required if the case requires confirmatory or reflex testing, or if the sample is insufficient, or if a recollection is required.
Additional Information and Resources
Preparation Before Specimen Collection
Collect blood sample for this test after fasting overnight (for 8–12 hours). Fasting means that no food or drink (aside from water) is to be consumed.
Avoid the consumption of any iron-containing supplements for 24 hours prior to collecting blood sample.
50 μL in a microtainer
Microtainer (regular blood tube)
This test requires a blood sample from a finger prick. All supplies for sample collection are provided in the kit.
- First wash and dry hands. Warm hands aid in blood collection.
- Clean the finger prick site with the alcohol swab and allow to air dry.
- Use the provided lancet to puncture the skin in one quick, continuous and deliberate stroke.
- Wipe away the first drop of blood.
- Massage hand and finger to increase blood flow to the puncture site. Angle arm and hand downwards to facilitate blood collection on the fingertip.
- Drip blood into the microtainer tube.
- Dispose of all sharps safely and return sample to the laboratory in the provided prepaid return shipping envelope.
NOTES: Avoid squeezing or ‘milking’ the finger excessively. If more blood is required and blood flow stops, perform a second skin puncture on another finger. Do not touch the fingertip.
Maintain specimen at temperatures between 2°C and 30°C during storage and transport.
Blood samples can be refrigerated or kept at room temperature for up to 7 days.
Causes for Rejection
- Incorrect or incomplete patient identification
- Incorrect specimen collection
- Inappropriate storage and transport conditions
- Incorrect specimen volume
- Severe hemolysis
To measure iron, ferritin, and transferrin levels in a blood sample for the evaluation of iron status, including red blood cell production and destruction, iron metabolism, and iron transport.
Increased iron concentrations occur in haemolytic anemias, hemochromatosis, and acute liver disease. Decreased iron concentrations are seen in iron deficiency and anemia of chronic disease, with major causes of iron deficiency including gastrointestinal bleeding and menstrual bleeding.
- This report is not intended for use in medico-legal applications.
- These results should be interpreted in conjunction with other laboratory and clinical information.
- Correct specimen collection and handling is required for optimal assay performance.
- Interferences from medication or endogenous substances may affect results.
- Chronic inflammatory disorders, infections, and chronic renal failure may interfere with ferritin analyses.
- Values obtained with different assay methods should not be used interchangeably in serial testing.
- This assay is not recommended for use during pregnancy, as ferritin diminishes late in pregnancy even when adequate iron stores are present.
- False results may occur in specimens from individuals that have received preparations of mouse monoclonal antibodies for diagnosis or therapy.
Colorimetric (ferene) (Alinity c Iron assay)
Chemiluminescent microparticle immunoassay (Alinity i Ferritin assay)
Immunoturbidimetric (Alinity c Transferrin assay)
|Iron1||Male||65 – 175 μg/dL|
|Female||50 – 170 μg/dL|
|Ferritin2||Male||40 – 300 ng/mL|
|Female||20 – 200 ng/mL|
|Transferrin3||Male 15 – 60 years||174 – 364 mg/dL|
|Male > 60 years||163 – 344 mg/dL|
|Female 15 – 60 years||180 – 382 mg/dL|
|Female > 60 years||173 – 360 mg/dL|
|Transferrin Saturation4||Adult||14 – 50 %|
|Total Iron Binding Capacity5||Adult||255 – 450 μg/dL|
These reference ranges were obtained from:
1 Alinity c Iron assay package insert. (Source: Tietz NW, editor. Clinical Guide to Laboratory Tests, 4th ed. St. Louis, MO: Elsevier Saunders; 2006:634-635.)
2 Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015 May 7;372(19):1832-43.
3 Alinity c Transferrin package insert. (Source: Ritchie RF, et al. Reference distributions for the negative acute-phase serum proteins, albumin, transferrin and transthyretin: a practical, simple and clinically relevant approach in a large cohort. J Clin Lab Anal. 1999;13(6):273-9.)
4 “Laboratory Reference Ranges” from the Endocrine Society.
5 Iron Binding Capacity, In StatPearls [Internet]