Understand your Iron Blood Test Results…

This page helps you to understand blood test results for Iron (Iron (Serum) /Total iron binding capacity / Iron Saturation (Transferrin Saturation) / Ferritin) and gives you the reference range to determine if your lab test results mean that you have high, low or normal Iron levels. 

We outline the risk factors associated with both raised and lower Vitamin D levels.

Reference Ranges for Iron (serum):  Please sign up to see ranges for Total iron binding capacity / Iron Saturation (Transferrin Saturation)

Measurment unit Metric Optimal Risk
US Conventional Units ug/dl = mcg/dl 56-168 <56 or > 168
Standard International Units umol/L 10-30 <10 or > 30
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What is Iron

Iron is an essential trace element and nutrient that is absorbed from food and transported throughout the body by transferrin, a protein produced by the liver [98].

The amount of iron present in the blood will vary throughout the day and from day to day. For this reason, serum iron is almost always measured with the total iron-binding capacity, from which the transferrin saturation (iron saturation) can be calculated. Transferrin Saturation is a more reliable indicator of iron status than just iron or total iron binding capacity alone [98].

Iron (Serum) – The serum iron test measures the amount of iron that is in transit in the body – the iron that is bound to transferrin [98].

Total iron binding capacity – Iron moves through the blood attached to a protein called transferrin. This test helps determine how well that protein can carry iron in your blood [98].

Iron Saturation (Transferrin Saturation) – Reflects the amount of iron being transported in the blood and also its capacity to carry more. In healthy people, about 15-50% of available transferrin sites are used to transport iron [98].

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Function of Iron

Iron performs many important functions in the body. It is primarily involved in the transfer of oxygen from the lungs to tissues. Iron also plays a role in metabolism as a component of some proteins and enzymes, and is involved in maintaining immune function and energy production [98].

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Risk factors associated with Iron

Iron deficiency is the most common nutritional deficiency and the leading cause of anemia in the world. In the USA, despite food fortification, iron deficiency is on the rise in certain populations [99].

A low iron (serum) result with a high transferrin or total iron binding capacity is usually due to iron deficiency. Iron deficiency is usually due to long-term or heavy bleeding. However, it can also be due to increased iron requirements (in pregnancy), rapid growth (in children), poor diet, and problems with absorption (stomach or intestinal disease). If the iron-deficiency anemia is severe, shortness of breath, dizziness, chest pain, headaches, and leg pains may occur [99].

Iron overload is an excess iron in vital organs. Iron overload may increase the risk for liver disease (cirrhosis, cancer), heart disease, diabetes, osteoarthritis, osteoporosis, metabolic syndrome or hypothyroidism [99].  Iron overload can be inherited (genetic) or acquired by receiving numerous blood transfusions, getting iron shots or injections, or consuming high levels of supplemental iron. Some of the genetic disorders that result in iron overload include are hereditary hemochromatosis (all types), African iron overload, sickle cell disease, thalassemia, X-linked sideroblastic anemia, enzyme deficiencies (pyruvate kinase; glucose-6-phosphate dehydrogenase) and very rare protein transport disorders aceruloplasminemia and atransferrinemia [99].

Anemia of chronic disease – Some chronic diseases, like rheumatoid arthritis, inflammatory bowel disease, and some types of cancer—can interfere with the body’s ability to use its stored iron. Taking more iron from foods or supplements usually does not reduce the resulting anemia of chronic disease because iron is diverted from the blood circulation to storage sites. The main therapy for anemia of chronic disease is treatment of the underlying disease [100].

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Notable variations by demographic group

African American and Hispanic women and their young children are more prone to iron deficiency, possibly because of diet or perhaps different hemoglobin needs. Men are rarely iron deficient; but when they are, it is generally due to blood loss from the digestive tract (sometimes indicating disease), diseases that affect iron absorption, and in some cases, alcohol abuse [99].

Frequencies of hereditary conditions that cause iron overload vary significantly between racial/ethnic groups and within some racial/ethnic groups across geographic regions [101].

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Diet to improve Iron

Iron is found naturally in many foods and is added to some fortified food products. The following foods are good sources of iron if you are deficient, or foods that you may want to limit if you have too much iron in your blood

  • Lean meat, seafood, and poultry.
  • White beans, lentils, spinach, kidney beans, and peas.
  • Nuts and some dried fruits, such as raisins [100].Iron in food comes in two forms: heme iron and nonheme iron. Nonheme iron is found in plant foods and iron-fortified food products. Meat, seafood, and poultry have both heme and nonheme iron.
  • Your body absorbs iron from plant sources better when you eat it with meat, poultry, seafood, and foods that contain vitamin C, like citrus fruits, strawberries, sweet peppers, tomatoes, and broccoli [100].


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Supplements for Iron

In most cases, people should get most of their iron requirements from food, advises the US federal government’s Dietary Guidelines for Americans. In some cases, where there is a deficiency supplements can provide the additional iron required, but it is recommended to do this with close supervision form your doctor [100].

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Exercise to improve Iron

The prevalence of iron deficiency is likely to be higher in athletic populations and groups, especially in younger female athletes, than in healthy sedentary individuals suggesting that exercise reduces the amount of iron stored in the body. Athletes, and young female athletes in particular should monitor there iron levels and if there is a deficiency use diet to correct it where possible [102].

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Sleep for Iron

Focusing on sleep quality will not impact iron levels. However research suggests that iron deficiency may not only have a direct effect on sleep itself, In the long run, iron deficiency may also potentially affect sleep regulatory mechanisms indirectly through altered response to other stressors and challenges [103].