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Tests To Determine Iron Levels

TESTS to determine IRON LEVELS

When iron levels are too high or too low for a person’s age or gender the person can experience signs, symptoms or decreased ability to perform activities.  

Among the most basic and essential tests to determine iron levels are 

     fasting* serum iron    
     total iron-binding capacity (TIBC) or unbound-iron binding capacity (UIBC)
     serum ferritin

Iron Disorders Institute (IDI), is sponsored by Ironology. Ironology is now offering direct-to-consumer lab tests. Test vouchers can be purchased online in 45 participating states and the District of Columbia. Tests will be authorized by a physician affiliated with our lab partner. After receiving the voucher, patients can go to a conveniently located patient service center in their community and provide a blood sample drawn by a licensed phlebotomist. The sample will be analyzed by a CLIA approved laboratory. Test results will be delivered securely and directly to only the patient/customer, the ordering physician and IDI. IDI will inform any patients whose test results indicate an iron imbalance such as iron overload or iron deficiency according to the IDI iron reference ranges established by its medical advisers.When either of Health-e-Iron's proprietary panels called Ironology™ Iron Panel are ordered, you test results will include a measurement of your body's antioxidant defenses. This is a very important measure because even moderately elevated iron can trigger oxidative stress and free radical activity. It's very important to know the strength of your body's natural defense system.

This service is attractively priced. Our prices are 65 to 70% less than those commonly charged by hospitals and laboratory testing centers.

Our affiliate Health-e-Iron's Ironology™ Iron Panel test panel contains all of the tests we specialize in included in a standard iron panel plus GGT (Gamma Glutamyl transferase) and hemoglobin (HgB). The following is a description of the tests and our rationale for suggesting that each be included in a single sample blood draw as part of a comprehensive panel. There you'll find hundreds of peer-reviewed scientific articles, and substantial summary information including graphs and health risk charts. These materials will guide you through the process and help you understand how testing these measures can help you take charge of your own health. You can read a more comprehensive description of these tests on our Iron Tests page.

Brief description of tests

Hemoglobin measures functional iron. This iron delivers oxygen to cells and carries carbon dioxide away from cells. Hemoglobin varies by age and gender.

TS% (transferrin-iron saturation percentage)
Fasting* serum iron and TIBC together provide the information to calculate the transferrin-iron saturation percentage (TS%). TS% is an indirect measure of one’s ability to bind iron and transport it to various sites such as the bone marrow or liver.

Calculating TS%:
Fasting* serum iron ÷ TIBC X 100%= transferrin-iron saturation percentage (TS%) 
*Fasting is nothing by mouth (except water or prescribed medications) after midnight or at least 5 hours before tests. 

Fasting TS% is normally between 25-35%.   
A fasting TS% above 45% suggests iron loading, although elevated TS% could be a transient (passing) situation. Various foods and conditions can influence serum iron. You may wish to request a repeat fasting test with a stricter 72 hour pre-test avoidances of foods and substances: red meat, supplements, alcohol, vitamin C rich juices or high sugar foods/beverages. These items can increase iron absorption or alter results. A fasting TS% below 20 suggests iron deficiency or anemia of inflammatory response also called anemia of chronic disease. 

TIBC, UIBC and Transferrin:
Some laboratories measure TIBC, while others measure UIBC or  transferrin.The body makes transferrin based on iron needs. Generally  about one-third of transferrin is used to bind and transport iron. Because 2/3 of transferrin is unbound, you have a great capacity to bind iron. This 2/3 portion represents the Unsaturated Iron Binding Capacity (UIBC). Said another way,  UIBC measures the unsaturated binding capacity of transferrin.TIBC (total iron binding capacity) is UIBC plus the serum iron measurement.UIBC+SI=TIBC

Serum ferritin (SF) ranges vary by age and gender. 

Serum ferritin is elevated in conditions of iron overload, liver disease, alcohol abuse, nicotine product abuse (used to stop smoking) and in people who are sick with illnesses, which causes inflammation. SF is naturally elevated in newborns and infants. Serum ferritin is low in people who are iron deficient. Read about elevated serum ferritin in infants and newborns or about Anemia of Chronic Disease (ACD) also called anemia of inflammatory response.

A more complete description of the tests including in our special test panel is included on our Iron Tests page or go directly to our affiliated Health-e-Iron web site. Some additional information of interest can be found below.

Get the entire IRON picture

Hemoglobin gives you part of the iron picture, but to better determine iron status, you need to look at iron in several different ways. Besides hemoglobin which indicates how much iron you have in use, you need to know how much iron is bound to transferrin or unbound (UIBC or free) or contained in storage in ferritin. In some cases you may need to know how much iron is contained in bone marrow.  

Hemoglobin, serum iron, TIBC or UIBC and serum ferritin are sufficient to establish a basic picture of one’s iron status, but in conditions of disease that may be due to blood cell production or cancers, other tests   or procedures are needed to determine the cause for abnormal iron levels. These include (but are not limited to) a complete blood count with differential, Zinc Protoporphyrin immunological tests, hormone tests, retic count (reticulocyte count), C-reactive Protein (CRP), sedimentation rate (SED rate), B12 or folate levels, genetic testing, tissue biopsy, MRI, ultrasound, bone marrow aspiration, blood smears, urine or fecal sampling, scopes (endoscope or colonoscopy) and tests associated with specific diseases or conditions that can have anemia or iron overload as a symptom or consequence. To read about these specific tests or procedures, we suggest that you visit The National Library of Medicine MedlinePlus:  www.nlm.nih.gov/medlineplus
To download PDF versions of our charts, visit the READING ROOM. Here you can browse or use the search feature to find articles of interest, charts, forms, patient stories, links, diet and supplement information, treatment centers, access our healthcare provider registry, check our calendar of events, become a volunteer,  or make  a donation.  Our books are excellent resources for understanding iron disorders such as hemochromatosis, anemia of chronic disease, iron overload with anemia and iron deficiency. 

Too little iron or too much iron changes the way we grow, develop and function.

Our Need For Iron
Read more about the body's need for iron. 

What Is Iron?
Read more about the body's need for iron. 
Iron We Consume
Read more about the body's need for iron. 
Read more about the body's need for iron. 

Recommended Daily Allowance
Read more about the body's need for iron.   
Read more about the body's need for iron. 
How Much Iron Is In The Body
Read more about the body's need for iron.

Iron Levels -Test
Read more about tests to determine iron and antioxidant levels  
How Iron Triggers Free Radical Activity
Read more about iron-catalyzed oxidative stress