What is the significance of a patient having iron levels of 118, total iron-binding capacity (TIBC) of 408, transferrin saturation of 29%, vitamin B12 (B12) levels of 283, and ferritin (Fer) levels of 53, with normal hemoglobin?

From the Guidelines

Based on the provided lab values, your iron studies appear to be within normal ranges, and no specific treatment or supplementation is needed at this time. Your serum iron is 118, total iron binding capacity (TIBC) is 408, transferrin saturation is 29%, vitamin B12 is 283, and ferritin is 53, with normal hemoglobin. Transferrin saturation between 20-50% is typically considered normal, and your value of 29% falls within this range 1. Your ferritin level of 53 is sufficient, though it's in the lower-normal range for most laboratory standards. Vitamin B12 at 283 is also adequate for normal red blood cell production. These values collectively suggest that your body has sufficient iron for hemoglobin production and oxygen transport. Some key points to consider:

• Transferrin saturation (TSAT) reflects iron that is readily available for erythropoiesis, and a TSAT of 29% indicates that your body has sufficient iron for hemoglobin production 1.
• Serum ferritin reflects storage iron, and a level of 53 is considered sufficient, though it's in the lower-normal range for most laboratory standards 1.
• Vitamin B12 is essential for normal red blood cell production, and a level of 283 is considered adequate 1. Continue with a balanced diet that includes iron-rich foods such as lean meats, beans, and leafy greens to maintain these healthy levels. Regular follow-up with your healthcare provider is recommended to monitor these values over time, especially if you experience symptoms like fatigue or weakness. It's also important to note that the diagnosis of iron deficiency can be complex, and a combination of parameters should be assessed, including transferrin saturation, serum ferritin, and inflammatory markers 1. In the absence of biochemical or clinical inflammation, ferritin is a reliable indicator of iron storage levels, and a serum ferritin level < 15 μg/L indicates absolute iron deficiency 1. However, in the presence of inflammation, the lower limit of ferritin consistent with normal iron stores should be increased to 100 μg/L 1. In your case, since there is no indication of inflammation, your ferritin level of 53 is considered sufficient. Overall, your iron studies appear to be within normal ranges, and no specific treatment or supplementation is needed at this time. However, it's always best to consult with your healthcare provider to determine the best course of action based on your individual needs and health status. Some studies suggest that even once daily oral iron therapy is associated with increased hepcidin levels that inhibit effective absorption of iron, therefore supporting a strategy of alternate day oral iron supplementation 1. But in your case, since your iron studies are within normal ranges, there is no need for iron supplementation at this time. Regular monitoring of your iron status is recommended to ensure that your iron stores remain adequate, especially if you experience symptoms like fatigue or weakness 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Iron Deficiency and Supplementation

• Iron deficiency is a common cause of morbidity and can arise as a consequence or complication from many diseases 2.
• The use of intravenous iron has increased significantly in the last decade, but concerns remain about indications and administration 2.
• Oral iron supplementation can be an effective strategy to treat and prevent iron deficiency anemia (IDA), but guidelines vary 3.

Treatment Options

• Modern intravenous iron preparations can facilitate rapid iron repletion in one or two doses, both for absolute iron deficiency and, in the presence of inflammation, functional iron deficiency 2.
• Oral iron doses ≥60 mg should be given on alternate days to maximize fractional iron absorption 3.
• Providing morning doses of 60-120 mg iron as a ferrous salt given with ascorbic acid on alternate days may be an optimal oral dosing regimen for women with iron-deficiency and mild IDA 3.

Iron Status and Supplementation

• Ferritin concentration increased significantly between baseline and post-supplementation as well as between baseline and 6 months after supplementation with ferrous sulfate or iron bis-glycinate chelate 4.
• Lactoferrin supplementation had better effects on serum iron, ferritin, and hemoglobin concentration compared with ferrous sulfate 5.
• Iron deficiency is one of the leading contributors to the global burden of disease, and particularly affects children, premenopausal women, and people in low-income and middle-income countries 6.

Patient-Specific Considerations

• An underlying cause should be sought in all patients presenting with iron deficiency, and screening for coeliac disease should be considered routinely 6.
• Endoscopic investigation to exclude bleeding gastrointestinal lesions is warranted in men and postmenopausal women presenting with iron deficiency anaemia 6.
• Iron supplementation programmes in low-income countries comprise part of the solution to meeting WHO Global Nutrition Targets 6.

Lab Results

• The provided lab results (Iron 118, TIBC 408, Transferrin Sat 29, B12 283, Ferritin 53, normal hemoglobin) indicate that the patient has iron deficiency, but the treatment options and patient-specific considerations should be evaluated by a healthcare professional 2, 3, 4, 6, 5.