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 lab values provided, your iron studies appear to be within normal ranges, and no specific iron 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. These values suggest adequate iron stores and no evidence of iron deficiency anemia or iron overload. Ferritin, which reflects your body's iron stores, is above the lower threshold (typically around 20-30 ng/mL), indicating sufficient iron reserves 1. Your transferrin saturation of 29% falls within the normal range of 20-50%, confirming appropriate iron transport in your blood 1. Vitamin B12 levels are also adequate, supporting proper red blood cell formation. To maintain these healthy levels, continue consuming a balanced diet that includes iron-rich foods such as lean meats, beans, leafy greens, and fortified cereals. Regular monitoring of these values during annual check-ups is recommended, especially if you experience symptoms like unusual fatigue, weakness, or shortness of breath 1. It is also important to note that the diagnosis of iron deficiency can be complex, especially in the presence of inflammation, and may require further evaluation and consideration of other factors, such as transferrin receptor concentrations and inflammatory parameters 1. However, based on the provided lab values, no immediate action is required, and a wait-and-see approach with regular monitoring is recommended.

From the FDA Drug Label

Purpose Iron Supplement Therapy Ferrous Sulphate is an iron supplement for iron deficiency and iron deficiency anemia when the need for such therapy has been determined by a physician. The patient's iron level is 118, TIBC is 408, transferrin saturation is 29%, B12 is 283, and ferritin is 53, with normal hemoglobin.

• The patient's iron level and ferritin are within normal limits, but the transferrin saturation is slightly low.
• The TIBC is elevated, which may indicate iron deficiency. Based on the information provided, it is unclear if the patient requires iron supplement therapy. The decision to start iron therapy should be determined by a physician, considering the patient's overall clinical picture and laboratory results 2.

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 3.
• The use of intravenous iron has increased significantly in the last decade, but concerns remain about indications and administration 3.
• Oral iron supplementation can be an effective strategy to treat and prevent iron deficiency anemia (IDA), but guidelines vary 4.
• A study suggests that 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 4.

Diagnosis and Treatment

• Iron deficiency should be suspected as anemia cause when transferrin saturation is low, even if serum ferritin can be spuriously normal 5.
• Intravenous iron therapy is reserved for iron deficiency anemia patients with intolerance or unresponsiveness of oral iron 5.
• The main treatment target for intravenous iron is an improvement of the quality of life, for which hemoglobin is a surrogate marker 5.
• Individual selection of the appropriate iron therapy and evaluation of treatment response are mandatory to safely deliver improved outcome through intravenous iron therapies 5.

Iron Status and Supplementation

• Ferritin concentration increased significantly after supplementation with ferrous sulfate or iron bis-glycinate chelate in schoolchildren with iron deficiency but without anemia 6.
• Supplementing with 30 mg/d of elementary iron, either as ferrous sulfate or iron bis-glycinate chelate for 90 days, showed positive effects on increasing ferritin concentration in schoolchildren with low iron stores 6.
• 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 7.
• Anaemia is one of many consequences of iron deficiency, and clinical and functional impairments can occur in the absence of anaemia 7.

Lab Results

• The provided lab results (Iron 118, TIBC 408, Transferrin Sat 29, B12 283, Ferritin 53, normal hemoglobin) indicate iron deficiency, as transferrin saturation is low and ferritin levels are below normal 5, 7.
• These results suggest that iron supplementation may be necessary to improve iron status and prevent further complications 3, 4, 5, 7.