What is the interpretation of labs showing low iron levels (Iron) of 17, low iron saturation (Iron Sat) of 5%, elevated transferrin (Transferrin) of 215, and elevated total iron-binding capacity (TIBC) of 316, and what intervention is needed?

From the Guidelines

This patient has iron deficiency based on the laboratory values showing low serum iron (17 μg/dL) and low iron saturation (5%), and the patient should start oral iron supplementation, preferably ferrous sulfate 325 mg taken once or twice daily between meals with vitamin C to enhance absorption. The patient's transferrin and total iron binding capacity (TIBC) levels are within normal limits, which further supports the diagnosis of iron deficiency 1.

The patient's iron deficiency is likely due to inadequate dietary intake, and dietary counseling to increase iron-rich foods (red meat, leafy greens, beans) is also recommended as a supportive measure alongside supplementation 1. If oral iron is not tolerated or if there is malabsorption, intravenous iron formulations like iron sucrose or ferric carboxymaltose may be necessary 1.

Some key points to consider in the management of this patient's iron deficiency include:

• The frequency of administration and duration of benefit of iron supplementation is dependent on the underlying etiology of the iron deficiency 1
• Laboratory evaluation following iron supplementation should include a complete blood count (CBC) and iron parameters (ferritin, percent transferrin saturation) 4 to 8 weeks after the last infusion 1
• The goal ferritin level is 50 ng/mL, regardless of sex at birth, and a transferrin saturation (TSAT) <20% has high sensitivity for diagnosing absolute or functional iron deficiency 1
• Reticulocyte hemoglobin content (CHr) or reticulocyte hemoglobin equivalent (RET-He) can be used as a direct assessment of the functional availability of iron to the erythropoietic tissue 1

Overall, the patient's iron deficiency should be managed with a combination of oral iron supplementation, dietary counseling, and regular laboratory monitoring to assess the response to treatment and adjust the management plan as needed 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Lab Results Interpretation

• Iron level: 17 (low)
• Iron saturation: 5% (low)
• Transferrin: 215 (low)
• Total Iron-Binding Capacity (TIBC): 316 (elevated)

Diagnosis and Intervention

• The patient's lab results indicate iron deficiency anemia, characterized by low iron levels, low iron saturation, and elevated TIBC 2, 3.
• The patient may require iron supplementation to replenish iron stores and correct anemia.
• Oral iron supplementation is usually the first line of treatment, but it may cause gastrointestinal side effects and have limited efficacy in certain cases 3, 4.
• Intravenous iron therapy can be considered if oral iron supplementation is ineffective or not tolerated, particularly in patients with chronic kidney disease or other conditions associated with iron deficiency 2, 5.
• Alternative oral iron formulations, such as Sucrosomial® iron, may offer improved gastrointestinal tolerance and efficacy compared to traditional oral iron salts 4.
• The choice of intervention should be guided by the patient's individual needs, medical history, and response to prior therapy 2, 5.