What are the laboratory findings characteristic of classic iron deficiency anemia?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 5, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

Classic iron deficiency anemia is characterized by laboratory findings including microcytic hypochromic red blood cells, decreased mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), low serum iron levels, elevated total iron binding capacity (TIBC), decreased transferrin saturation, and low serum ferritin. The diagnosis of iron deficiency anemia is typically based on biochemical and hematological laboratory findings, and the identification of iron deficiency prior to anemia development is also important 1. Some key laboratory parameters include:

  • Decreased MCV and MCH
  • Low serum iron levels
  • Elevated TIBC
  • Decreased transferrin saturation (typically below 15%)
  • Low serum ferritin (usually less than 30 ng/mL) A peripheral blood smear may show microcytic red cells with increased central pallor, anisocytosis, and poikilocytosis, and red cell distribution width (RDW) is typically elevated, indicating variation in red cell size 2. The most recent study 3 suggests that using mean corpuscular volume (MCV) alone may not be sufficient to detect co-existing iron deficiency anemia in patients with sickle cell disorders, and a combination of tests might be useful. However, the most important laboratory parameter for diagnosing iron deficiency anemia is serum ferritin, which reflects the body's iron stores 4. In clinical practice, a ferritin level of less than 30 ng/mL is often used as a diagnostic cut-off for iron deficiency anemia, but this value may need to be adjusted based on the individual patient's circumstances and the presence of inflammation or other conditions that may affect ferritin levels 4.

References

Research

Diagnosis of iron-deficient states.

Critical reviews in clinical laboratory sciences, 2015

Research

Anemia: Evaluation and Diagnostic Tests.

The Medical clinics of North America, 2017

Research

[Iron deficiency anaemia--interpretation of biochemical and haematological findings].

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.