From the Guidelines
A low Fe/TIBC percent indicates iron deficiency, with values below 20% suggesting depleted iron stores. This measurement, also known as transferrin saturation, represents the percentage of iron binding sites on transferrin that are occupied by iron, with normal values typically ranging from 20-50% 1. When this percentage falls below 20%, it strongly suggests that the body's iron stores are depleted, which can lead to anemia if left untreated, causing symptoms like fatigue, weakness, pale skin, and shortness of breath.
Key Points to Consider
- Iron deficiency can result from blood loss, poor absorption, or increased iron requirements 1.
- Treatment typically involves oral iron supplements, such as ferrous sulfate, taken with vitamin C to enhance absorption 1.
- Dietary changes to include iron-rich foods like red meat, spinach, and beans can complement supplementation.
- Follow-up testing is important to monitor response to treatment, with improvement in transferrin saturation expected within 1-2 months of proper supplementation.
Important Considerations
- The distinction between absolute and functional iron deficiency is crucial, as functional iron deficiency can occur despite normal or elevated serum ferritin levels 1.
- Inflammation and other conditions can affect TIBC readings, making it essential to consider the clinical context when interpreting results 1.
- Serial measurements of TSAT can help distinguish between functional iron deficiency and an inflammatory iron block, guiding treatment decisions 1.
From the Research
Iron Deficiency and Fe/TIBC Percent
- A low Fe (Iron)/TIBC (Total Iron Binding Capacity) percent indicates iron deficiency anemia, which occurs when the body does not have enough iron to produce adequate amounts of hemoglobin, a substance in red blood cells that enables them to carry oxygen around the body 2.
- The Fe/TIBC ratio is used to evaluate iron deficiency, with a low ratio suggesting iron deficiency anemia 3.
- Iron deficiency anemia can be caused by various factors, including poor dietary intake, increased demand, insufficient iron absorption, and disorders affecting iron metabolism 4, 5.
- A low Fe/TIBC percent can also be seen in chronic diseases such as chronic kidney disease, where iron deficiency is common and can be absolute or functional 3.
Diagnosis and Treatment
- Diagnosis of iron deficiency anemia involves laboratory tests, including serum ferritin, transferrin saturation, and complete blood count 2, 6.
- Treatment of iron deficiency anemia typically involves iron supplementation, which can be oral or intravenous, depending on the severity of the deficiency and the patient's underlying condition 5, 6.
- In patients with chronic kidney disease, intravenous iron supplementation is often preferred, especially for those on dialysis 3.
Special Considerations
- In women and girls of reproductive age, iron deficiency is common, and diagnosis and treatment should take into account the presence of inflammation and pregnancy status 6.
- In pediatric patients, iron deficiency can have significant effects on growth and development, and early diagnosis and treatment are essential 4.
- In patients with chronic diseases, iron deficiency can exacerbate symptoms and worsen outcomes, making prompt diagnosis and treatment crucial 5, 3.