From the Guidelines
A complete iron panel typically includes plasma iron, transferrin, transferrin saturation, ferritin, CRP, and hepcidin, as well as evaluation of red blood cell morphology, as recommended by the most recent and highest quality study 1.
Components of an Iron Panel
The components of an iron panel can vary, but the most comprehensive panel should include:
- Plasma iron: measures the amount of iron in the blood
- Transferrin: reflects the blood's capacity to bind iron with transferrin
- Transferrin saturation: calculated as a percentage by dividing serum iron by TIBC and multiplying by 100, indicating how much of the transferrin is carrying iron
- Ferritin: measures iron stores in the body and is the most sensitive test for iron deficiency
- CRP: measures inflammation, which can affect iron metabolism
- Hepcidin: regulates iron metabolism and can help diagnose conditions like iron deficiency anemia or iron overload disorders
- Evaluation of red blood cell morphology: can help diagnose conditions like anemia or red cell disorders
Importance of a Complete Iron Panel
A complete iron panel is essential for diagnosing and managing conditions like iron deficiency anemia, anemia of chronic disease, or iron overload disorders like hemochromatosis. The combination of these tests is more valuable than any single measurement, as they reflect different aspects of iron metabolism and storage in the body.
Diagnosis and Management
The diagnosis of iron deficiency or iron overload disorders requires a combination of laboratory tests and clinical evaluation. The most recent and highest quality study 1 recommends a combination of tests, including plasma iron, transferrin, transferrin saturation, ferritin, CRP, and hepcidin, as well as evaluation of red blood cell morphology.
Recent Guidelines
Recent guidelines, such as the ESPEN micronutrient guideline 1, recommend a comprehensive approach to diagnosing and managing iron deficiency and iron overload disorders. The guideline recommends a combination of tests, including plasma iron, transferrin, transferrin saturation, ferritin, CRP, and hepcidin, as well as evaluation of red blood cell morphology.
Clinical Practice
In clinical practice, a complete iron panel should be used to diagnose and manage conditions like iron deficiency anemia, anemia of chronic disease, or iron overload disorders like hemochromatosis. The combination of tests provides a comprehensive picture of iron metabolism and can help guide treatment decisions. Some key points to consider when interpreting the results of an iron panel include:
- Transferrin saturation > 45% and serum ferritin > 200 μg/L (female) or > 300 μg/L (male) may indicate iron overload 1
- Serum ferritin < 30 μg/L or transferrin saturation < 16% may indicate iron deficiency 1
- CRP and hepcidin levels can help diagnose and manage conditions like anemia of chronic disease or iron overload disorders 1
From the FDA Drug Label
Serum iron, total iron binding capacity (TIBC) and percent saturation of transferrin are other important tests for detecting and monitoring the iron deficient state The components included in a complete iron panel are:
- Serum iron
- Total iron binding capacity (TIBC)
- Percent saturation of transferrin 2
From the Research
Components of an Iron Panel
An iron panel typically includes several components to assess iron status and diagnose iron deficiency or overload. These components are:
- Serum iron: measures the amount of iron in the blood 3, 4, 5
- Total iron binding capacity (TIBC): measures the blood's capacity to bind iron 3, 4, 5
- Transferrin saturation (TS): calculates the percentage of transferrin that is saturated with iron 3, 4, 6
- Serum ferritin: measures the amount of ferritin, a protein that stores iron, in the blood 3, 4, 7, 6, 5
- Soluble transferrin receptor (sTfR): measures the level of transferrin receptor in the blood, which can help diagnose iron deficiency 7, 6
Additional Tests
In some cases, additional tests may be included in an iron panel, such as:
- Reticulocyte hemoglobin content: measures the amount of hemoglobin in reticulocytes (young red blood cells) 6
- Percentage of hypochromic red cells: measures the percentage of red blood cells that are pale or hypochromic 6
- Hepcidin: a hepatic polypeptide that plays a role in iron mobilization 6
Diagnostic Criteria
The diagnostic criteria for iron deficiency and iron deficiency anemia vary, but commonly include: