Normal Iron Studies – No Iron Deficiency Present
These iron studies are completely normal and do not indicate iron deficiency or any pathological iron disorder. No treatment is required based on these laboratory values alone.
Interpretation of the Laboratory Values
Your iron parameters fall well within normal ranges and do not meet criteria for iron deficiency by any established guideline 1:
- Iron saturation of 33% is normal (well above the <20% threshold for absolute iron deficiency in most populations and >30% threshold used in some guidelines) 1
- Serum ferritin would need to be assessed, but with normal iron saturation, significant iron deficiency is unlikely 1
- TIBC of 350 is within normal range (typically 250-450 mcg/dL) 1
- Serum iron of 114 is normal (typically 60-170 mcg/dL) 1
Diagnostic Thresholds for Iron Deficiency
Absolute iron deficiency in the general population requires transferrin saturation <16% and/or serum ferritin <12 ng/mL 1. In chronic kidney disease patients, more liberal thresholds are used (TSAT <20% and ferritin <100 ng/mL) 1. Your iron saturation of 33% exceeds all these cutoffs by a substantial margin.
Functional iron deficiency (inadequate iron availability despite adequate stores) typically presents with TSAT <20-30% in the context of erythropoietin therapy or increased erythropoietic demand 1. This is not applicable to your values.
Clinical Context Matters
While these isolated values are normal, the British Society of Gastroenterology emphasizes that if anemia is present despite normal iron studies, investigation for other causes is warranted 1:
- If hemoglobin is low: Consider vitamin B12 deficiency, folate deficiency, anemia of chronic disease, hemoglobinopathies, or bone marrow disorders 1
- If hemoglobin is normal: No further workup for iron status is needed 1
No Treatment Indicated
Iron supplementation is not indicated and could be harmful when iron studies are normal 1. The NKF-K/DOQI guidelines specifically warn against iron supplementation when ferritin is adequate and TSAT is >20%, as this risks iron overload without clinical benefit 1. Iron overload carries risks of infection, cardiovascular complications, and oxidative tissue damage 2.
When to Reassess
Recheck iron studies only if: