What is the significance of low iron binding capacity (Total Iron Binding Capacity, TIBC), normal unsaturated iron binding capacity (Unsaturated Iron Binding Capacity, UIBC), low serum iron, and low iron saturation in a patient's lab results?

From the Guidelines

These lab results indicate iron deficiency, and I strongly recommend starting an oral iron supplement to address this issue and improve your quality of life. Your total iron binding capacity (TIBC) is low at 212 μg/dL (normal range 250-450), iron level is low at 24 μg/dL (normal range 27-139), and iron saturation is low at 11% (normal range 15-55%) 1. Only your unsaturated iron binding capacity (UIBC) is within normal range at 188 μg/dL. I recommend starting an oral iron supplement such as ferrous sulfate 325 mg once or twice daily, taken on an empty stomach with vitamin C (like orange juice) to enhance absorption, as suggested by recent guidelines 1. Some key points to consider when taking iron supplements include:

• Avoid taking iron with calcium, dairy, coffee, tea, or antacids as these reduce absorption
• Common side effects include constipation and dark stools
• If you experience significant gastrointestinal discomfort, consider ferrous gluconate which may be better tolerated It is essential to identify and address the underlying cause of your iron deficiency, which can result from inadequate dietary intake, poor absorption, or blood loss 1. Follow up with your healthcare provider to monitor your response to supplementation and to investigate potential causes of your iron deficiency, and consider regular assessment of iron status every 1–3 months, depending on your clinical status and response to iron supplementation 1.

From the Research

Iron Deficiency and Supplementation

• The patient's lab results show low iron levels (24 ug/dL) and low iron saturation (11%) 2, 3.
• The Total Iron Binding Capacity (TIBC) is low (212 ug/dL), and the Unbound Iron Binding Capacity (UIBC) is normal (188 ug/dL) 3.
• Iron deficiency anemia is a common condition that can be treated with oral iron supplementation, which is usually efficacious in correcting iron-deficiency anemia and replenishing iron stores 2.
• However, oral iron supplementation can cause gastrointestinal side effects, and intravenous iron therapy can be used as an alternative for patients with intolerance or unresponsiveness to oral iron 4, 5.

Treatment Options

• Ferrous sulfate is a commonly prescribed oral iron supplement, but it can cause significant gastrointestinal side effects in adults 5.
• Other oral iron supplements, such as ferric maltol and sucrosomial iron, are available and may have fewer side effects 2.
• Intravenous iron therapy can rapidly achieve therapeutic targets without gastrointestinal complications and is reserved for iron deficiency anemia patients with intolerance or unresponsiveness to oral iron 4.

Diagnosis and Evaluation

• The diagnosis of iron deficiency anemia should include a thorough evaluation of the patient's medical history, physical examination, and laboratory tests, including hemoglobin concentration, serum ferritin concentration, and transferrin saturation 3.
• The patient's lab results should be evaluated in the context of their medical history and physical examination to determine the underlying cause of iron deficiency anemia 3.