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Home :: Iron and total iron binding capacity

Iron And Total Iron binding Capacity

Iron is essential to the formation and function of hemoglobin, as well as many other heme and nonheme compounds. After iron is absorbed by the intestine, it's distributed to various body compartments for synthesis, storage, and transport. Serum iron concentration is normally highest in the morning and declines progressively during the day; thus, the sample should be drawn in the morning.

An iron assay is used to measure the amount of iron bound to transferring in blood plasma. Total iron binding capacity (TIBC) measures the amount of iron that would appear in plasma if all the transferring were saturated with iron.

Serum iron and TIBC are of greater diagnostic usefulness when performed with the serum ferritin assay, but together these tests may not accurately reflect the state of other iron compartments, such as myoglobin iron and the labile iron pool. Bone marrow or liver biopsy, and iron absorption or excretion studies may yield more information

Purpose

  • To estimate total iron storage
  • To aid diagnosis of hemochromatosis . To help distinguish iron deficiency anemia from anemia of chronic disease.
  • To help evaluate nutritional status

Patient preparation

  • Explain to the patient that this test evaluates the body's capacity to store iron.
  • Tell him that a blood sample will be taken. Explain who will perform the venipuncture and when.
  • Reassure him that drawing a blood sample will take less than 3 minutes.
  • Explain that he may feel slight discomfort from the tourniquet pressure and the needle puncture.
  • Review the patient's drug history for medications that may interfere with test results; withhold chloramphenicol, corticotropin, iron supplements, and oral contraceptives. If such medications must be continued, note this on the laboratory slip.
  • Inform the patient that food or fluids needs not be restricted before the test.

Procedure and posttest care

  • Perform a venipuncture, collecting sample in a 7-ml red-top tube.
  • If a hematoma develops at the venipuncture site, apply wann soaks.
  • Resume administration of medications withheld before the test.
Precautions
  • Handle the sample gently to prevent hemolysis; send it to the laboratory immediately.

Reference values

Normal serum iron and TlBC values are as follows:

serum iron

  • - Males: 50 to 150 ug/dl
  • - Females: 35 to 145 ug/dl

TIDC

  • - Males and females: 250 to 400 ug/dl

saturation

  • - Males and females: 14% to 50%

Abnormal findings

In iron deficiency, serum iron levels decrease and TlBC increases, decreasing saturation. In cases of chronic inflammation (such as in rheumatoid arthritis), serum iron may be low in the presence of adequate body stores, but TIBC may remain unchanged or may decrease to preserve normal saturation. Iron overload may not alter serum levels until relatively late but, in general, serum iron increases and TlBC remains the same, which increases the saturation.

Interfering factors

  • Hemolysis due to rough handling of the sample or failure to send the sample to the laboratory immediately
  • Chloramphenicol and oral contraceptives (possible false-positive)
  • Corticotropin (possible false­negative)
  • Iron supplements (possible false­positive serum iron values but false­negative TIBC)

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