Other names: Iron (serum), IRON, TOTAL, IRON, SERUM
Optimal Result:
27 - 159 µg/dL,
4.83 - 28.46 µmol/L,
or
27 - 159 umol/L.
Iron - the basics:
- Iron is supplied by the diet.
- As much as 70% of the iron in the body is found in the hemoglobin of the red blood cells (RBCs).
- The other 30% is stored in the form of ferritin and hemosiderin (=iron-storage complex within cells, not widely available).
- About 10% of the ingested iron is absorbed in the small intestine and transported to the plasma.
- Abnormal levels of iron are characteristic of many diseases, including iron-deficiency anemia and hemochromatosis (=Iron overload).
Where is iron found in the body?
Most iron in the body is bound to red blood cells or stored in the spleen and cannot be directly tested.
Iron is found in different parts of the body:
- In the blood. About 65% of all iron is in the blood. Iron in the blood is mostly bound to the transportation protein transferrin.
- In muscles
- In the liver (called ferritin)
- In enzymes in the body.
Iron and transferrin:
- After iron is absorbed in the small intestine and transported to the plasma, there the iron is bound to a globulin protein called transferrin and carried to the bone marrow for incorporation into hemoglobin.
- Transferrin exists in relation to the need for iron. When iron stores are low, transferrin levels increase, whereas transferrin is low when there is too much iron.
- Usually about one-third of the transferrin is being used to transport iron. Because of this, the blood serum has considerable extra iron-binding capacity, which is the Unsaturated Iron Binding Capacity (UIBC). The TIBC equals UIBC plus the serum iron measurement. Some laboratories measure UIBC, some measure TIBC, and some measure transferrin.
- The serum iron determination is a measurement of the quantity of iron bound to transferrin.
Why is iron so important?
- Iron is an essential element required for hemoglobin production.
- The human body requires iron to perform many vital physiological functions.
What is hemoglobin?
Hemoglobin oxygenates the blood. Without iron, red blood cells cannot reproduce in the body.
How is iron absorbed in the body?
- The body takes in iron from the food you eat so it is important to have good sources of iron in your diet. Only about 10% of the iron you consume is absorbed.
- The process of iron absorption is tightly regulated because your body does not have any biochemical ways of removing iron. Instead, iron is lost through processes such as bleeding, menstruation, and breast-feeding. Additionally, iron within the body is constantly being recycled and reused.
What does a serum test do?
A serum iron test measures iron levels in the serum component of the blood. A serum iron test is ordered after abnormal results are found in a hemoglobin test or a complete blood count, or when you are showing symptoms of anemia.
How is iron measured?
- Iron is often measured in micrograms per deciliter (mcg/dl), normal ranges for serum iron differ depending on an individual’s age and sex.
- Child-bearing women have the highest requirements for iron because of the monthly loss of blood in their menstrual cycles.
- If your results are abnormal, additional tests will determine whether iron is being stored in your liver, not being transported to the right places in your body, or what type of anemia you have.
Seeing a high iron (serum) level on your lab report?
Here’s what it could mean, why it happens, and what steps you can take.
Chronic iron overload — also called hemochromatosis or hemosiderosis — happens when too much iron builds up in the body.
Excess iron is often deposited in vital organs like the brain, liver, and heart, which can lead to serious health issues if left untreated.
Important:
Recent or massive blood transfusions can temporarily raise iron levels. If you've recently had a transfusion, it’s best to repeat iron testing later for an accurate result.
High serum iron can happen for several reasons, including:
Hemolytic anemia (when red blood cells break apart)
Iron overdose (taking too much iron through supplements or diet)
Iron overload (body’s inability to properly eliminate iron)
Liver conditions (hemochromatosis, hemosiderosis, hepatitis, liver failure)
Frequent blood transfusions
Lead poisoning
Use of birth control pills
High intake of vitamin B6 or B12
Even mild cases of iron overload can increase the risk of:
Liver disease (cirrhosis, liver cancer)
Heart disease (heart attack, heart failure)
Diabetes mellitus
Joint problems (osteoarthritis, osteoporosis)
Metabolic syndrome
Hormone imbalances (hypothyroidism, hypogonadism)
Iron overload can also worsen or speed up certain brain-related conditions like Alzheimer’s, Parkinson’s, Huntington’s disease, epilepsy, and multiple sclerosis.
The main treatment for iron overload is iron reduction therapy.
If your hemoglobin levels are healthy enough, your doctor may recommend:
Therapeutic phlebotomy (regular blood removal)
Blood donation to lower iron stores
Always follow your doctor’s guidance before starting any iron-lowering treatment.
Yes!
When iron is high, it's important to also look at related markers like TIBC, UIBC, transferrin saturation, and ferritin for a full picture.
In some cases, iron poisoning is suspected when serum iron is higher than Total Iron Binding Capacity (TIBC).
| Condition | Serum Iron | TIBC/Transferrin | UIBC | Transferrin Saturation (%) | Ferritin |
|---|---|---|---|---|---|
| Hemochromatosis/Hemosiderosis | High | Low | Low | High | High |
| Hemolytic Anemia | High | Low/Normal | Low/Normal | High | High |
| Sideroblastic Anemia | High/Normal | Low/Normal | Low/Normal | High | High |
| Iron Poisoning | High | Normal | Low | High | Normal |
High iron levels are important to investigate but manageable with the right care.
Talk to your doctor about the next steps based on your full lab results and overall health picture.
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Iron deficiency is a condition resulting from too little iron in the body. Iron deficiency can be the result of numerous and multiple causes.
Possible Causes:
- Your diet may not contain enough iron-rich foods. Even a vitamin C deficiency affects the absorption of iron in the diet, and it’s possible that if you’re low in vitamin C, you won’t absorb enough iron from other foods.
- If you are a woman in the child-bearing years, then heavy menstrual periods could contribute to low iron levels. That’s because blood is exiting the body at high levels – and taking iron with it.
- Acute or chronic blood loss, including from ulcers or bleeding from the GI tract
- Anemia (iron-deficiency, sickle cell, vitamin B6 deficiency, vitamin B12 deficiency, vitamin C deficiency)
- Pregnancy
- Bone marrow conditions
- Infections
- Hypothyroidism
- Kwashiorkor (malnutrition)
- Associated with blood loss during surgery
Possible symptoms:
- premature births
- low birth weight babies
- delayed growth and development
- delayed normal infant activity and movement.
- Lower IQs have been linked to iron deficiency occurring during critical periods of growth.
- Iron deficiency can result in poor memory or poor cognitive skills (mental function) and can result in poor performance in school, work, etc.
Possible signs of iron deficiency:
A person who is iron deficient may also be anemic and as a result may have one or more symptoms of anemia.
These can include:
- chronic fatigue
- Weakness
- Dizziness
- Headaches
- Depression
- sore tongue
- sensitivity to cold (low body temp)
- shortness of breath doing simple tasks (climbing stairs, walking short distances, doing housework)
- restless legs syndrome
- pica (the desire to chew ice or non-food items,)
- and loss of interest in work, recreation, relationships, and intimacy.
Most at risk for iron deficiency:
Women, children and the elderly are most at risk. African American and Hispanic women and their young children are prone to iron deficiency, possibly because of diet or perhaps different hemoglobin needs. Men are rarely iron deficient; but when they are, it is generally due to blood loss from the digestive tract (sometimes indicating disease), diseases that affect iron absorption, and in some cases, alcohol abuse. Except for those who are strict vegetarians, men rarely have dietary iron deficiency.
Possible correlations to other markers:
You should also correlate your low iron levels to other biomarkers.
A decreased serum iron level, elevated total iron-binding capacity (TIBC), and low transferrin saturation value are characteristic of iron-deficiency anemia.
Here are possible scenarios of correlation:
|
Disease |
Iron |
TIBC/ Transferrin |
UIBC |
Transferrin Saturation (%) |
Ferritin |
|---|---|---|---|---|---|
|
Iron Deficiency |
Low |
High |
High |
Low | Low |
|
Chronic Illness |
Low |
Low/Normal |
Low/Normal | Low/Normal |
High/Normal |
- You can also look at RDW (=Red Cell Distribution Width) and MCV (=Mean Corpuscular Volume), if you have those measurements, to distinguish between different kinds of anemias. Refer to your RDW and MCV markers for more information.
- Low zinc levels can also be associated with iron deficiency anemia. Zinc is the co-factor of several enzymes and plays a role in iron metabolism, so zinc deficiency is associated with IDA (=iron deficiency anemia). Refer to your zinc marker for more information.
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Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
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Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
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