What are iron studies?

Iron studies (Fe) are a set of blood tests to measure and estimate the amount of elemental iron carried in the blood and stored in the body tissues. Iron is an essential component of  haemoglobin, and iron deficiency is a common cause of anaemia (low blood count).

Iron studies consist of a number of components;

  • Ferritin – the most accurate marker of total body iron stores and the first component to fall in the setting of iron deficiency.
  • Serum iron – the next most useful component, giving an estimate of iron being carried in the blood.
  • Transferrin – a protein which caries iron in the blood; it may be increased in the presence of inflammation or infection anywhere in the body and is therefore less useful.

How are iron studies performed?

Iron studies are carried out in the form of a blood test. A few millilitres of blood from a vein are required.

Why would you need an iron study?

Iron studies are commonly performed in the setting of anaemia (low haemoglobin or low blood count), especially a so-called ‘microcytic anaemia‘, where the red blood cells are decreased in size.

Iron-deficiency anaemia will often show suggestive clues on the peripheral blood film – a test where the blood cells are looked at under a microscope, and specific abnormalities of cell shape and size are described.

Iron stores, most accurately reflected by the ferritin level, may be decreased long before red blood cell production is affected, and before actual anaemia develops.

Symptoms of anaemia include pale skin and mucous membranes (such as the tongue, and the conjunctiva lining the inside of the lower eyelids), tiredness, shortness of breath on exertion and sometimes postural light-headedness.

A condition called haemochromatosis occurs when the body stores too much iron. This can result in damage to organs such as the heart, pancreas, liver, and skin – so-called ‘bronze diabetes’.

A similar situation can occur in people who receive frequent blood transfusions for many years (for example, for thalassaemia), due to a build-up of iron which is carried in the transfused red blood cells.

Test results, explained

Interpretation of the values produced in an iron study can be confusing.

If iron deficiency is discovered, it usually means that the cause needs to be identified and iron treatment started – in the form of iron tablets or liquid.

Small amounts of blood loss over a long period of time is a common cause of iron deficiency, and many patients undergo tests such as Upper GI Endoscopy and Colonoscopy – ‘tops and tails’ – to search for a bleeding source in the stomach or bowel.

Occasionally, iron deficiency is due to an inadequate diet.

Next steps

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Also known as

  • Haematinics


* Anemia – American spelling for Anaemia


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