Iron Panel (IRON, TRANSFERRIN, TIBC and % SATURATION)

Label Mnemonic:	IRON
Epic code:	LAB94
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Chemistry
6240 RCP
356-3527

Specimen(s):

Plasma

Collection Medium:

Plasma Separator Tube 4.5 mL

Alternate Collection Media:

Call laboratory for additional acceptable specimen collection containers.

Minimum:

3 mL whole blood from light green top tube or ONE Microtainer^® for pediatric patients. Avoid hemolysis.

Testing Schedule:

24 hrs/day, 7 days a week, including holidays.

Turn Around Time:

1 hour (upon receipt in laboratory)

Reference Range:

Iron
     Adult males:                 59-158 μg/dL
     Adult Females:               37-145 μg/dL

     ISAT adult range for 18 Years up to Unspecified:
     Males:                       20-50%
     Females:                     15-50%

     Pediatric ranges for serum iron:
       0 - 4 months:              110-270 μg/dL
       5 months - 23 months:      30-70 μg/dL
       24 months - 35 months:     20-124 μg/dL
       3 years - 11 years:        53-119 μg/dL
       12 years and older:        Use adult ranges above

Transferrin:                      200-360 mg/dL

TIBC:                             0-11 months: 100-400 μg/dL
                                  12 months & older: 250-425 μg/dL

Iron (transferrin) saturation:    Males: 20-50%
                                  Females: 15-50%
                                  0-10 days: 56-74%
                                  11 days - 12 months: 17-34%
                                  13 months - 10 years: 22-39%
                                  11-17 years: 27-44%

Comments:

Refer to BD Microtainer^® Tubes product sheet for detailed sample collection instructions.

This panel was modified January 24, 2017 by inclusion of total iron binding capacity (TIBC) in addition to iron (transferrin) % saturation.

This is a panel of testing that includes plasma iron, transferrin, and iron (transferrin) % saturation. Plasma iron and transferrin are directly determined by assay. Iron (transferrin) % saturation is calculated by an equation using plasma iron and transferrin. TIBC is a calculated parameter derived from the transferrin plasma concentration.

In hereditary hemochromatosis, serum iron is usually > 150 μg/dL and iron (transferrin) saturation is greater than 60%. In advanced iron overload states, the percent saturation is often greater than 90%.

Measurement of the iron panel alone may be unreliable for evaluating iron deficiency anemia. Ferritin and/or soluble transferrin receptor may be needed for workup of anemia.

This test is also performed in the Iowa River Landing (IRL) clinical laboratory (for specimens drawn at that site).

Test Limitations:

Icterus: No significant interference up to an I index of 60 
(approximate conjugated and unconjugated bilirubin concentration: 60 
mg/dL). 

Hemolysis: No significant interference up to an H index of 200 
(approximate hemoglobin concentration: 200 mg/dL). Higher hemoglobin 
concentrations lead to false-positive values due to contamination of 
the sample with hemoglobin-bound iron. 

Lipemia (Intralipid): No significant interference up to an L index of 
1500 (approximate triglycerides concentration: 3000 mg/dL). There is 
poor correlation between turbidity and triglycerides concentration. 

In patients treated with iron supplements or metal-binding drugs, the 
drug-bound iron may not properly react in the test, resulting in 
artificially low values.  In very rare cases gammopathy, in particular 
type IgM (Waldenstrom's macroglobulinemia), may cause unreliable 
results.

Transferrin saturation is not reliable when there are high ferritin 
concentrations greater than 1,200 ug/L.

Methodology:

Colorimetric (iron)
Immunoturbimetric assay (transferrin)

CPT Code:

83540, 84466, 83550

See also:
Ferritin, Plasma
Transferrin, Plasma

See Additional Information:
Chemistry Pediatric Reference Ranges