Interpretation of iron profile
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iron deficiency anemia diagnosis serum iron TIBC transferrin saturation
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Here is a detailed interpretation of Mrs. Ankita's iron profile:
Patient Summary
Mrs. Ankita | 26 years | Female | Collected: 02/05/2026
Results at a Glance
| Test | Result | Reference Range | Flag | Interpretation |
|---|---|---|---|---|
| Serum Iron | 15.24 μg/dL | 37–145 μg/dL | 🔴 LOW | Markedly low |
| UIBC | 409.00 μg/dL | 110–370 μg/dL | 🔴 HIGH | Elevated |
| TIBC | 424.24 μg/dL | 228–428 μg/dL | ✅ Normal (upper limit) | Borderline high |
| % Transferrin Saturation | 3.59% | 20–50% | 🔴 LOW | Critically low |
Interpretation
This iron profile is classic for Iron Deficiency Anemia (IDA), showing all four hallmark features:
1. Very Low Serum Iron (15.24 μg/dL)
Serum iron is only ~41% of the lower normal limit. This reflects a severely depleted circulating iron pool available for hemoglobin synthesis. — Harrison's Principles of Internal Medicine 22E
2. Elevated UIBC (409 μg/dL)
UIBC (Unsaturated Iron Binding Capacity) represents the unfilled iron-binding sites on transferrin. When iron stores are depleted, transferrin remains largely unoccupied, driving UIBC up. This is a direct marker of iron deficiency. — Quick Compendium of Clinical Pathology, 5th ed.
3. TIBC at Upper Normal Limit (424.24 μg/dL)
TIBC reflects the total transferrin concentration. In iron deficiency, the liver upregulates transferrin synthesis as a compensatory response, pushing TIBC toward the upper limit or above the reference range. Here it sits at the very top of the normal range — consistent with developing IDA. — Tietz Textbook of Laboratory Medicine, 7th ed.
4. Critically Low Transferrin Saturation (3.59%)
This is the most sensitive indicator. Normal saturation is 20–50%; a saturation < 15% confirms iron deficiency, and 3.59% is profoundly low. The formula:
% Saturation = (Serum Iron / TIBC) × 100 = (15.24 / 424.24) × 100 = 3.59%
Quick Compendium of Clinical Pathology, 5th ed. states that % saturation < 15% is diagnostic of iron deficiency; Tietz Textbook sets the cutoff at < 15% as well.
Clinical Significance
This pattern — ↓ serum iron + ↑ UIBC + ↑/normal TIBC + ↓↓ transferrin saturation — is the textbook picture of iron deficiency. In a 26-year-old premenopausal woman, the most common causes are:
- Chronic menstrual blood loss (most likely) — menstruating women lose ~30 mg iron per cycle and are at high risk. — Harrison's 22E
- Poor dietary intake — vegetarian/vegan diet lacking heme iron
- Malabsorption — e.g., celiac disease, post-gastrectomy
- Occult gastrointestinal blood loss (less common in this age group but must be excluded if no menstrual cause)
What to Do Next
Since this is only the iron profile (page 1 of 3), the full workup likely includes or should include:
- Complete Blood Count (CBC) — to check for microcytic hypochromic anemia (low MCV, low MCH, high RDW)
- Serum Ferritin — the most sensitive single test for iron stores (low ferritin < 30 μg/L confirms iron deficiency)
- Peripheral blood smear — may show hypochromic microcytes and pencil/elliptocyte cells
- Reticulocyte count
Summary
Mrs. Ankita's iron profile is strongly consistent with iron deficiency, almost certainly iron deficiency anemia (IDA) given the severity of transferrin saturation at 3.59%. She should be evaluated by her physician for the underlying cause and started on oral iron supplementation (e.g., ferrous sulfate 150–200 mg elemental iron/day) with dietary counseling. A follow-up iron profile and CBC in 4–8 weeks will confirm treatment response.
⚠️ This interpretation is for informational purposes. Clinical correlation and physician consultation are essential before any treatment decisions.
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