Iron Deficiency Profile

What is Iron deficiency profile?

An iron deficiency profile is a battery of blood tests which are performed in order to determine the levels of iron in your body. The set of tests include-

– Serum Ferritin
– Serum Iron
– Total Iron Binding Capacity (TIBC)
– Iron Saturation (Transferrin Saturation)

Why has my physician asked me to undergo an iron deficiency profile test?

Iron deficiency can lead to a plethora of symptoms, the ones related to iron deficiency anemia being the most serious. Your doctor may ask you to go for an iron deficiency profile test if you present with the following clinical features-

– Pale yellow skin
– Listlessness
– Fatigue during routine activities
– Tachycardia (increase in heart beat)
– Generalized weakness
– Frequent headaches
– Brittle nails and hair
– Spoon shaped nails
– Sore tongue
– Fissures at the angles of mouth
– Cold intolerance
– Difficulty in swallowing solid food (dysphagia)
– Pica (abnormal food cravings)
– Lapses in attention
– Memory loss

In severe cases, an enlarged spleen or pseudotumor cerebri may be the presenting features. Infants and young children may present with failure to thrive and decreased appetite.

What puts me at risk to develop iron deficiency?

Iron deficiency is very common in the general population; most of the cases go undiagnosed. The following categories of individuals are at an increased risk of developing iron deficiency-

– Women with heavy menstrual cycles, pregnant women, breastfeeding women and those who have given birth recently are all at risk of developing iron deficiency.

– Infants especially those with a low birth weight and the premature babies.

– Children- To support their active growth, children need extra iron in their diet. If the requirement is not met, iron deficiency may emerge.

– People with chronic bleeding disorders such as peptic ulcer, hemorrhoids, tumors of gastrointestinal tract, angiodysplasia and frequent nose bleeds.

– People suffering from gastrointestinal disorders hampering with the absorption of iron. These include inflammatory bowel diseases, and celiac disease.

– Vegetarians who do not include iron rich food in their diet.

– People who have undergone a major surgery, suffered trauma, and donate blood frequently.

Which foods are a rich source of iron?

The minimum daily requirement of iron varies from person to person, depending on the sex and age. The recommended daily dietary allowance of different individuals is as below-

What are the main functions of iron in our body?

Almost 70 % of the iron in human body is stored in the form of hemoglobin in red blood cells and myoglobin in the muscle cells. Iron is primarily required by the body for transfer of oxygen from the lungs to the body tissues. Iron also plays an important role in the body’s metabolism as a component of essential enzymes. It plays a vital role in the formation of DNA.

How do I prepare for the iron deficiency test?

Although no specific preparations are required before undergoing an iron deficiency test, a few important points should be kept in mind-

– Tell your doctor about your medical history including the medicines or supplements that you might be consuming. Certain medicines such as proton pump inhibitors, antacids and calcium supplements may tamper with the iron levels of your body.

– Do not forget to tell your doctor if you suffer from a bleeding disorder or are taking a blood thinning medicine (e.g. Aspirin).

Can pregnant women undergo this test?

Yes, you can undergo iron deficiency test if you are pregnant or breastfeeding your child. It is a safe, risk free test with no potential hazard to a gravid female or to her unborn fetus.

Is this test recommended for children?

Yes, children can safely undergo iron deficiency test as it is a simple, safe and risk-free procedure.

Do I need to fast before the iron deficiency test?

Yes, you need to fast for 8-12 hours before undergoing an iron deficiency test. An iron deficiency test is generally performed in the morning as the blood iron levels tend to fall by 30% as the day progresses.

How is the iron deficiency test performed?

An iron deficiency test is performed as an outpatient procedure. The test can be carried out in a doctor’s office or at a diagnostic center. It is a safe, minimally invasive and quick test. No sedation is given. The procedure includes the following simple steps-

You will be escorted by a technician to the area designated for collecting blood samples. You will be asked to sit on a comfortable chair or made to lie on a bed.

You will be asked to roll up your sleeves. Generally, the elbow region of the non-dominant arm is chosen. The median cubital vein-a superficial vein lying in the region of cubital fossa is the preferred vessel.

The technician will apply a tourniquet proximally to the site chosen for venipuncture. This makes the veins more prominent, allowing easier access. The area is cleaned with a disinfectant. A sterile needle is used to puncture the vein and draw about 5 ml of blood.

Pressure is applied to the vein with a sterile gauze after the needle is withdrawn. Tourniquet is released. The blood sample is collected in a vial. A small bandage is applied over the site from where blood has been drawn.

What are the risks associated with this test?

As is the case with any procedure involving venipuncture, you will feel a stinging sensation when the needle punctures your vein. The pain perception varies in different individuals. Bleeding, bruising and inflammation of the vein may be encountered. You may also experience mild nausea and dizziness at the sight of blood. It is advisable to look away during the procedure if you are faint hearted. An infection at the site of puncture can be a late complication. If you notice any abscess or pus at the site of venous invasion, consult your doctor.

When will I get my iron deficiency profile report?

You can get the results of your iron deficiency profile within 24 hours.

What do the results of my test convey?

Serum Ferritin– Ferritin is a blood protein which contains iron. The normal range for serum ferritin is 24 to 336 micrograms per liter in males and 11 to 307 micrograms per liter in females. A low level of ferritin conveys that your body stores are depleting and that you are suffering from iron deficiency. High levels convey a state of iron excess.

Serum Iron- This test measures the levels of iron in your serum. The normal levels of serum iron are 65 to 175 mcg/dL in males and 50-170 mcg/dl in females. Low levels of serum iron point towards iron deficiency while high levels are seen in iron overload.

Total Iron Binding Capacity (TIBC)- This test ascertains your body’s ability to transport iron in the blood. Transferrin is a major protein transporting iron and its levels are often checked along with this test. The normal values for TIBC are 250 to 450 mcg/dL for both men and women. A high value means that the iron levels in your blood are low. A lower value points towards a state of iron excess.

Iron Saturation (Transferrin Saturation)- It is the value of serum iron divided by the value of total iron-binding capacity and is denoted as a percentage. The reference range for transferrin saturation in males is 20-50% and females is 15-50%. A low value indicates iron deficiency while a higher value detects iron excess.

What is iron deficiency anemia?

Anemia is the disorder when the number of red blood cells (RBC) in the body is low or the hemoglobin content in RBCs is low. Anemia resulting due to a deficiency of iron in the body is known as iron deficiency anemia.  According to the World Health Organization (WHO), about 2 billion people in the world suffer from anemia and the cause in 50% of these cases is a deficiency of iron. Blood tests to detect iron deficiency anemia include-

– Complete blood count (CBC)
– Peripheral smear
– Hemoglobin electrophoresis
– Reticulocyte hemoglobin content

What are the complicationsof iron deficiency anemia?

Iron deficiency anemia if left untreated can lead to serious complications with multisystemic involvement. The major complications include-

– Psychiatric manifestations including depression
– Cardiac disorders- These include arrhythmias, cardiomegaly and in severe cases cardiac failure
– An increased predisposition to infections
– Developmental delays in children

The incidence of Intrauterine growth retardation, premature delivery and low birth weight increases in pregnant females suffering from anemia. This condition is associated with a high maternal and child mortality.

What is the treatment of iron deficiency?

Diagnosing and treating the reason for iron deficiency is the foremost intervention required.

– In majority of patients, oral iron therapy with ferrous sulfate is the most cost-effective remedy.

– Parenteral iron therapy is used in cases where the patient is either unable to absorb iron or the oral therapy is not adequate to correct the iron deficiency.

– Surgical intervention is carried out in certain cases to arrest the source of active bleeding and to make sure that it does not happen again.

– Infusion of packed RBCs is indicated when the patient is suffering from acute bleeding or is at risk of suffering from hypoxia or coronary inadequacy.

What is the cost of undergoing an iron deficiency profile in India?

In most of the diagnostic centers Serum iron, TIBC & Transferrin saturation are part of a single test and cost Rs 500-750. Serum ferritin test costs Rs 700-1000.  The actual cost may vary depending on the city that you reside in.