What is an Iron Profile?
An iron profile includes several markers that help us identify iron deficiency. Iron is an essential mineral in the formation of Hemoglobin. Hemoglobin is the protein that transports oxygen to the tissues inside the red blood cells.
If our body do not have enough iron, the following will happen:
Less hemoglobin is formed;
Fewer red blood cells are produced;
Smaller red blood cells are produced.
The iron profile often includes the following tests:
Iron: measures the amount of circulating iron molecules in blood. May be affected by recent intake of iron through diet or supplement.
Transferrin: the protein that transports iron to red blood cells or body iron stores.
Transferrin saturation: measures the percentage of transferrin that is occupied by iron.
Ferritin: the protein that stores iron in the liver and spleen. Its decrease indicates iron deficiency.
An iron profile can sometimes also include the following tests:
TIBC: Total Iron-Binding Capacity. The blood's ability to bind and transport iron. TIBC is closely related to levels of transferrin, the protein that transports iron in the blood.
UIBC: Unsaturated Iron-Binding Capacity. This refers to the proportion of transferrin that have not yet been saturated with iron, i.e. the blood's reserve capacity to bind more iron than what it already does.
For more information about iron and pregnancy specifically, click here.
Why is this analysis important?
An iron profile is often included in a general health check because iron deficiency is one of the most common reasons behind fatigue. Iron deficiency can also be associated with weakness, sleeping problems and hair loss.
It is especially common for women of child-bearing age to suffer from iron deficiency, since women lose a certain amount of blood and iron every month due to menstruation. It is estimated that as high as 20 percent of women under 50 years old do not have enough iron in their body.
Iron deficiency is also more common in vegetarians and vegans since meat is an important source of iron. However, it is still possible to get enough iron from whole grain, nuts, dried fruits, green leafy vegetables and fortified cereals.
In some rare cases, a genetic disorder called hemochromatosis can be detected with an iron profile. This is a disorder where too much iron builds up in your body, also called “iron overload” and is more common in male and people of Northern European descent. Having too much iron can also lead to fatigue, and many also suffer from joint pain.
In short, it is useful to perform an iron profile in the blood to:
Identify iron deficiency
Identify iron overload
Monitor cases of iron deficiency anemia and its response to treatment
The reference ranges for the markers in an iron profile can be different depending on the laboratory and technique used. Sex and age can also affect the reference ranges. Doctors usually also take into account a number of factors when evaluating an iron profile. The following markers can be decreased in the presence of iron deficiency:
Total red blood cell count
Mean corpuscular volume (MCV)
Other markers such as transferrin, TIBC and UIBC can instead be increased in the presence of iron deficiency.
Iron deficiency may be caused by the following mechanisms:
Bleeding (for example heavy menstruation, bleeding hemorrhoids or surgery)
Occult gastrointestinal bleeding
Iron malabsorption (as in Celiac disease, chronic gastritis or following gastric surgeries)
Diet low in iron (such as a vegetarian or vegan diet)
Increased need of iron (such as during pregnancy)
The iron level in the blood fluctuates depending on recent iron intake via diet or supplement. Iron levels also vary depending on the time of the day, being higher in the morning than the evening. Ferritin, which measures the body’s long-term iron storage is therefore a better marker for long-term iron deficiency. However, ferritin levels can increase under inflammatory states, such as arthritis or even a common cold. This is the opposite of transferrin, which decreases under inflammatory states. Intake of large quantities of alcohol can also greatly increase ferritin levels.
Iron deficiency without any obvious reason should be further investigated by a doctor as hidden bleeding sources, such as bleeding from the gastrointestinal tract could be present.
Women planning pregnancy can require more iron than normal because the growth of the unborn baby drastically increases the body’s demand for iron and the women’s iron stores are often close to depleted at the end of a pregnancy.
Tests that include an iron profile
Causes and diagnosis of iron deficiency and iron deficiency anemia in adults. Stanley L Schrier, MD, Michael Auerbach, MD, UpToDate Apr 02, 2019
Patient education: Anemia caused by low iron (The Basics). UpToDate Apr 17, 2019.
Patient education: Anemia caused by low iron in adults (Beyond the Basics). Stanley L Schrier, MD, Michael Auerbach, MD, UpToDateApr 09, 2019.