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Know about your anemia with Iron and Total Iron-binding Capacity (TIBC) test – live a better life


Do you feel that the normal day to day activities are making you excessively tired? Have you been lately pointed out for pallor on your face? Does your heart race more than usual or have you been missing beats? In case, you are bothered by these mentioned issues, you definitely need a thorough medical assessment. Your physician will order various blood tests including Iron studies.


What do Iron and TIBC tests measure?

Iron is an essential mineral in all cells of your body and forms heme part of hemoglobin which is a protein in your red blood cells that assists carry oxygen throughout the body to enable normal body functions. It is easily assessed by testing your serum Iron levels

Iron is transported throughout your bloodstream by a protein called transferrin, which is produced by your liver. The Total Iron-binding Capacity (TIBC) test measures how much Iron is carried in your bloodstream by transferrin. It assesses whether there is too much or too little Iron in your bloodstream.

What do levels of Iron and TIBC test indicate?

You can gain valuable information about your Iron status by Iron and TIBC tests and it is beneficial to be aware of the conditions which alter their levels.

High TIBC: High TIBC indicates a low level of Iron in your blood as less Iron is available for binding with transferrin. Causes of high TIBC include:

  • Dietary deficiency of Iron
  • Increased blood loss during menstruation
  • Pregnancy
  • Chronic conditions such as gastrointestinal tract diseases, kidney failure, Rheumatoid arthritis, cancers

Low TIBC: Low TIBC generally points to high level of Iron or Iron overload in your blood as more Iron is available for binding with transferrin. Causes of low TIBC include:

  • Sideroblastic anemia
  • Frequent blood transfusions
  • Hemolytic anemia
  • Sickle cell anemia
  • Hemochromatosis


What can you know about your anemia with Iron and TIBC testing?

You can know about your Iron status and clinical outcomes associated with your condition with Iron and TIBC testing.

Iron deficiency anemia

You are susceptible to develop Iron deficiency anemia in case your diet is lacking this essential mineral. Both inadequate intake of Iron or decreased absorption of Iron in your blood can lead to Iron deficiency anemia. Dietary Iron is available in two forms: heme Iron, which is found in meat; and nonheme Iron, which is found in plants such as dark green, leafy vegetables, spinach, beans, whole grains and dairy foods. Dietary factors have minimal effect on the absorption of heme Iron, on the other hand, nonheme Iron makes up the major part of consumed Iron which requires acid digestion and varies according to the concentration of enhancers such as ascorbate, meat and inhibitors such as calcium, fiber, tea, coffee, wine found in the diet. Iron deficiency results when Iron demand by the body is not met by Iron absorption from the diet. Other risk factors include: increased blood loss during menstruation, pregnancy, and chronic infections.

The symptoms of low Iron levels include: feeling tired and weak, skin pallor, dizziness, headache, shortness of breath, palpitations, cold feet and hands and decreased concentration. Laboratory changes occurring in several stages of anemia include an increase in the Iron-carrying protein transferrin. The amount of Iron available to bind to this molecule is reduced, causing a decrease in the transferrin saturation and an increase in the Total Iron-Binding Capacity. Red blood cells are smaller (microcytic) and light colored (hypochromic) than normal on blood film.

Anemia due to Gastrointestinal tract disorder

You are at risk of Iron deficiency anemia in case you have a Gastrointestinal tract (GIT) disorder. Bleeding, malabsorption and inflammation have essential roles in the context of different GIT conditions that lead to the development of anemia. Your well-being, quality of life, exercise capacity and cognitive functions can be decreased. These symptoms must prompt a diagnostic work-up for anemia which includes assessing Iron status (transferrin saturation, TIBC, ferritin, Hemoglobin) and inflammation (C-reactive protein) and lead to further treatment.

Sideroblastic anemia

Sideroblastic anemia is a group of blood disorders characterized by an impaired ability of your bone marrow to produce normal red blood cells. Although your serum Iron levels are normal, the Iron inside red blood cells is inadequately used to make hemoglobin. This leads to accumulation of Iron in the red blood cells, giving a ringed appearance to the nucleus (ringed sideroblast). According to the cause, it can be classified as hereditary (congenital), and acquired. Hereditary causes include mutation in the genes linked to hemoglobin metabolism. Acquired causes include Lead poisoning, excess intake of alcohol, nutritional deficiencies such as Copper and Vitamin B6 deficiency, medications such as anti-tuberculous agents, antibiotics, progesterone, chelators, and Busulfan.

The signs and symptoms of this condition are related to the Iron overload in you body and may include fatigue, weakness, enlargement of the liver or spleen, abdominal pain, change in skin color to bronze or gray and irregular heart beat. The diagnostic workup for sideroblastic anemia includes blood work (complete blood count, peripheral smear, Iron studies) and a bone marrow aspiration and/or biopsy.

Sickle Cell Anaemia

Sickle cell anemia is one of the commonest haemoglobinopathies due to a point mutation of the β-globin gene. You can have lifelong haemolytic anaemia characterized by the breakdown of abnormal sickle shaped cells. This frequently requires red cell transfusion which leads to Iron overload.


Your Iron and TIBC values are best interpreted by your physician along with additional Iron studies (typically, Hemoglobin, ferritin, transferrin saturation, blood film) and in terms of the clinical presentation of your baseline health state. Timely management of your Iron status will assist you in living a better life.