Serum Iron Test

Iron is essential for the production of red blood cells. About 70% of your body's iron is present in haemoglobin and myoglobin. Haemoglobin is a substance present in red blood cells and myoglobin is present in muscle cells. Haemoglobin is essential for the transport of oxygen from the lungs to all organs. Myoglobin stores and releases oxygen into muscle cells.

About 6% of the body's iron is in proteins. These proteins are essential for respiration and energy metabolism. Iron is a component of enzymes involved in the synthesis of collagen and neurotransmitters.

Ferritin is present in cells and blood circulation. Ferritin stores around 25% of the iron in the body. The average adult man has roughly 1,000 mg of iron stored in his body enough to last three years. A woman only has about 300 mg, enough for about six months. When iron stores get depleted as a result of poor intake, haemoglobin levels fall.

Iron depletion occurs when the body's iron stores reduce. Further reductions are known as iron-deficient erythropoiesis, which results in iron deficiency anaemia. The human body cannot produce iron and must be obtained through food. The daily iron requirement for adults is 1.8 mg. The body absorbs and uses just around 10 to 30 per cent of the iron you consume. Iron toxicity can result from consuming high doses of iron supplements for an extended period or from a single overdose.

A serum iron test determines the amount of iron in the blood. The serum is the liquid that remains after red blood cells plus clotting factors are removed from the blood. The serum iron test can detect blood iron levels that are unusually low or excessive. The serum iron test is a requisition when the doctor suspects an iron deficiency or an iron overload.

Too much or too little iron can create health concerns. Iron excess can build up in the organs over time, causing catastrophic damage to the liver or brain. The serum iron test will assist the doctor in providing a more precise diagnosis. Depending on how recently the iron supplement is taken, the iron level fluctuates. The serum iron test reports will be accurate if done in the morning on an empty stomach.

Other names of Serum Iron Test

• Ferrous ion
• Anaemia-serum iron
• Fe++
• Iron-serum
• Ferric ion
• Fe+2

What does the iron serum test measure and who is it prescribed for?

The serum iron test measures the levels of iron in the blood sample. Serum iron reports are used for the diagnosis of iron deficiencies and iron overload.

Serum iron test is a routine screening in:

• Women planning for pregnancy
• Pregnant women
• Newborns
• Adolescent girls during puberty
• People with a history of chronic alcohol consumption
• Elderly people

A serum iron test is indicated if a person is experiencing the following symptoms of iron deficiency:

• Unusual fatigue and tiredness
• Skin pallor includes pale face, gums, inside of lower eyelids and nails
• Shortness of breath
• Headaches
• Dizziness
• Difficulty concentrating
• Grumpiness
• Muscle weakness
• Heart palpitations
• Damaged hair and skin
• Swollen mouth
• Smooth glossy tongue
• Restless legs syndrome
• Spoon-shaped Brittle nails
• Strange cravings with a desire to eat ice, clay, dirt, chalk or paper
• Depression

A serum iron test is indicated if a person is experiencing the following symptoms of iron overload :

• Pain in abdomen
• Painful joints
• Skin bronzing
• Dark pigmentation over the skin
• Fatigue
• Heart troubles
• Lack of energy
• Lack of sexual drive
• Weight loss
• Muscle weakness
• Nausea
• Vomiting
• Diarrhoea

Considering serum iron chart values, the doctor will determine the treatment of iron deficiency or iron overload. The serum iron test procedure is applicable for males and females, both adults and children.

Along with medicinal treatment, adding foods rich in iron also helps in overcoming iron deficiency. Foods such as spinach, legumes, peas, shellfish, red meat, pumpkin seeds, broccoli, lentils, eggs and oysters help to reach serum iron normal range values.

The serum iron test range may vary depending on age, sex, medical history and test technique. The serum iron test range is higher in males compared to females.

The following table gives serum iron normal range:

The serum iron in different age groups:

It's possible that the serum iron test reports don't indicate an issue. Enquire with the health care provider about the implications of the serum iron test reports. People with a serum iron normal range can follow a regular diet and don't need supplements.

Serum iron chart values vary according to age, gender and various laboratories. Serum iron chart values are lower in women than in men. Menstrual bleeding can be a reason for this variation. Decreased levels of serum iron mean iron deficiency.

Serum iron report values could be low due to:

• Low dietary intake

When the diet does not contain iron-rich food or lacks vitamins necessary for iron absorption, iron levels fall.

• Low iron absorption

The deficiency of some proteins interferes with iron absorption lowering serum iron levels.

• Excess iron elimination

Absorbed and stored iron is lost during internal or external bleeding, depleting serum iron levels.

Serum iron results could be less in the following conditions:

• Gastrointestinal blood loss

Gastric ulcers, peptic ulcers, and piles are some diseases in which gradual blood loss adds to a reduction in serum iron levels.

• Heavy menstrual cycles

Women with frequent menses or cycles with heavy bleeding may suffer from low iron levels.

• Sideroblastic anaemia

In sideroblastic anaemia, bone marrow forms abnormal red blood cells that interfere with iron levels causing iron deficiency.

Serum iron report values could be high due to:

• Iron poisoning

A condition occurs due to the consumption of increased doses of iron supplements.

• Iron overload

Where the body naturally retains too much iron due to some underlying cause.

• Increased vitamin

Increased Vitamin B-6 and Vitamin B-12 in the diet lead to excess iron absorption and retention.

Serum iron results could be high in the following conditions:

• Haemolytic anaemia

A condition characterised by increased red blood cell destruction liberating excess iron in circulation.

• Haemolysis

In haemolysis, immature or abnormal red blood cells are destroyed, which increases serum iron values. 

• Liver diseases

Healthy liver functions are essential for iron metabolism, absorption and retention. Any disease that affects liver cells, in turn, affects iron absorption and retention.

• Hepatic necrosis

Hepcidin protein produced by the liver is essential for iron metabolism. In Hepatic necrosis, hepcidin production decreases as serum iron levels increase.

• Liver failure

Liver failure increases serum iron levels due to a lack of proteins and enzymes needed for iron metabolism.

• Hepatitis

Hepatitis is a condition characterised by inflammation of Hepatic cells commonly due to viral infection. Affected liver parenchyma becomes a cause for the increase in serum iron values. 

• Haemochromatosis

Haemochromatosis is a genetic disease where the body stores too much iron. Hereditary Haemochromatosis increases the absorption of iron from the diet leading to iron toxicity.

• Frequent blood transfusions

The amount of blood transfusions is closely related to iron excess. Iron levels in the transfused blood range from 200 to 250 milligrammes per unit. Iron overload is a danger for individuals who receive more than 10 to 20 units of blood.

Certain medications interfere with the serum iron test results. Such as:

• Antibiotics
• Estrogens and birth control tablets
• Antihypertensive medications
• Medications for cholesterol
• Deferoxamine, a kind of antihistamine
• Drugs for gout
• Testosterone hormone replacement medicines

The serum iron needs a simple blood sample.

Test Preparation

The iron test is a blood test that requires fasting. The healthcare provider may ask for fasting for 12 hours or overnight before sample collection. Some medications might interfere with serum iron results, for which the doctor may ask you to stop these medications for a few days before the test.

The iron test procedure is not painful. A blood sample is obtained from one of the veins in the arm. The iron test procedure takes 5 minutes to complete.

Test inclusions: What parameters are included?

The serum iron results give an idea about the decrease and increase in the iron levels in the blood. The serum iron test is recommended when there are symptoms of iron deficiency or iron toxicity, both in men and women. The serum iron test chart includes only one parameter, the levels of iron in the blood.

How frequently should you take this test?

All mineral deficiencies require time to get better. So does an iron deficiency for which you are on treatment. The serum iron test is repeated every three months for:

• Monitoring iron levels
• Regulating the dose of iron supplements
• Assessing the treatment of causative disease

This three-month check-up will reveal whether iron levels have increased, decreased or remained the same. People with serum iron levels above or below the usual range must follow their doctor's recommendations.

Gastrointestinal blood loss, anaemia, peptic ulcer, sideroblastic anaemia, haemochromatosis, haemolysis