How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

Iron levels are highest in the morning. It's best to do this test in the morning, if a deficiency is suspected.

How to Prepare for the Test

Make sure your doctor knows about all the medications your are taking.

Drugs that can increase iron include estrogens, birth control pills, and methyldopa.

Drugs that can lower iron include cholestyramine, colchicine, deferoxamine, methicillin, allopurinol, and testosterone.

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others will feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

Your doctor may order this test if you have signs of low iron (iron deficiency).

Normal Results

• Iron: 60-170 mcg/dL
• TIBC: 240-450 mcg/dL
• Transferrin saturation: 20-50%

Note: mcg/dl = micrograms per deciliter

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

Higher-than-normal levels may mean:

• Hemochromatosis
• Hemolysis
• Hemolytic anemias
• Hemosiderosis
• Liver tissue death (hepatic necrosis)
• Hepatitis
• Vitamin B-12 deficiency, vitamin B-6 deficiency
• Iron poisoning
• Many blood transfusions

Lower-than-normal levels may mean:

• Chronic gastrointestinal blood loss
• Chronic heavy menstrual bleeding
• Poor absorption of iron
• Not enough dietary iron
• Pregnancy

Other conditions under which the test may be performed:

• Anemia of chronic disease

Risks

There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Alternative Names

Fe+2; Ferric ion; Fe++; Ferrous ion; Iron - serum

References

Ginder G. Microcytic and hypochromic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 163.

Yee DL, Bollard CM, Geaghan SM. Appendix: Normal Blood Values: Selected Reference Values for Neonatal, Pediatric, And Adult Populations. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 164.

Update Date: 3/21/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.