Iron (Fe) Lab Values

Hey everyone. My name is Abby and I’m with nursing.com. In this lesson, we’ll talk about iron levels, their normal value, as well as times when we might see them increase or decrease, and why we should draw this lab. Let’s dive in!

An iron lab measures the amount of iron in the blood. Iron is in an element that is an important component of hemoglobin, which resides in red blood cells. It’s so important because iron aids hemoglobin in the transport of oxygen from the lungs to all of the cells in the body. The storage form of iron is called ferritin. Ferritin is measured in a separate lab, but you can see here is a cartoon version if you will, of ferritin, and you can see how iron is stored within it. Iron is bound and transported in the blood, in ferritin via transferrin. That’s how it’s bound to the ferritin. 

Some clinical indications for taking an iron lab would be, if there has been a major amount of blood loss, hemochromatosis, like this individual with the thin legs in the picture, if there’s a known mal-absorption of iron, so this could be some type of autoimmune disease or a poor diet, um, even different types of anemia, or it could be to identify an iron overload. It also helps to determine the etiology of certain anemias, uh, whether that be thalassemia, or sideroblastic anemia, or iron deficiency anemia. 

Normal lab values for iron are between 50 and 175 micrograms per deciliter. It’s collected in a plasma separator tube like this green one here. An increase will be seen in the case of hemochromatosis, like we saw with that gentleman with dark legs. It can also be increased in lead toxicity or in iron poisoning, so maybe iron supplements were overtaken. It can also be increased in acute liver disease, because iron can bind itself within organs and cause a lot of organ damage. It can also be increased in patients that have multiple blood transfusions. It’s also going to be increased in hemolytic anemia because those lead red blood cells are blasting open and spitting out contents like the hemoglobin and iron, and also, sideroblastic anemia. It will be decreased in the case of blood loss, that could be from a heavy GI bleed, it could even be from heavy menstruation, or chronic hematuria. It’s also related to hypothyroidism and of course, iron deficiency anemia. And then, as we mentioned, it can also be due to inadequate absorption. 

Linchpins for this lesson are that the iron lab measures iron concentration in the blood to evaluate for blood loss, anemias, and liver disease. Normal values are between 50 and 175 micrograms per deciliter, and we would see an increased value if there was an excess intake of iron, like in poisoning, those that get regular blood transfusions, and in certain anemias, like hemolytic anemia. It’s going to be decreased if there’s blood loss, because of course, if there’s blood loss, then we have fewer red blood cells. If we have fewer red blood cells, we have less hemoglobin, and if we have less hemoglobin with iron bound to it, right, it’s all making sense. It’s also linked to an iron deficiency and a lack of absorption. 

Now you all did great on this lesson. I hope that contributed to a great understanding. Now go out, be your best self today and as always, happy nursing.

References:

• https://www.mayoclinic.org/tests-procedures/ferritin-test/about/pac-20384928
• https://www.ncbi.nlm.nih.gov/books/NBK538336/#:~:text=%5B7%5D%20One%20molecule%20of%20oxygen,to%20transport%20four%20oxygen%20molecules
• https://ltd.aruplab.com/Tests/Pub/0020037
• http://www.nursing.com