1. Assessment of Iron Status
David L. Gee, PhD
FCSN 442
Nutrition Assessment Laboratory 1

2. Iron Status Stage one - iron deficiency Depletion of iron stores
Ferritin - primary storage form of iron
Serum ferritin reflects tissue levels
Low serum ferritin - early iron deficiency 16

3. Iron Status Stage Two Iron Deficiency Iron deficiency without anemia
Transferrin - serum iron transport protein
Serum iron reflects transferrin iron
Each transferrin protein can bind two iron atoms 17

4. Transferrin Normal transferrin saturation (TS)= 30%
Total Iron Binding Capacity (TIBC)
add excess iron to serum to saturate transferrin, remove unbound iron, measure total iron = TIBC
TS = [(serum iron)/TIBC]*100
low TS = stage 2 iron deficiency 18

5. Iron Status Stage Three Iron Deficiency Iron deficiency anemia
low iron stores (low serum ferritin)
low transferrin saturation
microcytic hypochromic anemia 19

6. Hemoglobin Widely used diagnosis of late stage iron deficiency
Table 9-6 cutoff values for Hgb based on 5th pct, NHANES II
hemodilution during
early pregnancy
early exercise training 20

7. Hematocrit Packed RBC cell volume
%HCT = % of RBC making up whole blood volume
Manual measurement
Automated blood counters
calculated from RBC count and MCV
high due to dehydration 21

8. Mean Corpuscular Volume
MCV
average size of RBC
elevated with:
folate and B12 deficiency
decreased with:
iron deficiency 22

9. Mean Corpuscular Hemoglobin
MCH = amount of hemoglobin in RBC
picograms per cell
Mean corpuscular hemoglobin concentration (MCHC)
average concentration of HB in RBC
g/l 23