What blood test shows iron levels
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Blood Tests for Measuring Iron Levels
Serum Ferritin: The Gold Standard for Iron Deficiency Diagnosis
Serum ferritin is widely recognized as the most powerful and reliable test for diagnosing iron deficiency anemia. It measures the stored iron in the body, providing a clear indication of iron levels. Studies have shown that serum ferritin radioimmunoassay has an area under the receiver operating characteristic curve of 0.95, making it highly effective in diagnosing iron deficiency across various patient populations, including those with inflammatory, liver, or neoplastic diseases1. In elderly patients, serum ferritin has been identified as the best test for distinguishing iron deficiency, with specific likelihood ratios indicating the probability of iron deficiency based on ferritin levels3.
Complete Blood Count (CBC) Parameters: An Accessible Alternative
In resource-limited settings, where ferritin tests may be cost-prohibitive, complete blood count (CBC) parameters can serve as a practical alternative for diagnosing iron deficiency and iron deficiency anemia. Key CBC parameters such as red blood cell (RBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), and hematocrit have shown varying degrees of diagnostic capability. For instance, an MCHC cutoff of 337.5 g/L and an MCH cutoff of 29.15 pg have demonstrated high discriminating power for iron deficiency anemia, with areas under the ROC curve of 0.80 and 0.81, respectively2.
Transferrin Saturation and Free Erythrocyte Protoporphyrin
Other blood tests that can help assess iron status include transferrin saturation and free erythrocyte protoporphyrin. Transferrin saturation measures the percentage of transferrin (a protein that transports iron) that is saturated with iron, while free erythrocyte protoporphyrin indicates the amount of protoporphyrin in red blood cells that is not bound to iron. These tests can provide additional insights into iron supply for erythropoiesis and overall iron metabolism5.
Innovative Point-of-Care Diagnostics: ironPhone
Recent advancements have led to the development of portable diagnostic tools like the ironPhone, which quantifies serum ferritin levels using a mobile device. This innovative platform includes a smartphone accessory, an app, and a disposable lateral flow immunoassay test strip, allowing for rapid assessment of iron status from a drop of fingerprick blood. Initial validations have shown a high correlation with standard laboratory methods, making it a promising tool for point-of-care diagnostics, especially in settings with limited access to traditional laboratory facilities4.
Conclusion
Serum ferritin remains the gold standard for diagnosing iron deficiency due to its high accuracy and reliability. However, in resource-limited settings, CBC parameters and innovative tools like the ironPhone offer practical alternatives for assessing iron levels. Understanding the strengths and limitations of each test can help healthcare providers make informed decisions about diagnosing and managing iron deficiency.
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Most relevant research papers on this topic
Laboratory diagnosis of iron-deficiency Anemia: An overview
Serum ferritin radioimmunoassay is the most powerful test for diagnosing iron-deficiency anemia, with a 0.95 area under the receiver operating characteristic curve and can be applied to all patients.
Systematic Review
Highly CitedUsing complete blood count parameters in the diagnosis of iron deficiency and iron deficiency anemia in Filipino women
CBC parameters can effectively discriminate iron deficiency anemia in Filipino women, offering potential as a cost-effective diagnostic tool in resource-limited settings.
Observational StudyDiagnosis of iron-deficiency anemia in the elderly.
Serum ferritin is the best test for diagnosing iron-deficiency anemia in elderly patients, with values up to 45 micrograms/L increasing the likelihood of iron deficiency and values over 45 micrograms/L decreasing the likelihood of iron deficiency.
Observational StudyHighly CitedironPhone: Mobile device-coupled point-of-care diagnostics for assessment of iron status by quantification of serum ferritin.
The ironPhone is a portable diagnostics device that accurately quantifies serum ferritin concentrations from fingerprick blood, demonstrating potential for point-of-care iron status assessment.
The laboratory assessment of iron status--an update.
The laboratory assessment of iron status has advanced since 1957, with new methods for assessing storage iron, erythropoiesis, and iron metabolism, but understanding pathological processes is crucial for accurate interpretation.
Highly CitedClinical utility of the reticulocyte hemoglobin content in the diagnosis of iron deficiency.
Reticulocyte hemoglobin content (CHr) has the highest sensitivity and specificity for predicting iron deficiency in bone marrow, especially when excluding patients with high mean cellular volume or red cell disorders.
Observational StudyHighly CitedDiurnal variation of serum iron, iron-binding capacity, transferrin saturation, and ferritin levels.
Restricting iron specimen collections to a specific time of day does not improve the reliability of the test result.
Observational StudyHighly CitedReticulocyte hemoglobin content (MCHr) in the detection of iron deficiency.
MCHr is a reliable test for detecting iron deficiency in non-anemic adults, with the best sensitivity and diagnostic value compared to erythrocyte indices.
Observational StudyTotal Iron Measurement in Human Serum With a Novel Smartphone-Based Assay
The novel smartphone-based assay effectively measures total iron in human serum, offering a low-cost, portable method for detecting iron deficiency and overloads.
The Role of Reticulocyte Hemoglobin Content for Diagnosis of Iron Deficiency and Iron Deficiency Anemia, and Monitoring of Iron Therapy: a Literature Review.
Reticulocyte hemoglobin content (CHr) is an effective, easy-to-use test for diagnosing iron deficiency and monitoring iron therapy, but requires standardized cutoff values for accurate diagnosis.
Systematic Review