Iron studies pattern in iron deficiency anemia shows which combination?

• A. Low ferritin, low transferrin saturation, high TIBC
• B. Normal ferritin, high transferrin saturation, normal TIBC
• C. High ferritin, high transferrin saturation, low TIBC
• D. Low ferritin, high transferrin saturation, low TIBC

Answer: (A)

Iron stores drop when iron is scarce, so ferritin, which reflects stored iron, falls in iron deficiency anemia. With low iron in the blood, the amount of iron bound to transferrin drops, reducing transferrin saturation. In response, the liver increases transferrin production to capture whatever iron is available, which raises the total iron-binding capacity. Put together, the typical iron studies pattern is low ferritin, low transferrin saturation, and high TIBC. This combination fits iron deficiency as the body’s attempt to mobilize and capture more iron, even though stores and circulating iron are depleted.

Other patterns don’t fit iron deficiency: normal ferritin with high transferrin saturation would suggest adequate iron or iron overload; high ferritin with high transferrin saturation points toward iron overload or inflammation; and low ferritin with high transferrin saturation would imply iron present in the blood despite low stores, which isn’t characteristic of iron deficiency.