Tests to evaluate iron metabolism disorders

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Tests to evaluate iron metabolism disorders are often indicated in combination in cases where the results of the blood cell analysis are abnormal or the patient has fatigue, dizziness, and muscle weakness. body, blue skin, pale mucous membranes accompanied by symptoms of iron deficiency / iron poisoning.

1. Consequences of iron metabolism disorders

Iron metabolism disorder is very dangerous, it can cause serious consequences such as:
1.1 Iron deficiency anemia The cause of iron deficiency anemia due to iron metabolism disorders is because:
The supply of iron iron from the daily menu is not guaranteed; Because gastric bypass surgery reduces the absorption of iron or the patient is infected with helminths leading to blood loss. Chronic inflammation increases iron stores in macrophages; Pregnant and lactating women, children born prematurely or in the developing age, girls in puberty need to increase iron requirements can also be subject to iron deficiency anemia due to iron deficiency anemia. iron metabolism disorders. With iron deficiency anemia, tests show hypochromic small red blood cells, decreased iron stores in the body, and cellular dysfunction.
Iron overload The cause of iron overload in iron metabolism disorders is because the patient has to have blood transfusions for a long time, causing a large amount of iron to be introduced into the body but not eliminated in time. As a result, iron is deposited in tissues and organs.
Warning signs of iron overload are impaired liver function, endocrine glands, thereby causing some diseases such as diabetes, hypothyroidism, heart failure or arrhythmia.

2. Tests to evaluate iron metabolism disorders

Below are some commonly ordered tests to evaluate iron metabolism disorders:
Iron and Transferrin (Tf) Serum iron determination for the purpose of determining the amount of iron bound to serum transferrin in the body. Transferrin (a glycoprotein in the blood plasma capable of binding to iron) binds best to Fe3+ ions, thanks to the specific receptor (receptor) attached to the cell membrane, transferrin will be transported into the cell. In an acidic environment, the receptor - transferrin complex will return to the cell membrane, while transferrin will return to the plasma to play the role of reusing iron transport.
Transferrin shows a relationship with iron requirements in the human body. When iron stores are low, the saturation level of Transferrin increases and vice versa. The reference value of this iron metabolism disorder test is:
Serum iron: 7 - 27 μmol/L; Transferrin: 2.0 - 3.6 g/L. When tested with this method, if you see a decrease in iron and an increase in Transferrin, it could be a sign of iron deficiency. A decrease in iron and a decrease in Transferrin suggests that there is an inflammatory response caused by some malignancy.
Transferrin saturation (TfS) Transferrin saturation is the percentage of Transferrin sites that have been bound to iron. The reference value of this test is 15 - 45%. Transferrin saturation was calculated by the formula:
TfS = (serum iron *100) /TIBC (where TIBC is total iron-binding capacity).
If the transferrin saturation is reduced after the test, it is possible that the patient is experiencing iron deficiency in iron metabolism disorders of chronic disease. If transferrin saturation is reduced alone, it is not an indicator of iron deficiency alone.
Ferritin This is an indicator of the body's iron stores, it provides a valuable information on the status of iron stores as well as completely independent of serum iron. Normal ferritin in men is from 23 to 336 ng/ml, and in women is from 11 to 306 ng/ml.
In iron deficiency, ferritin will be reduced before serum iron is decreased. Therefore, a decreased ferritin test is a fairly specific sign of iron deficiency. In cases of disorders in the distribution and use of iron, when tested, iron and ferritin increased. In cases of iron overload, the amount of ferritin increases due to increased stores.
TIBC (total iron-binding capacity) test This iron-deficiency assay is used to assess the maximum amount of iron that can bind to Transferrin.
The normal value of TIBC in healthy people is 255 - 450 μg/dL.
UIBC (serum unsaturated iron) test This is the amount of iron that is able to bind to Transferrin, also known as Transferrin's iron binding potential. TIBC and UIBC preliminarily assess the body's iron billet early in the absence of anemia.
Soluble Transferrin receptor (sTfR) test This test for iron metabolism disorders will help reflect the cells' need for iron. The soluble transferrin receptor helps in early diagnosis of iron deficiency as well as effective treatment of iron deficiency anemia to make a decision to stop iron supplementation when the iron needs of the cells are normal.

3. When is an iron metabolism test ordered?

Tests to evaluate iron metabolism disorders are indicated together in cases of abnormal blood cell analysis results or in cases where the patient has:
Fatigue with flowers dizzy eyes; There are signs of physical weakness; Blue skin and pale mucous membranes; Suspect chronic iron overload; Iron overload or poisoning with symptoms such as joint pain, lack of energy, abdominal pain, loss of sex drive or heart problems; Detection and assessment of iron toxicity.

4. Notes before testing to evaluate iron metabolism disorder

For healthy people, a normal diet can provide enough iron to prevent iron-deficiency anemia. However, when iron requirements are increased (eg, with chronic gastrointestinal bleeding, prolonged menstruation, pregnant or lactating women), iron deficiency may be present, requiring iron supplementation. diet, then the iron parameters should be tested. Where iron levels remain low with dietary iron supplementation, the cause of iron metabolism disorders should be treated until iron status returns to normal.
Besides, before testing to evaluate iron metabolism disorders, patients should note the following basic things:
Low serum iron can also occur in cases where the body cannot use it. iron properly. In some other cases, people with chronic diseases, especially cancer, chronic infections or autoimmune diseases, the body is also unable to produce red blood cells on its own, which leads to the test results showing transferrin decreased and serum iron decreased but ferritin increased. When the body is deficient in iron, it is recommended to supplement iron-rich foods such as green vegetables, wheat germ, whole grains, raisins and molasses... first, if the condition does not improve, then it should be tested. . Pregnant women and people with iron deficiency often need iron supplements. However, if used in excess, it will lead to iron poisoning, especially for children, so caution should be taken. Iron deficiency anemia usually develops gradually. In the early stages, ferritin levels will be low, but serum iron and TIBC will usually be normal and there will be no signs of anemia. When donating 1/2 liter of blood, the body will lose about 250 mg of iron. The serum ferritin level will decrease with each blood donation, however, it will gradually return to normal. Serum iron and TIBC will not be affected by blood donation.. In summary, there are many test methods to evaluate iron metabolism disorders. These evaluation tests are often ordered in combination when the results of the complete blood count are abnormal or in cases of fatigue, dizziness, weakness, pale skin, mucous membranes. pale skin or symptoms of iron deficiency, iron poisoning. To get accurate results, patients need to conduct the test at a reputable hospital with modern equipment system. Currently, the Hematology Department (Blood Complete Blood Test) - Vinmec International General Hospital is one of the leading prestigious addresses in the country, trusted by a large number of patients for examination and treatment. Thanks to the use of modern machines and equipment to check and analyze blood, it has provided accurate information on red blood cells, white blood cells, platelets, hemoglobin,... Overall assessment of the health status of the person being tested, early detection of the disease and suggestions for timely treatment. In particular, with a space designed according to 5-star hotel standards, Vinmec guarantees to bring patients the most comfort, friendliness and peace of mind when visiting and receiving treatment at the hospital.

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