Iron studies
What ferritin, serum iron, transferrin and transferrin saturation measure, the RCPA and ASH 2026 ferritin thresholds, reading iron studies in inflammation, the patterns of deficiency, inflammation, overload and recent iron, and worked examples.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Ferritin reflects iron stores but rises with inflammation. Transferrin saturation (TSAT) reflects iron available to the marrow right now.
- Ferritin under 30 µg/L diagnoses iron deficiency in adults (RCPA protocol 2021; ASH 2026). A low ferritin is almost never falsely low.
- With inflammation, think deficiency if ferritin is under 100 µg/L or TSAT under 20% (ASH 2026).
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Sources
- American Society of Hematology 2026 guidelines for diagnosis of iron deficiencyPowers JM et al., Blood Adv 2026;10:7353-74, 2026
- Iron Studies Standardised Reporting ProtocolAU/NZRoyal College of Pathologists of Australasia, 2021
- Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing of blood donors by Australian Red Cross LifebloodAU/NZZhang GD, Johnstone D, Leahy MF, Olynyk JK. Med J Aust 2024;221:360-4, 2024
- Updating the diagnosis and management of elevated serum ferritin levels in the era of routine ferritin testing of blood donors by Australian Red Cross LifebloodAU/NZZhang GD, Chen J, Johnstone DM, Delatycki MB, et al. Med J Aust 2025;222(7):334-6, 2025
- Therapeutic Guidelines (eTG complete): iron deficiencyAU/NZTherapeutic Guidelines Limited
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy