Iron, Serum
Medical Test

Diseases (113)
Screening/Initial Testing (3)
Diagnostic Testing (44)
Anemia, NOS
10
Note:
Liver Disease
9
Note:

Rule out iron liver disease.

Alopecia
8
Note:

Rule out iron deficiency.

Chronic gastritis
8
Note:

Evaluate for possible iron deficiency secondary to achlorhydria. Especially if anemia is present.

Chronic liver disease
8
Note:

Rule out liver disease due to iron overload, hemochromatosis.

Gastrointestinal hemorrhage
8
Note:

If anemia is present, esp. if microcytic/hypochromic.

Hepatic steatosis (fatty liver)
8
Note:

Rule out hemochromatosis.

Jaundice
8
Note:
Chronic hepatitis
7
Note:

Rule out hemochromatosis.

Pernicious anemia
7
Note:

If patient is diagnosed with folate or Vit. B12 deficiency but the MCV is normal or low

Viral hepatitis type C
7
Note:

To rule out hemochromatosis

Acute hepatic failure
6
Note:

Rule out iron load, hemochromatosis.

Autoimmune hemolytic anemia
6
Note:

Rule out iron deficiency anemia.

Budd-Chiari syndrome
6
Note:

Rule out hemochromatosis.

Chronic myeloid leukemia (CML)
6
Note:

If anemia present.

Chronic myelomonocytic leukemia
6
Note:

To evaluate and monitor anemia.

Disease Management Testing (22)
Anemia, NOS
10
Note:

To monitor iron related therapy in iron related deficiency anemia.

Pernicious anemia
9
Note:

If patient has been previously shown to have concommitant iron deficiency

Pregnancy without complications
8
Note:

If anemia is seen.

Ulcerative colitis
8
Note:

Rule out iron deficiency if anemia is present.

Chronic liver disease
7
Note:

If chronic liver disease cased by iron overload.

Inflammatory bowel disease
7
Note:

If abnormally low?

Acute myeloid leukemia (AML)
6
Note:

If hemoglobin is low due to anemia.

Follicular lymphoma
6
Note:

If hemoglobin is low due anemia.

Other Supportive/Alternative Tests (44)
Acute lymphoid ( lymphoblastic) leukemia (ALC)
5
Note:

If hemoglobin is low due to anemia.

Adult T-cell leukemia/lymphoma
5
Note:

If hemoglobin is low due to anemia.

Adult preventative health screening
5
Note:

I hemoglobin is low.

Alveolar rhabdomyosarcoma
5
Note:

If hemoglobin is low due to anemia.

Anaplastic large cell lymphoma
5
Note:

If hemoglobin is low due to anemia.

Benign neoplasm of liver and/or biliary ducts
5
Note:

If hemoglobin is low due to anemia.

Burkitt lymphoma
5
Note:

If hemoglobin is low due to anemia.

Cancer of unknown primary site
5
Note:

If hemoglobin is low due to anemia.

Diffuse large B-cell lymphoma
5
Note:

If hemoglobin is low due to anemia.

Geriatric health maintenance
5
Note:

If hemoglobin is low.

Hepatocellular carcinoma
5
Note:

If hemoglobin is low due to anemia.

Kaposi's sarcoma
5
Note:

If hemoglobin is low due to anemia.

Malignant Melanoma
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm of lung
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm of testis (Testicular cancer)
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm of thymus
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, adrenal gland
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, brain
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, endometrium (endometrial cancer)
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, extrahepatic bile duct
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, female breast
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, ovary
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, pancreas
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, pituitary gland
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, renal pelvis (kidney)
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, stomach
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, thyroid gland
5
Note:

If hemoglobin is low due to anemia.

Malignant neoplasm, uterine cervix (cervical cancer)
5
Note:

If hemoglobin is low due to anemia.

Mantle cell lymphoma
5
Note:

If hemoglobin is low due to anemia.

Merkel Cell Carcinoma
5
Note:

If hemoglobin is low due to anemia.

Multiple myeloma
5
Note:

If hemoglobin is low due to anemia.

Neoplasm of soft tissue (soft tissue sarcomas)
5
Note:

If hemoglobin is low due to anemia.

Neuroendocrine Neoplasms (Carcinoid Tumors)
5
Note:

If hemoglobin is low due to anemia.

Non-Hodgkin lymphoma
5
Note:

If hemoglobin is low due to anemia.

Non-small cell carcinoma, lung
5
Note:

If hemoglobin is low due to anemia.

Peripheral T-cell lymphoma
5
Note:

If hemoglobin is low due to anemia.

Primary myelofibrosis (PMF)
5
Note:

If hemoglobin is low due to anemia.

Overview

Iron is a structural part of hemoglobin, which functions to transport oxygen. Ingested iron is mainly absorbed in the form of Fe2 + in the duodenum and upper jejunum. Absorbed iron is then transported in blood plasma by transferrin-iron complexes. A maximum of 2 Fe2 + ions per transferrin molecule can be transported. Serum iron is almost completely bound to transferrin.

Testing for iron (non-heme) levels is used in the diagnosis and treatment of diseases such as iron deficiency anemia and hemochromatosis. Hemochromatosis is a disease associated with iron deposits in tissues, usually deposited in the form of iron-containing pigments such as hemosiderin and hemofuscin. Disease is characterized by pigmentation of the skin and chronic renal disease. In addition, iron testing can be useful in the diagnosis and monitoring of microcytic anemias (e.g. due to iron metabolism disorders and hemoglobinopathies), macrocytic anemias (e.g. due to vitamin B12 deficiency, folic acid deficiency, and drug-induced metabolic disorders of unknown origin), normocytic anemias such as anemia of chronic renal disease (erythropoetin deficiency), hemolytic anemia, bone marrow disease, and toxic bone marrow damage. Percent iron saturation should also be obtained because it is more helpful than serum iron in estimating iron stores and evaluating for iron deficiency anemia.

Clinical Utility
  • Differential diagnosis of anemia, especially with hypochromia and/or low red blood cell MCV
  • As an aid in diagnosis of thalassemia and sideroblastic anemia
  • As an aid in diagnosis of hemochromatosis
  • Diagnosis of iron deficiency

Interpretation

Increased in:

  • Hemosiderosis due to increased iron uptake
  • Multiple transfusions
  • Hemolytic anemia
  • Pernicious anemia
  • Aplastic or hypoplastic anemia
  • Viral hepatitis
  • Lead poisoning
  • Thalassemias
  • Some drugs: estrogens, ethanol, oral contraceptives

Decreased in:

  • Iron deficiency
  • Nephrotic syndrome
  • Chronic renal failure
  • Many infections
  • Active hematopoiesis
  • Remission of pernicious anemia
  • Some malignancies (some carcinomas)
  • Gastrectomy
  • Nutritional (children and premenopausal women)
  • Pregnancy
  • Chronic blood loss due to bleeding

Reference Ranges
  mcg/dL umol/L
Newborn:  100-250  [17.9-44.8]
Infant: 40-100  [7.2-17.9]
Child:  50-120  [9.0-21.5]
Adult    
M:  65-175  [11.6-31.3]
F:  50-170  [9.0-30.4]
Intoxicated child: 280-2550  [50.1-456.5]
Fatally poisoned child:  1800  [322.2]


 

 

Methodology

Timed Endpoint Spectroscopy Method.

Specimen Collection

Serum (SST) or Plasma Heparin (Green)

Draw blood before other specimens that require anticoagulated tubes. Reject hemolyzed samples.

Stability:

  • Ambient: 14 days
  • Refrigerated: 14 days
  • Frozen: 28 days
  • Separate serum of Plasma within 45 minutes of collection.

Additional Testing

Complete Blood Count with RBC Indices, Vitamin B12, Folate, Ferritin, TIBC, Transferrin, Transferrin Receptor, Erythropoietin, Hemochromatosis Mutation, Lead Level, Occult Blood, Porphyrins Urine.

CPT
83540$6.47

ICD10
ICD CODE AND DESCRIPTIONLCD CODENCD CODE
A51.32 - Syphilitic alopecia—190.18
B17 - Other acute viral hepatitis—190.18
B17.1 - Acute hepatitis C—190.18
B18 - Chronic viral hepatitis—190.18
B18.0 - Chronic viral hepatitis B with delta-agent—190.18
B18.1 - Chronic viral hepatitis B without delta-agent—190.18
B18.2 - Chronic viral hepatitis C—190.18
B18.8 - Other chronic viral hepatitis—190.18
B18.9 - Chronic viral hepatitis, unspecified—190.18
B19 - Unspecified viral hepatitis—190.18
B19.2 - Unspecified viral hepatitis C—190.18
B19.20 - Unspecified viral hepatitis C without hepatic coma—190.18
B19.21 - Unspecified viral hepatitis C with hepatic coma—190.18
B25.1 - Cytomegaloviral hepatitis—190.18
B26.81 - Mumps hepatitis—190.18
B58.1 - Toxoplasma hepatitis—190.18
C00 - Malignant neoplasm of lip—190.18
C00.9 - Malignant neoplasm of lip, unspecified—190.18
C01 - Malignant neoplasm of base of tongue—190.18
C02 - Malignant neoplasm of other and unspecified parts of tongue—190.18
C02.9 - Malignant neoplasm of tongue, unspecified—190.18
C03 - Malignant neoplasm of gum—190.18
C03.0 - Malignant neoplasm of upper gum—190.18
C03.1 - Malignant neoplasm of lower gum—190.18
C03.9 - Malignant neoplasm of gum, unspecified—190.18
C04.9 - Malignant neoplasm of floor of mouth, unspecified—190.18
C05 - Malignant neoplasm of palate—190.18
C05.9 - Malignant neoplasm of palate, unspecified—190.18
C06.0 - Malignant neoplasm of cheek mucosa—190.18
C06.9 - Malignant neoplasm of mouth, unspecified—190.18
C07 - Malignant neoplasm of parotid gland—190.18
C08 - Malignant neoplasm of other and unspecified major salivary glands—190.18
C08.0 - Malignant neoplasm of submandibular gland—190.18
C08.1 - Malignant neoplasm of sublingual gland—190.18
C08.9 - Malignant neoplasm of major salivary gland, unspecified—190.18
C09 - Malignant neoplasm of tonsil—190.18
C09.9 - Malignant neoplasm of tonsil, unspecified—190.18
C10 - Malignant neoplasm of oropharynx—190.18
C10.9 - Malignant neoplasm of oropharynx, unspecified—190.18
C11 - Malignant neoplasm of nasopharynx—190.18
C11.9 - Malignant neoplasm of nasopharynx, unspecified—190.18
C12 - Malignant neoplasm of pyriform sinus—190.18
C13 - Malignant neoplasm of hypopharynx—190.18
C14 - Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx—190.18
C15 - Malignant neoplasm of esophagus—190.18
C16 - Malignant neoplasm of stomach—190.18
C16.1 - Malignant neoplasm of fundus of stomach—190.18
C16.2 - Malignant neoplasm of body of stomach—190.18
C16.5 - Malignant neoplasm of lesser curvature of stomach, unspecified—190.18
C16.6 - Malignant neoplasm of greater curvature of stomach, unspecified—190.18

Additional ICD10
ICD CODE AND DESCRIPTIONLCD CODENCD CODE
A51.45 - Secondary syphilitic hepatitis—190.18
B00.81 - Herpesviral hepatitis—190.18
B17.0 - Acute delta-(super) infection of hepatitis B carrier—190.18
B17.1 - Acute hepatitis C—190.18
B17.10 - Acute hepatitis C without hepatic coma—190.18
B17.11 - Acute hepatitis C with hepatic coma—190.18
B17.2 - Acute hepatitis E—190.18
B17.8 - Other specified acute viral hepatitis—190.18
B17.9 - Acute viral hepatitis, unspecified—190.18
B18.0 - Chronic viral hepatitis B with delta-agent—190.18
B18.1 - Chronic viral hepatitis B without delta-agent—190.18
B18.2 - Chronic viral hepatitis C—190.18
B18.8 - Other chronic viral hepatitis—190.18
B18.9 - Chronic viral hepatitis, unspecified—190.18
B19.0 - Unspecified viral hepatitis with hepatic coma—190.18
B19.1 - Unspecified viral hepatitis B—190.18
B19.10 - Unspecified viral hepatitis B without hepatic coma—190.18
B19.11 - Unspecified viral hepatitis B with hepatic coma—190.18
B19.2 - Unspecified viral hepatitis C—190.18
B19.20 - Unspecified viral hepatitis C without hepatic coma—190.18
B19.21 - Unspecified viral hepatitis C with hepatic coma—190.18
B19.9 - Unspecified viral hepatitis without hepatic coma—190.18
B25.1 - Cytomegaloviral hepatitis—190.18
B26.81 - Mumps hepatitis—190.18
B58.1 - Toxoplasma hepatitis—190.18
B94.2 - Sequelae of viral hepatitis—190.18
C00.0 - Malignant neoplasm of external upper lip—190.18
C00.1 - Malignant neoplasm of external lower lip—190.18
C00.2 - Malignant neoplasm of external lip, unspecified—190.18
C00.3 - Malignant neoplasm of upper lip, inner aspect—190.18
C00.4 - Malignant neoplasm of lower lip, inner aspect—190.18
C00.5 - Malignant neoplasm of lip, unspecified, inner aspect—190.18
C00.6 - Malignant neoplasm of commissure of lip, unspecified—190.18
C00.8 - Malignant neoplasm of overlapping sites of lip—190.18
C00.9 - Malignant neoplasm of lip, unspecified—190.18
C02.0 - Malignant neoplasm of dorsal surface of tongue—190.18
C02.1 - Malignant neoplasm of border of tongue—190.18
C02.2 - Malignant neoplasm of ventral surface of tongue—190.18
C02.3 - Malignant neoplasm of anterior two-thirds of tongue, part unspecified—190.18
C02.4 - Malignant neoplasm of lingual tonsil—190.18
C02.8 - Malignant neoplasm of overlapping sites of tongue—190.18
C02.9 - Malignant neoplasm of tongue, unspecified—190.18
C03.0 - Malignant neoplasm of upper gum—190.18
C03.1 - Malignant neoplasm of lower gum—190.18
C03.9 - Malignant neoplasm of gum, unspecified—190.18
C05.0 - Malignant neoplasm of hard palate—190.18
C05.1 - Malignant neoplasm of soft palate—190.18
C05.2 - Malignant neoplasm of uvula—190.18
C05.8 - Malignant neoplasm of overlapping sites of palate—190.18
C05.9 - Malignant neoplasm of palate, unspecified—190.18

References