Iron is an essential trace element, located within each cell, the bulk of which is found in the erythrocytes. It is absorbed mainly in the duodenum. If the organism does not need iron, it is stored in the form of ferritin. The concentration of plasma and serum ferritin is proportional to the size of body iron stores in healthy individuals and those with early iron deficiency. When the serum ferritin concentration falls below 12 μg/L, the iron stores are totally depleted. An increased total iron-binding capacity (> 400 μg/dL) is therefore indicative of storage iron depletion. It is less precise than the serum ferritin concentration. During iron deficiency the participation of iron in heme formation is reduced, which leads to a gradual accumulation of protoporphyrin. The serum transferrin receptor (sTfR) is a more sensitive indicator of iron deficiency. The elevated sTfR is the first laboratory criterion of iron deficiency after the depletion of the iron stores in the organism and its increase continues in direct proportion to the severity of the iron deficiency. Each evaluation of the iron status should include the Hb concentration, since it is indicative of a more advanced stage of iron deficiency.
Akesson A, Bjellerup P, Berglund M, Bremme K, Vahter M. Serum transferrin receptor: A specific marker of iron deficiency in pregnancy. Am J Clin Nutr. 1998;68:1241-1246.
Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr. 2001;131:568S-579S; discussion 580S.
Borel MJ, Smith SH, Brigham DE et al. The impact of varying degrees of iron nutriture on several functional consequences of iron deficiency in rats. J Nutr. 1991;121:729-736.
Bothwell TH, Charlton RW, Cook JD, Finch CA. 1979. Iron Metabolism in Man. Oxford: Blackwell Scientific.
Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006;10(5):377-85.
Braun J. Erythrocyte zinc protoporphyrin. Kidney Int Suppl. 1999;69:S57-S60.
Chalevelakis G, Tsiroyannis K, Hatziioannou J, Arapakis G. Screening for thalassaemia and/or iron deficiency: Evaluation of some discrimination functions. Scan J Clin Lab Invest. 1984;44:1-6.
Charlton RW, Bothwell TH. Iron absorption. Annu Rev Med. 1983;34:55-68.
Chen OS, Schalinske KL, Eisenstein RS. Dietary iron intake modulates the activity of iron regulatory proteins and the abundance of ferritin and mitochondrial aconitase in rat liver. J Nutr. 1997;127:238-248.
Cook JD, Baynes RD, Skikne BS. Iron deficiency and the measurement of iron status. Nutr Res Rev. 1992;5:189-202.
Cook J. The nutritional assessment of iron status. Arch Latinoam Nutr. 1999;49:11S-14S.
Dietary reference intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. A Report of the Panel on Micronutrients. Institute of Medicine. National academy press. Washington, D.C. 2001.
Ekiz C, Agaoglu L, Karakas Z et al. The effect of iron deficiency anemia on the function of the immune system. The Hematol J. 2005;5:579-583.
Ferguson BJ, Skikne BS, Simpson KM, Baynes RD, Cook JD. Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia. J Lab Clin Med. 1992;119:385-390.
Finch CA, Huebers H. Perspectives in iron metabolism. N Engl J Med. 1982;306:1520-1528.
Finch C. Regulators of iron balance in humans. Blood. 1994;84:1697-1702.
Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr. 2001;131:649S-666S; discussion 666S-668S.
Hallberg L, Sandström B, Aggett PJ. Iron, zinc and other trace elements. In: Garow JS, James WPT (eds) Human nutrition and dietetics. Edinburgh: Churchill Livingstone. 1993; pp. 174-207.
Hallberg L. Perspectives on nutritional iron deficiency. Annu Rev Nutr. 2001;21:1-21.
Hambidge M. Biomarkers of Nutritional Exposure and Nutritional Status. Biomarkers of Trace Mineral Intake and Status. J Nutr. 2003;133:948S-955S.
Hurrell R. Iron. In: Hurrell R (eds).The mineral fortification of foods. Surrey: Leatherhead Food RA. 1999;pp. 54-93.
INAG (International Nutritional Anemia Consultive Group). Safety of iron supplementation programs in malaria-endemic regions. Washington, DC: ILSI press. 2000.
Konijn AM. Iron metabolism in inflammation. Baillieres Clin Haematol. 1994;7:829-849.
Martinez-Torres C, Cubeddu L, Dillmann E et al. Effect of exposure to low temperature on normal and iron-deficient subjects. Am J Physiol.1984;246:R380-383.
Medeiros DM, Beard JL. Dietary iron deficiency results in cardiac eccentric hypertrophy in rats. P Soc Exp Biol Med. 1998;218:370-375.
Morse A, Beard JL, Jones B. Behavioral and neurochemical alterations in iron deficient mice. Proc Soc Exp Biol Med. 1999;220:147-152.
Pinero D, Jones B, Beard J. Variations in dietary iron alter behavior in developing rats. J Nutr. 2001;131:311-318.
Ravel R. 1989. Clinical Laboratory Medicine: Clinical Application of Laboratory Data. Chicago: Year Book Medical Publishers.
Schellenberg D, Menendez C, Kahigwa E et al. Intermittent treatment for malaria and anaemia control at time of routine vaccinations in Tanzanian infants: a randomised, placebo-controlled trial. Lancet. 2001;357:1471-1477.
Serap S, Derbent A, Uysal S, Turhan N. Hepcidin, iron status, and inflammation variables among healthy pregnant women in the Turkish population. The Journal of Maternal-Fetal & Neonatal Medicine. 2013. doi: 10.3109/14767058.2013.804054.
Smith SM, Smith SH, Beard JL. Heart norepinephrine content in iron deficiency anemia. P Soc Exp Biol Med. 1990;193:306-312.
Staubli Asobayire F, Adou P, Davidsson L et al. Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Côte d'Ivoire. Am J Clin Nutr. 2001;74:776-782.
Valberg LS. Plasma ferritin concentration: Their clinical significance and relevance to patient care. Can Med Assoc. 1980;122:1240-1248.
WHO/UNICEF/United Nations University. Iron deficiency anemia: Assessment, prevention, and control. WHO, Geneva, 2001. WHO/NHD/01.3.
Email this article (Login required) 
