Transferrin: Effects

Transferrin is an iron transport protein in the blood that is one of the anti-acute phase proteins (see below). It transfers iron either to erythrocytes (red blood cells) as functional iron or to the reticuloendothelial system as storage iron. Transferrin saturation (TfS) can be calculated from transferrin and iron:

  • TfS (%) = ( iron in μg/dl / transferrin in mg/dl ) x 70.9
  • TfS (%) = ( iron in μmol/l / transferrin in mg/dl ) x 398

The procedure

Material needed

  • Blood serum

Preparation of the patient

  • Not necessary

Disruptive factors

  • Not known

Normal value transferrin – adult

Normal value in mg/dl
Turbidimetric 200-400
Nephelometric 212-360

Normal value transferrin – children

Age Normal value in mg/dl
<2 weeks 158-268
< 6 months 202-302
> 1 year 261-353
> 14 years 240-360

Normal value transferrin saturation – adult

Normal value in % 16-45

Normal value transferrin saturation – children

Age Normal value in %
Preterm infants 11,4-44,2
Matured 29,4-46,0
<5 years 7-44
6-9 years 17-42
10-14 years 11-36 (♀) 2-40 (♂)
14-19 years 6-33

Indications – Transferrin

  • Suspected iron deficiency
  • Suspicion of hemochromatosis

Indications – transferrin saturation (TSAT)

  • Functional iron deficiency
  • Suspected iron overload

Interpretation

Interpretation of elevated values – transferrin

Interpretation of decreased values – transferrin

  • Acute inflammation, unspecified (anti-acute phase protein = negative APP).
  • Protein loss syndromes
    • Enterally such as exudative enteropathy.
    • Renal such as nephrotic syndrome
  • Chronic inflammation, unspecified (infectious anemia).
  • Hemochromatosis (iron storage disease).
  • Hemoglobinopathy (diseases caused by disorders in the formation of hemoglobin (red blood pigment)), such as thalassemia.
  • Liver cirrhosis – connective tissue remodeling of the liver, which leads to functional impairment.
  • Neoplasms, unspecified (tumor anemia).

Interpretation of elevated values – transferrin saturation (= V. a. iron overload).

  • Primary (genetic) hemochromatosis (iron storage disease).
  • Secondary hemochromatosis due to:
    • Blood transfusions, clustered.
    • Chronic inflammation, unspecified; infectious anemia.
    • Hemolysis (dissolution of red blood cells);
    • Hemoglobinopathy (diseases caused by disorders in the formation of hemoglobin (red blood pigment)), e.g., thalassemia.
    • Neoplasms, unspecified (tumor anemia).
    • Lead poisoning
  • Hypersiderinemic anemia (including drug-induced anemia).
  • Megaloblastic anemia – form of anemia caused by a deficiency of vitamin B12 or folic acid.

Interpretation of decreased values – transferrin saturation.

  • Iron deficiency
  • Chronic infections, unspecified
  • Liver parenchymal damage
  • Neoplasia (neoplasms)
  • Uremia (occurrence of urinary substances in the blood above normal values).

Other indications

  • Transferrin reacts as an anti-acute phase protein (= negative APP). This means that a decreased transferrin value may be decreased due to inflammation and would otherwise be in the normal range. Therefore, transferrin should be assessed in parallel with C reactive protein (acute-phase protein).
  • Ferritin and transferrin concentration always behave oppositely, i.e. transferrin reacts only when the iron stores are already depleted.