Test

Normal Values

Abnormal Increase

Vitamin B12 Measurement of

160 950 pg/mL
(as a general
Vitamin B12 in
guideline)
blood
May help identify a
cause of
megaloblastic
anemia
Used to evaluate
malnourished
patients
Function:
Conversion of
inactive folate to
active form;
gastric acid
detaches B12
from binding
proteins;
absorbed in small
intestine aided by
Intrinsic Factor
(IF)

-Leukemia
-Polycythemia vera
-Severe liver
disease
-Myeloproliferative
disease
-Supplementation

Intrinsic
Factor (IF)
Antibody

Indications

**Can contribute to
neutropenia and
thrombocytopenia
Negative
Used to diagnose
pernicious
anemia
Function:
Necessary for
Vitamin B12
absorption in

-Pernicious anemia

Abnormal
Decrease
-Pernicious
anemia
-Peripheral
neuropathy
-Malabsorption
syndrome
-Atrophic
gastritis
-Pregnancy
-Alcoholism

Interfering
Factors
-EtOH (alcohol)
-Aspirin
-Aminoglycoside
antibiotics
-Anticonvulsants
-Colchicine
-Oral
contraceptives

N/A

-Injection of
Vitamin B12
within 48 hrs

small intestine
Test

Indications

Normal Values

Abnormal Increase

Anti-Parietal Used to diagnose

Negative
Cell
autoimmune
Antibody
cause of
pernicious
anemia
Function: Located
in proximal
stomach, produce
HCl and IF

-Pernicious anemia
-Atrophic gastritis
-Insulin-dependent
diabetes mellitus
(IDDM)
-Thyroiditis
-Myxedema
-Addison disease
-Iron-deficiency
anemia
-Juvenile diabetes

Serum
Used to diagnose
Folate (Folic
megaloblastic
Acid)
anemia
Used for
evaluation of
malnutrition,
especially in
alcoholics
Function: normal
function of RBCs
and WBCs,
synthesis of
certain purines
and pyrimidines
(precursors of
DNA) as well as
amino acids, fetal
development

-Vegetarianism

5 25 ng/mL

Abnormal
Decrease
N/A

Interfering
Factors
N/A

-Megaloblastic
anemia
-Hemolytic
anemia
-Pregnancy
-Malnutrition
-Liver disease
-Sprue
-Celiac disease
-Chronic kidney
disease (CKD)
-Some antiseizure meds,
anti-malarials,
EtOH,
methotrexate

-Folate-deficient
patient who has
received a blood
transfusion
-Radionuclide
administration
should be
avoided for at
least 24 hrs

Test

Indications

Total Serum Measurement of

Iron (Fe)
the quantity of Fe
(circulating
bound to
iron)
transferrin
Evaluate iron
deficiency
Evaluate iron
overload
Evaluate iron
poisoning
Monitor iron
replacement
therapy

Total Iron
Binding
Capacity
(TIBC)

Normal Values

Abnormal Increase

Male: 80 180
mcg/dL
Female: 60
160 mcg/dL

-Iron overload
(hemochromatosis
or hemosiderosis);
causes deposits in
brain, liver and
heart
dysfunction
-Iron poisoning
-Hemolytic anemia
-Massive blood
transfusions
-Hepatitis or
hepatic necrosis
-Lead toxicity

Measurement of all 250 460

proteins available mcg/dL
for binding
mobile iron
Indirect yet
accurate
measure of
transferrin
More a reflection
of liver function

-Iron deficiency
anemia (more
availability for iron
binding = lack of
iron present)
-Colon cancer
-Pregnancy (late)
-Polycythemia vera
-Estrogen therapy

Abnormal
Decrease
-Iron-deficiency
anemia
(insufficient
intake,
inadequate
absorption,
increased
requirements,
blood loss)
-Chronic blood
loss
-Inadequate
intestinal
absorption of
iron
-Pregnancy (late)
-Neoplasia
Hypoproteinemia
-Malnutrition
-Inflammatory
diseases
-Cirrhosis
-Hemolytic
anemia
-Pernicious
anemia

Interfering
Factors
-Recent blood
transfusion
-Recent
ingestion of high
iron content
meal

-Fluorides and
oral
contraceptives
(increased
levels)
-ACTH (adrenocorticotropic
hormone) and
chloramphenicol
(decreased

and nutrition
than of iron
metabolism

Test

Indications

Normal Values

Abnormal Increase

Transferrin

Helps establish
cause of
abnormal Fe &
TIBC

Male: 215 365

mg/dL
Female: 250
380 mg/dL

-Iron deficiency
anemia (more
availability for iron
binding = lack of
iron present)
-Colon cancer
-Pregnancy (late)
-Polycythemia vera
-Estrogen therapy

Transferrin
Saturation

Evaluate iron
deficiency
Evaluate iron
overload
Evaluate iron
poisoning
Monitor iron
replacement
therapy

Male: 20 50%
Female: 15
50%

-Hemochromatosis
-Hemosiderosis
-Increased iron
intake
-Hemolytic
anemias

**To calculate:
Transferrin sat
(%) = (serum
iron level x
100%)/TIBC

-Sickle cell
anemia

levels)

Abnormal
Decrease
-Iron overload
-Malnutrition
-Inflammatory
diseases
-Cirrhosis
-Hemolytic
anemia
-Sideroblastic
anemia
-Megaloblastic
anemia
-Malignancy
-Iron-deficiency
anemia
-Chronic illnesses
(i.e. malignancy)

Interfering
Factors
N/A

N/A

Ferritin
Most sensitive test
(stored iron
to determine iron
over time)
deficiency
anemia
The major ironstorage protein
directly related to
serum iron levels
30% of Fe stored
in the form of
ferritin/hemosider
in

Male: 12 300
ng/mL
Female: 10
150 ng/mL
Critical Value:
Level below 10
mg/mL is
diagnostic of Fe
deficiency

-Hemochromatosis
-Hemosiderosis
-Fe poisoning
-Megaloblastic and
hemolytic anemias
-Alcoholic
hepatobiliary
disease, chronic
hepatitis, cirrhosis
-Inflammatory
disease
-Advanced cancers
-Chronic illness
leukemias,
collagen vascular

-Iron deficiency
anemia
-Severe protein
deficiency
-Hemodialysis

-Recent
transfusions
-Recent
ingestion of a
high iron
concentration
meal
-Recent
administration
of a
radionucleide