Lzhss increased what does it mean. Total iron-binding capacity of serum (tbc), blood

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Lzhss increased what does it mean

Latent (unsaturated) iron-binding capacity of serum (LZhSS, NZhSS, UIBC) is an indicator used to detect iron deficiency in the body. The main indications for the appointment: differential diagnosis of anemia, liver disease (acute hepatitis, cirrhosis), nephritis, evaluation of treatment with iron preparations, various chronic diseases, pathology of the gastrointestinal tract and associated iron absorption.

Normally, transferrin is saturated with iron by approximately 30%, and the extra amount of iron that can bind to transferrin is called the latent (unsaturated) serum iron-binding capacity. LZhSS or NZhSS - represents the difference between the total iron-binding capacity (OZHSS) and the actual saturation of transferrin. This is expressed by the formula: LZhSS (NZhSS) \u003d OZHSS - Serum iron.

Total iron-binding capacity of serum (OJSS, Total Iron Binding Capacity, TIBC) - the maximum amount of iron that transferrin can attach to full saturation. It is set as the sum of indicators - Serum iron + latent (unsaturated) iron-binding capacity of serum (LZhSS, NZhSS - from the English Unsaturated Iron Binding Capacity, UIBC). Due to the exact molar ratio of iron binding by transferrin, the determination of TIBC can be replaced by a direct quantitative measurement of transferrin.

OZhSS - reflects the content of the transferrin protein in the serum (see "Transferrin (Siderophilin)", which carries iron in the blood.

Under physiological conditions, transferrin is saturated with iron by about 30% of the maximum capacity for saturation. The LVVR reflects the amount of iron that transferrin can attach to achieve maximum saturation. The determination of this iron is carried out after transferrin saturation with the addition of excess iron (ferric chloride is added). The unbound iron is removed, and the transferrin-bound iron is treated with acetic acid, after which the iron is released. This iron is reduced with hydroxylamine and thioglycolate. Next is the calculation of reduced iron. It is possible to determine unbound iron ions by reaction with ferene. The difference between the amount of excess iron ions (not bound to iron-binding sites) and the total amount of iron ions added to the serum is equal to the amount of iron ions bound to transferrin, which is expressed as the LVVR of the blood serum.

An increase in FBC is observed in iron deficiency anemia, in contrast to other types of hypochromic anemia. Such an increase in the content of transferrin in iron deficiency anemia is associated with an increase in its synthesis, which is a compensatory reaction in response to tissue iron deficiency.

LZhSS (latent iron-binding ability of blood serum)

What is the latent (unsaturated) iron-binding capacity of blood serum (LZhSS, NZhSS, Unsaturated Iron Binding Capacity, UIBC)?

Iron-binding capacity of blood serum is an indicator that characterizes the ability of blood serum to bind iron. Iron in the human body is in combination with a protein - transferrin. The iron-binding capacity of blood serum shows the concentration of transferrin in the blood serum and changes when there is a violation of the metabolism, breakdown and transport of iron in the body. To diagnose anemia, the determination of the latent iron-binding capacity of blood serum (LJCC) is used - this is the iron-binding capacity of blood serum without serum iron.

Indications for the purpose of the analysis:

• control of a diet with iron deficiency (lactic-vegetarian);
• pathology of the gastrointestinal tract, threatening the development of anemia;
• loss of iron (blood loss);
• systemic connective tissue diseases, severe chronic diseases.

When is the LVVR increased?

• Latent iron deficiency.
• Acute hepatitis.
• Late pregnancy.

When is the level of LVSS lowered?

• chronic infections.
• Thalassemia.
• Cirrhosis.
• Iron refractory anemia.
• Hematochromatosis.

The procedure for taking biomaterial is paid separately and depends on the type of material:

Serum latent iron-binding capacity

Serum latent iron-binding capacity is a laboratory indicator that reflects the potential ability of blood serum to bind additional iron.

Unsaturated iron-binding capacity of serum, NZhSS, LZhSS.

Iron indices, iron profile, unsaturated iron binding capacity, UIBC.

Colorimetric photometric method.

µmol/l (micromoles per liter).

What biomaterial can be used for research?

How to properly prepare for research?

• Do not eat for 8 hours before the analysis, you can drink pure non-carbonated water.
• Stop taking medications containing iron 72 hours before the test.
• Eliminate physical and emotional overstrain and do not smoke for 30 minutes before donating blood.

General information about the study

Iron is an important trace element in the body. It is part of the hemoglobin that fills red blood cells and allows them to carry oxygen from the lungs to organs and tissues.

Iron is part of the muscle protein myoglobin and some enzymes. It is absorbed from food and then carried by transferrin, a special protein that is formed in the liver.

Usually the body contains 4-5 g of iron, about 3-4 mg (0.1% of the total amount) circulates in the blood “in conjunction” with transferrin. The level of transferrin depends on the functioning of the liver and on the nutrition of the person. Normally, 1/3 of the binding centers of transferrin are filled with iron, the remaining 2/3 remain in reserve. The latent serum iron-binding capacity (LBI) reflects how much transferrin is "not filled" with iron.

This parameter can be calculated according to the following formula: LZhSS = TIBC - serum iron (TIBV is the total iron-binding capacity of blood serum - an indicator that characterizes the maximum ability of transferrin to “fill up” with iron).

In iron deficiency, transferrin becomes larger so that this protein can bind to the small amount of iron in the serum. Accordingly, the amount of transferrin “not occupied” by iron, that is, the latent iron-binding ability of serum, also increases.

Conversely, with an excess of iron, almost all the binding centers of transferrin are occupied by this microelement, so the latent iron-binding capacity of the serum decreases.

The amount of serum iron can vary significantly on different days and even within one day (especially in the morning hours), however, TIBC and LVVR normally remain relatively stable.

In the early stages, iron deficiency sometimes does not show any symptoms. If a person is otherwise healthy, then the disease can only make itself felt when hemoglobin drops below 100 g / l. Usually these are complaints of weakness, fatigue, dizziness, headaches.

What is research used for?

To determine the amount of iron in the body and its relationship with blood proteins (together with an analysis of serum iron, sometimes with a test for FBC and transferrin). These studies allow you to calculate the percentage of saturation of transferrin with iron, that is, to determine exactly how much iron the blood carries. This indicator most accurately characterizes the exchange of iron.

The purpose of these tests is to diagnose iron deficiency or excess. In patients with anemia, they can determine whether the disease is due to iron deficiency or other causes, such as chronic disease or vitamin B 12 deficiency.

When is the study scheduled?

• When any abnormalities are detected in the general blood test, hemoglobin, hematocrit, red blood cell count (along with a serum iron test).
• If you suspect a deficiency or excess of iron in the body. With a severe lack of iron, there is shortness of breath, pain in the chest and head, weakness in the legs. Some have a desire to eat unusual foods (chalk, clay), burning of the tip of the tongue, cracks in the corners of the mouth. Children may have learning difficulties.
• If you suspect an overload of the body with iron (hemochromatosis). This condition manifests itself in many ways, such as pain in the joints or in the abdomen, weakness, fatigue, decreased sex drive, and heart rhythm disturbances.
• When monitoring the effectiveness of the treatment of iron deficiency or excess.

Reference values: µmol/l.

The interpretation of the results of the analysis for LZhSS, as a rule, is made taking into account other indicators that evaluate iron metabolism.

Reasons for the increase in OVSS

• Anemia. It is usually caused by chronic blood loss or insufficient consumption of meat products.
• Third trimester of pregnancy. In this case, the level of iron in the serum decreases due to an increase in the need for it.
• Acute hepatitis.
• Multiple blood transfusions, intramuscular iron administration, inadequate administration of iron preparations.

Reasons for lowering the OZhSS

• Chronic diseases: systemic lupus erythematosus, rheumatoid arthritis, tuberculosis, bacterial endocarditis, Crohn's disease, etc.
• Hypoproteinemia associated with malabsorption, chronic liver disease, burns. A decrease in the amount of protein in the body leads, among other things, to a drop in the level of transferrin, which reduces TIBC.
• hereditary hemochromatosis. With this disease, too much iron is absorbed from food, the excess of which is deposited in various organs, causing their damage.
• Thalassemia is a hereditary disease in which the structure of hemoglobin is changed.
• Cirrhosis of the liver.
• Glomerulonephritis is inflammation of the kidneys.

What can influence the result?

• Estrogens, oral contraceptives lead to an increase in LVSS.
• ACTH, corticosteroids, testosterone can reduce VVR.
• Serum hemolysis makes the results unreliable.

• The amount of serum iron can vary significantly from day to day and even within one day (especially in the morning hours), however, LVVR and TIBC normally remain relatively stable.
• The total serum iron-binding capacity (TIBC) is calculated as the sum of the LVBC and the serum iron.
• With a lack of iron, its level drops, but the LZhSS rises.

Who orders the study?

General practitioner, internist, hematologist, gastroenterologist, rheumatologist, nephrologist, surgeon.

Total iron-binding capacity of serum (OZHSS) and latent (LZhSS): concept, norms, increase and decrease

Iron (ferrum, Fe) is one of the most important elements for the body. Almost all the iron that comes with food binds to proteins and subsequently enters into their composition. Everyone knows such an iron-containing protein as hemoglobin, which consists of a non-protein part - heme and globin protein. But in the body there are proteins that contain iron, but do not have a heme group, for example, ferritin, which provides a reserve of the element, or transferrin, which transfers it to its destination. An indicator of the functionality of the latter is total transferrin or total iron-binding capacity of serum (TIBC, TIBC) - this analysis will be discussed in this paper.

Transport protein (transferrin - TF, Tf) in the body of healthy people cannot "ride empty", that is, iron saturation should not be less than 25 - 30%.

The norm of OZHSS is 40.6 - 62.5 µmol / l. The reader can find more detailed information regarding normal values ​​in the table below, however, as always, it should be borne in mind that the norms in different sources and in different laboratories may differ.

Carries as much as it can take

Usually (if everything in the body is normal) approximately 35% of the transport protein is associated with Fe. This means that this protein takes for transfer and subsequently transports 30-40% of the total amount of the element, which corresponds to the same percentage (up to 40%) of the transferrin binding capacity (serum iron-binding capacity - WBC).

In other words: TIBC (total serum iron-binding capacity) in the laboratory is an analysis that indicates not the concentration of a transport protein, but the amount of iron that can “load” on transferrin and go to the bone marrow for erythropoiesis (formation of red blood cells) or to places where the stock of the item is stored. Or it can (also, being associated with tronferrin) go in the opposite direction: from the "stores" or from the sites of decay (phagocytic macrophages).

In general, iron moves around the body and gets where it needs to be thanks to the protein transferrin, which is a kind of vehicle for this element.

You need to leave something for others...

At the same time, transferrin cannot take on all the iron in the body (normally - from 30 to 40% of its maximum capacity), and if the transport protein is saturated by more than 50%, then the rest of the Fe contained in the serum it leaves other proteins (albumin, for example). In this case, it is clear that, having been saturated with the element by about a third, transferrin still left a lot of free space (60 - 70%). These untapped "vehicle" capabilities are referred to as the unsaturated or latent serum iron-binding capacity, or simply LVCC. This laboratory indicator can be easily calculated by the formula:

LZhSS is ≈ 2/3 (or about 70%) of the total capacity of the OZhSS. Average values ​​of the norm of latent iron-binding capacity of serum ≈ 50.2 mmol/L.

Based on the results obtained in the determination of iron in the blood serum and the total iron-binding capacity of the serum, it is possible to find the values ​​of CST - the coefficient of saturation of transferrin with iron (percentage of Fe in the TIBC):

The norm of the saturation coefficient in percentage terms is from 16 to 47 (the average value of the norm is 31.5).

To help the reader quickly understand the values ​​of some indicators that reflect the exchange of such an important chemical element for the body, it would be advisable to place them in the table:

It should be noted that WHO recommends slightly different (more extended) limits of normal values, for example: FBC - from 50 to 84 µmol / l, LZhSS - from 46 to 54 µmol / l, CNT - from 16 to 50%. However, the reader's attention was already focused on these issues at the beginning of this article.

Changes in the OZhSS under different circumstances

Since this work is devoted to the general iron-binding capacity of serum, it is necessary first of all to designate the states when the level of the described indicator is increased, and when it is lowered.

So, the values ​​of OZHSS are increased in cases of the following conditions (they will not necessarily be associated with some kind of pathology):

1. Hypochromic anemia;
2. During pregnancy - the longer the period, the more elevated the rate (see table);
3. Chronic blood loss (hemorrhoids, heavy periods);
4. Inflammatory process localized in the liver (hepatitis) or irreversible replacement of the hepatic parenchyma with connective tissue (cirrhosis);
5. Erythremia (true polycythemia - Wakez's disease);
6. Lack of a chemical element (Fe) in the diet or in violation of its absorption;
7. Taking (long-term) oral contraceptives;
8. Excessive intake of iron in the body;
9. Ferrotherapy (iron treatment) for a long time;
10. When blood transfusions cease to be a rarity (hematological pathology).

Also, the total iron-binding power of blood serum may normally have higher values ​​in children than in adults.

Meanwhile, there are a lot of diseases, when the FIA ​​shows an inclination to decline (the FSC indicator is lowered). These include:

1. Diseases that are called anemia, adding to them the definition: hemolytic, sickle cell, pernicious;
2. Hemochromatosis (a multisystem hereditary pathology called bronze diabetes, which is characterized by high absorption of Fe in the gastrointestinal tract and the subsequent spread of the element through tissues and organs);
3. Thalassemia;

Low/high level of Fe → values ​​of other indicators (OJSS, TF, CST)

A low level of the element (Fe) in the blood, as a rule, implies low values ​​of the total iron-binding power of the serum (including latent IBC). A similar blood picture develops in a number of pathological conditions that are accompanied by a lack of iron:

• Anemia (for differential diagnosis and clarification of the form of the disease, it is useful to conduct an analysis that calculates the level of ferritin in the blood);
• Chronic pathological processes in which iron levels are often low (malignant neoplasms, inflammatory reactions, infections).

stages of development of iron deficiency states

By the way, such an analysis as the iron-binding ability of serum can be easily replaced by a study of the concentration of the transporter Fe - transferrin (Tf) in blood plasma (serum), although more often the opposite happens, since the laboratory may not have reagent kits and equipment for this test.

The Tf norm for men is 23 - 43 µmol / l (2.0 - 3.8 g / l), for women, given their special relationship with iron, the normal values ​​of the transport protein somewhat expand their boundaries: 21 - 46 µmol / l (1. 85 - 4.05 g/l). Then, when interpreting the results of the analysis, one should take into account the change in transferrin in a particular pathology (see transferrin), for example, with an iron deficiency in the body, the level of its transporter will be increased.

If the level of iron in the body is high, then an increase in CST can also be expected (does this chemical element need to be determined somewhere?). The rate of saturation with ferrum of the protein carrying it is also increased in other diseases:

• Pathological conditions, among the laboratory signs of which there is an increased breakdown of red blood cells - erythrocytes (hemolysis);
• Hemoglobinopathies (Cooley's disease - thalassemia);
• Hemochromatosis (a hereditary disorder of iron metabolism, as a result of which Fe begins to actively accumulate in tissues, causing vivid clinical symptoms, where hyperpigmentation of the skin is among the very noticeable signs);
• Lack of vitamin B6;
• Iron poisoning (use of preparations containing Fe);
• nephrotic syndrome;
• In some cases, with the localization of the inflammatory process in the liver parenchyma (hepatitis).

In conclusion, once again I would like to remind you of the physiological deviations of the indicators of the FBC and iron:

During pregnancy (normally flowing), the values ​​​​of the FBC can increase by 1.5 - 2 times (and this is not scary), while iron during this period of time will tend to decrease.

In children who have just informed the world about their appearance (healthy), the total serum power gives low values, which then gradually begin to rise and approach the level of an adult. But the concentration of Fe in the blood immediately after birth shows quite high numbers, however, soon everything changes.

Latent iron-binding capacity of blood serum

Latent (unsaturated) iron-binding capacity of blood serum (LZhSS) reflects the ability of blood serum to bind iron.

All iron in the human body can be divided into extracellular, cellular and iron reserves. Extracellular is free iron in the blood serum and iron-binding proteins (transferrin), cellular is part of hemoglobin, myoglobin, enzymes (peroxidase, catalase, cytochromes), and iron reserves are hemosiderin and ferritin, which accumulate in the liver, spleen.

Transferrin, which carries iron, has two spaces for iron binding in one molecule, that is, one carrier protein molecule can simultaneously carry two iron ions. However, in the normal state, transferrin is "filled" with iron by only 30%. Serum latent iron-binding capacity:

• reflects the reserve capacity of transferrin,
• shows how much transferrin is free to bind iron,
• characterizes how transferrin is “not saturated” with iron.

The indicator is calculated on the basis of two parameters: serum iron and total iron-binding capacity of blood serum (TIBC), which characterizes the maximum possible filling of transferrin with iron. Calculation formula:

LZhSS \u003d TIHSS - serum iron.

The iron-binding capacity of serum varies depending on the iron content in the body. In iron deficiency anemia, when iron levels decrease, transferrin levels increase. "Unoccupied" iron transferrin - this is the LVSS, therefore, LVVR and OTVR increase.

With an excess intake of iron in the body, both metal-binding spaces in transferrin are filled with iron, it cannot attach even more iron ions, therefore, the LVC decreases.

Low levels of serum iron and low LVVR are characteristic of anemia that has arisen against the background of malignant tumors, against the background of chronic diseases.

Indications for analysis

Diagnosis of iron deficiency anemia.

Diet low in iron.

Assessment of the risk of anemia in diseases of the gastrointestinal tract.

Systemic connective tissue diseases.

Study preparation

One week before the analysis, stop taking iron supplements.

From the last meal to blood sampling, the time interval should be more than eight hours.

The day before, exclude fatty foods from the diet, do not take alcoholic beverages.

Do not smoke for 1 hour before taking blood for analysis.

Blood for research is taken in the morning on an empty stomach, even tea or coffee is excluded.

Let's drink plain water.

Research material

Interpretation of results

• Iron-deficiency anemia.
• Insufficient intake of iron from food.
• Violation of iron absorption in the intestine.
• Pregnancy (third trimester).
• Acute hepatitis.

• Hemochromatosis.
• Thalassemia.
• Increased destruction of red blood cells (hemolytic anemia).
• Chronic liver diseases.
• Decreased plasma protein content (renal failure, liver disease).
• Malignant tumors.
• Uncontrolled intake of iron preparations (drug overdose).

Select the symptoms that bother you, answer the questions. Find out how serious your problem is and whether you need to see a doctor.

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LVBC (serum iron-binding capacity)

LZhSS (latent iron-binding capacity of blood serum)

• Hypochromic (iron deficiency) anemia.
• Latent iron deficiency.
• Acute hepatitis.
• Late pregnancy.

When is the level of LVSS lowered?

• Decreased plasma protein content (nephrosis, starvation, tumors).
• chronic infections.
• Thalassemia.
• Cirrhosis.
• Iron refractory anemia.
• Hematochromatosis.

For advice, you can contact by phone.

Iron

Iron - the most important trace element involved in respiration, hematopoiesis, immunobiological and redox reactions, is part of more than 100 enzymes and is an indispensable component of hemoglobin and myohemoglobin.

The body of an adult contains about 4 g, of which about 2.5 g is hemoglobin iron. The main part of the iron is in the protein-bound form, and the other part of the iron is deposited in the liver, spleen, and bone marrow. Binding can be functionally active, as occurs in the case of hemoglobin and iron-containing enzymes (cytochromes and catalase), or in the form of inactive transport forms. Serum iron is in a bound state, as it forms complexes with β-1-globulins and transferrin. The small remaining part of the cation is bound by electrostatic forces of interaction with amino acids.

daily requirement human in iron is 10-30 mg, given that the absorption of iron from food is about 10%.

Iron is absorbed from food into the intestines in the form of Fe 2+, and it is better from animal food than from vegetable food in the presence of ascorbic acid in an amount of 1 mg per day. In the intestinal mucosa, it combines with the protein apoferritin, turning it into ferritin, which carries iron into the blood plasma. The transport of iron in the form of Fe 3+ is carried out by the blood plasma protein transferrin. The liver is able to store about 700 mg of iron mainly in the form of ferritin and a small amount of hemosiderin. Transferrin transfers iron to tissues, where it is used in the synthesis of iron-containing proteins (hemoglobin, myoglobin, catalase, cytochromes, iron-sulfur proteins, peroxidase). Thus, the concentration of iron in serum depends on resorption in the gastrointestinal tract, accumulation in the intestine, spleen and bone marrow, on the synthesis and breakdown of hemoglobin and its loss by the body.

Average iron values ​​are lower in women than in men by about 10 mg/dL, but both have iron values ​​that decrease with age. The concentration of iron has a daily rhythm, and in women it is associated with the menstrual cycle. During pregnancy, the iron content in the body decreases, especially in the second half of pregnancy.

Table No. 1 "Distribution of iron in the human body"

Table No. 2 “Normal values ​​​​of the main parameters of iron metabolism in the human body"

Determination of the total and unsaturated capacity of blood serum

Transferrin is a metal-binding transport protein, is a β-1-globulin. Transferrin is synthesized in liver cells and in small amounts in lymphoid tissue, mammary gland, testicles and ovaries. It consists of one polypeptide chain and two lateral hydrocarbon sections. The normal serum concentration is approximately 2-4 g/l, which corresponds to approximately 4% of the total plasma protein. In addition to blood serum, under physiological conditions, transferrin is determined in the lymph and tissue fluid, and under pathological conditions, also in the urine and exudative fluid. Approximately half of transferrin is in the vascular bed, the second half is extravascular (outside the vessels). The serum half-life of transferrin is 8-10 days.

Transferrin functions: transport and prevent the accumulation of free toxic iron ions in the blood plasma (serum).

Normally, transferrin is saturated with iron by about 30% of the maximum saturation capacity. The additional amount of iron that can bind to transferrin is " saturated iron binding capacity» blood serum (NZhSS). The maximum amount of iron that transferrin can attach is denoted as « Total iron binding capacity » blood serum (OZhSS). It consists of a bound, iron-saturated part (which is indicated by the “serum iron” indicator) and the free, latent, or unsaturated iron-binding ability of serum.

The total (total) ability to bind iron is the sum of indicators reflecting the content of iron in serum and NZhSS:

serum iron concentration + NIBC = TIBC

The TIBC index gives an idea of ​​the level of transferrin in the serum (plasma) of the blood. The ratio of iron bound in transferrin (serum iron) to total iron-binding capacity (TIBC) is called coefficient (percentage) of saturation of transferrin with iron (K, or PSVT).

K (%) \u003d serum iron / TIBC x 100

Fine :

• Concentration of OVSS (total iron-binding capacity) in blood serum45 - 72 µmol/l
• Unsaturated iron-binding capacity of blood serum
• (NJSS) 26.9 - 41.2 µmol/l
• The iron saturation coefficient of transferrin is about 30% (20 - 55%).

The value of the determination of serum ferritin.

Iron reserves in the body are concentrated in the depositing organs, where it accumulates in the form of the iron-containing protein ferritin, as well as in the composition of hemosiderin. Ferritin is a versatile iron storage protein found in virtually all cells and tissues of the body.

The level of ferritin in the blood serum adequately and quite fully reflects the state of the reserve iron in the human body, since the content of serum ferritin is a reflection of the active secretion of ferritin from the liver cells.

Normally, the concentration of ferritin in the plasma (serum) of the blood is: in men - 15 - 200 mcg / l, in women - 12 - 150 mcg / l. If the level of ferritin found in plasma (serum) is less than 12 μg / l, this indicates an iron deficiency state.

The ferritin concentration of 1 μg/l corresponds to the content of 8 mg of reserve (reserve) iron in the body.

Serum ferritin is an important diagnostic test for various diseases associated with impaired iron metabolism, iron deficiency conditions. However, in some forms of pathology, ferritin acts as an acute phase protein.

Clinical and diagnostic value of iron content in blood serum:

Increased serum iron concentration - hypersideremia:

• Excessive resorption of iron: excessive intravenous and intramuscular administration of iron preparations, frequent blood transfusions, acute poisoning with iron preparations; hereditary and acquired hematochromatosis (increased absorption and accumulation of iron in the body);
• hemolytic anemia;
• Hypoplastic and aplastic anemias;
• In 12 - and folic acid deficiency anemia;
• pernicious anemia;
• Increased hemolysis of erythrocytes;
• Liver diseases (viral hepatitis, acute hepatitis, acute liver necrosis);
• Chronic cholecystitis;
• Polycythemia (a disease accompanied by an increased content of red blood cells, white blood cells, platelets, hemoglobin);
• The use of hormonal contraceptives, estrogens.

Decreased serum iron concentration - hyposideremia:

• Acute infectious diseases;
• Liver cancer;
• Periods of active erythropoiesis (the initial phase of remission in pernicious anemia);
• Hemosiderosis of internal organs;
• uterine fibroids;
• Deficiency of vitamin C and B 2;
• iron deficiency anemia;
• Kidney disease (chronic renal failure);
• Insufficiency of iron content in food.

Iron in urine appears during treatment with iron preparations.

Clinical and diagnostic value of TIBC in blood serum:

TIBC is a measure of the serum concentration of transferrin, an iron transport protein. Under normal conditions, about 35% of transferrin is associated with iron.

Physiological changes in the OZhSS:

• Normal pregnancy (FIBC increases to 450 mcg / dl (80.55 mcmol / l), while the iron content decreases);
• Healthy children (TIBC decreases immediately after birth, then gradually rises to 400 mcg/dl (71.6 mcmol/l) in the second year of life).

Increasing the concentration of TIBC in serum:

• Increased serum iron concentration:

Liver damage (acute hepatitis, cirrhosis)

Excessive iron intake

Too long treatment with iron preparations

Pure blood transfusions

Hematochromatosis

• Decreased serum iron concentration:

Normal pregnancy

Acute and chronic blood loss

Sometimes with iron deficiency anemia

Decreased serum TIBC concentration:

• Acute and chronic infections;
• B 12 - and folic acid deficiency anemia (exacerbation), hemolytic anemia;
• Uremia;
• Diseases associated with neoplasms;
• nephrotic syndrome;
• Rheumatic inflammation of the joints

Clinical and diagnostic value of iron-binding proteins in blood serum:

Increased transferrin saturation noted with an excess of iron (iron poisoning, hemolytic diseases, thalassemia, hemochromatosis, pyridoxine deficiency, nephrosis, hepatitis).

Decreased transferrin saturation characteristic of iron deficiency, chronic infections, malignant neoplasms, late pregnancy.

Clinical and diagnostic value of ferritin:

Decreased serum ferrinite noted at:

• Iron deficiency states and diseases associated with impaired iron metabolism;
• Anemia accompanying pregnancy.

Increase in serum ferritin observed:

• Due to the redistribution of iron funds in: diseases associated with circulatory disorders (strokes, myocardial infarction); acute and chronic diseases associated with damage to the liver cells (hepatitis, cirrhosis of various etiologies, alcoholic liver damage); systemic lupus erythematosus, rheumatoid arthritis; oncological diseases (breast cancer, lymphogranulomatosis, acute myeloid and lymphoblastic leukemias).
• Due to inflammatory and necrobiotic processes: the level of ferritin as an acute phase protein increases with pulmonary infections, chronic urinary tract infections, osteomyelitis, burns.

Note:

• To obtain reliable results of the study, it should be borne in mind that taking preparations containing iron affects its concentration within 2-4 weeks after use. The patient should not take iron supplements for at least 5 days before taking blood for analysis. Otherwise, overestimated results may be obtained.
• The level of iron in serum has pronounced diurnal fluctuations: in the afternoon it is lower than in the morning by approximately 7 µmol/l.
• The determination should be performed in fresh, hemolysis-free blood serum. Serum should be separated immediately after the formation of a clot: in order to avoid the transfer of hemoglobin into it.
• The ware for the analysis of iron has to be absolutely pure. After normal washing, it is recommended to place the glass promise overnight in a 20g/l EDTA solution; then the dishes are thoroughly rinsed with bidistilled or deionized water and dried. It is also recommended to wash the glassware for determination in a 5 mol/l HCl solution, store it in a mol/l hydrochloric acid solution and rinse thoroughly with distilled water before use.