Best test to detect iron deficiency in community

ABSTRACT Determination of iron status in pregnancy and in young children is essential for both clinical and public health practice. Clinical diagnosis of iron deficiency (ID) through sampling of bone marrow to identify the absence of body iron stores is impractical in most cases. Serum ferritin (SF) concentrations are the most commonly deployed indicator for determining ID, and low SF concentrations reflect a state of iron depletion. However, there is considerable variation in SF cutoffs recommended by different expert groups to diagnose ID. Moreover, the cutoffs used in different clinical laboratories are heterogeneous. There are few studies of diagnostic test accuracy to establish the sensitivity and specificity of SF compared with key gold standards (such as absent bone marrow iron stores, increased intestinal iron absorption, and hemoglobin response to SF) among noninflamed, outpatient populations. The limited data available suggest the commonly recommended SF cutoff of 30 y ago, do not reflect ethnic or geographic diversity, and were performed in an era for which laboratory methods no longer reflect present practice. Future studies to define the appropriate SF cutoffs are urgently needed and would also provide an opportunity to compare this indicator with other established and emerging iron indexes. In addition, future work would benefit from a focus on elucidating cutoffs and indexes relevant to iron adequacy. BACKGROUND Indicators of iron status span an array of mea...

Diagnosis Hemochromatosis can be difficult to diagnose. Early symptoms such as stiff joints and fatigue may be due to conditions other than hemochromatosis. Many people with the disease don't have any symptoms other than high levels of iron in their blood. Hemochromatosis may be identified because of irregular blood test results after testing is done for other reasons. It also may be revealed when screening family members of people diagnosed with the disease. Blood tests The two key tests to detect iron overload are: • Serum transferrin saturation. This test measures the amount of iron bound to the protein transferrin that carries iron in your blood. Transferrin saturation values greater than 45% are considered too high. • Serum ferritin. This test measures the amount of iron stored in your liver. If the results of your serum transferrin saturation test are higher than usual, your health care provider may check your serum ferritin. These blood tests for iron are best performed after you have been fasting. Elevations in one or all of these tests can be found in other disorders. You may need to have the tests repeated for the most accurate results. Additional testing Your health care provider may suggest other tests to confirm the diagnosis and to look for other problems: • Liver function tests. These tests can help identify liver damage. • MRI . An MRI is a fast and noninvasive way to measure the degree of iron overload in your liver. • Testing for gene changes. Testing you...

• Fatigue (feeling tired or as though you don't have enough energy to do everyday things) • Difficulty concentrating • Dizziness • Cold hands and/or feet • Shortness of breath on exertion • Heart palpitations • Headaches • Pica (cravings for non-food items, such as grass, ice, dirt, etc.) • Restless legs syndrome • Pale or yellowish skin and mucus membranes • Brittle or spooned nails • Cracking at the corners of the mouth • Swollen or sore tongue • A weak pulse • A blood smear may also recognize some types of blood cancers such as leukemia and lymphoma, which cause anemia. Iron tests: Your healthcare provider may also order tests to assess iron levels in your body. Iron is an essential mineral for making red blood cells and is also important for healthy muscles, bone marrow, and organ function. Too little iron in the body can cause Test results will indicate whether you have too much or too little iron in your body. If your test results are not normal, it may not mean you have a medical condition that requires treatment. Women who are menstruating often have low iron levels, and some medicines such as birth control pills and estrogen can influence iron levels. Differential Diagnoses Anemia is often a sign of an underlying disease. And since a low RBC count or altered RBCs can be fairly quickly detected with routine blood tests (often even before signs and symptoms of anemia develop), the differential diagnosis is focused on finding the cause or risk factors that led to ane...

Background Iron-deficient erythropoiesis results in excess formation of zinc protoporphyrin (ZPP), which can be measured instantly and at low assay cost using portable haematofluorometers. ZPP is used as a screening marker of iron deficiency in individual pregnant women and children, but also to assess population iron status in combination with haemoglobin concentration. We examined associations between ZPP and disorders that are common in Africa. In addition, we assessed the diagnostic utility of ZPP (measured in whole blood and erythrocytes), alone or in combination with haemoglobin concentration, in detecting iron deficiency (plasma ferritin concentration 70 μmol/mol haem) resulted in gross overestimates of the prevalence of iron deficiency. Conclusions Erythrocyte ZPP has limited value to rule out iron deficiency when used for screening in conditions with a low prevalence (e.g., 10%). ZPP is of unreliable diagnostic utility when discriminating between pregnant women with and without iron deficiency. Based on these findings, guidelines on the use of ZPP to assess iron status in individuals or populations of pregnant women need review. Trial registration Zinc protoporphyrin (ZPP) indicates the systemic supply of iron to erythrocytes in bone marrow. Iron-deficient erythropoiesis results in excess formation of ZPP, which can be measured instantly and at low assay cost using portable haematofluorometers. ZPP has been used as a screening marker to manage iron deficiency in...

If someone is worried about low iron, they should go to their medical provider to have their iron level tested. But people may discover that their iron is low when they attempt to give blood. Before a blood donation, the blood center will test the iron level of donors to see if it is high enough for them to safely donate. While this test will not indicate why a person’s iron is low or diagnose a medical condition, it can serve as a first alert for low iron levels. If the test indicates a lower-than-expected iron level, the individual can see their health care provider for further tests. Testing for iron deficiency through a blood sample People worry about iron deficiency or low iron when they’re feeling tired and fatigued on a daily basis because these are common symptoms of anemia. Iron is an important element in blood and is needed for red blood cells to carry oxygen throughout the body. A doctor can test for iron deficiency by taking a blood sample. Testing iron levels through a finger prick Iron levels are often tested using the finger-prick method. This test is faster and less expensive than the tests a doctor may do by drawing blood from a vein. A clinic or blood donation location will prick your finger to draw a few drops of blood, which are then used to measure the hemoglobin level. Hemoglobin is the protein in the blood that carries iron, so a low hemoglobin level often indicates low iron levels. If the test indicates a low hemoglobin level, further blood tests at...

Background Zinc protoporphyrin (ZPP) has been used to screen and manage iron deficiency in individual children, but it has also been recommended to assess population iron status. The diagnostic utility of ZPP used in combination with haemoglobin concentration has not been evaluated in pre-school children. We aimed to a) identify factors associated with ZPP in children aged 12–36 months; b) assess the diagnostic performance and utility of ZPP, either alone or in combination with haemoglobin, to detect iron deficiency. Methods We used baseline data from 338 Kenyan children enrolled in a community-based randomised trial. To identify factors related to ZZP measured in whole blood or erythrocytes, we used bivariate and multiple linear regression analysis. To assess diagnostic performance, we excluded children with elevated plasma concentrations of C-reactive protein or α 1-acid glycoprotein, and with Plasmodium infection, and we analysed receiver operating characteristics (ROC) curves, with iron deficiency defined as plasma ferritin concentration 5.93120) correctly ruled out iron deficiency in 37.4%–53.7% of children screened, depending on the true prevalence, with both specificity and negative predictive value ≥90%. Conclusions In young children, whole blood ZPP and erythrocyte ZPP have added diagnostic value in detecting iron deficiency compared to haemoglobin concentration alone. A single diagnostic score based on haemoglobin concentration and whole blood ZPP can ru...