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In iron deficiency, the iron level is low but the TIBC is increased, thus transferrin saturation becomes very low. In iron overload states, such as hemochromatosis, the iron level will be high and the TIBC will be low or normal, causing the transferrin saturation to increase. UIBC may be ordered as an alternative to TIBC.
At this stage, ferritin will be low, but serum iron and TIBC are usually normal and there is no anemia. As the iron deficiency worsens, serum iron levels fall, TIBC and transferrin rise, and anemia starts to develop.