Iron and haematology . Patient guide

Serum Iron

What is Serum Iron

Serum iron measures the iron currently circulating in the bloodstream, bound to its transport protein transferrin. It is part of the full iron studies panel together with ferritin, TIBC, and transferrin saturation, and it has a strong diurnal rhythm so morning sampling is preferred.

This biomarker entry is being clinically reviewed by our team. The factual content draws on UK guidance (NICE, NHS, Royal Colleges and the relevant speciality society where cited).

Reference range

Reported in µmol/L (also seen as µg/dL (multiply µmol/L by 5.6)). Final reports always carry the issuing laboratory's range, which is what your clinician will interpret against.

Group Range Note
Adult men 11 to 30 µmol/L; sample in the morning
Adult women (pre-menopause) 9 to 30  
Adult women (post-menopause) 11 to 30  

What it is

Most iron in the bloodstream is bound to transferrin and being transported between the gut, liver, spleen, and bone marrow. Only a small fraction of total body iron is in the bloodstream at any moment; the rest is stored as ferritin or held in haemoglobin. Serum iron alone does not give a complete picture of iron status, which is why it is interpreted alongside ferritin and TIBC.

Why a clinician would order it

Serum iron is requested as part of comprehensive iron studies in the work-up of anaemia, fatigue, hair shedding, or suspected iron overload. It is more useful for distinguishing iron deficiency anaemia from other anaemias than for diagnosing simple iron deficiency, which is more reliably picked up by a low ferritin.

If your level is outside the range

Symptoms of low Serum Iron

  • Fatigue, especially with exertion
  • Hair shedding
  • Breathlessness on stairs
  • Pale skin
  • Brittle nails
  • Symptoms typically overlap with low ferritin

What low can indicate. Iron deficiency (with low ferritin and high TIBC), anaemia of chronic disease (with low TIBC and normal or raised ferritin), recent blood loss, dietary insufficiency, or simply a normal diurnal trough.

Symptoms of high Serum Iron

  • Symptoms relate to underlying iron overload: joint pain, fatigue, skin pigmentation change, abdominal discomfort, diabetes

What high can indicate. Iron overload (haemochromatosis), recent iron supplementation, recent blood transfusion, haemolysis releasing iron from red cells, or liver disease.

Testing tips

Morning blood draw essential. Serum iron has a strong diurnal rhythm and afternoon levels can be 30 percent lower. Avoid iron supplements for 24 hours before the test. Interpret alongside ferritin and TIBC for the full picture (a panel of serum iron + TIBC + transferrin saturation + ferritin is the standard UK iron studies).

Where you can get this tested

Serum Iron is included in the following WMG Health panels. Same-day appointments at our Harley Street clinic, with results clinician-reviewed.

General Wellness
£279
View panel

Want a specific combination of markers we do not have a panel for? Build a custom panel and our clinicians will design one for you.

Symptoms often investigated with Serum Iron

Serum Iron is commonly tested when patients present with the following symptoms. If any of these resonate with you, the linked guides explain what to look for and which test pathway is appropriate.

Stress-Related Hair Loss: Testing the Real Drivers Severe stress can trigger heavy shedding 2 to 4 months later. Testing identifies the nutritional and thyroi... Read symptom guide → Hair Loss After COVID-19 or a Viral Illness Heavy shedding 2 to 4 months after COVID-19 is well documented (a viral telogen effluvium). A targeted pane... Read symptom guide → Erectile Changes: Blood Work That Matters Erectile changes can be vascular, hormonal or medication-related. A blood panel rules out the metabolic and... Read symptom guide → Perimenopause: Symptoms and When to Test Hot flushes, irregular cycles, sleep disruption and mood change can begin years before menopause. FSH, oest... Read symptom guide → Menopause: Symptoms and Bloodwork Context Menopause is diagnosed clinically (12 months without a period). Bloodwork has a role in younger women (unde... Read symptom guide → Thyroid Symptoms: When and What to Test Fatigue, weight change, hair loss, cold intolerance and mood change can all be thyroid driven. A full TSH, ... Read symptom guide →

Related markers

Ferritin Iron and haematology TIBC and Transferrin Saturation (TIBC, TSAT) Iron and haematology

Sources

UK guidance our clinicians use when interpreting this marker.

This page is general patient information, not personal medical advice. A GMC-registered clinician will review your results and tailor any interpretation to you. See our Editorial Policy for how we write and review content.

Common questions about Serum Iron

What is a normal Serum Iron range?

Adult men: 11 to 30 (µmol/L; sample in the morning). Adult women (pre-menopause): 9 to 30. Adult women (post-menopause): 11 to 30. Always interpret your own results against the laboratory range printed on your report, since assay-specific reference ranges vary.

What does a low Serum Iron result mean?

Iron deficiency (with low ferritin and high TIBC), anaemia of chronic disease (with low TIBC and normal or raised ferritin), recent blood loss, dietary insufficiency, or simply a normal diurnal trough.

What does a high Serum Iron result mean?

Iron overload (haemochromatosis), recent iron supplementation, recent blood transfusion, haemolysis releasing iron from red cells, or liver disease.

Do I need to fast or prepare for the Serum Iron blood test?

Morning blood draw essential. Serum iron has a strong diurnal rhythm and afternoon levels can be 30 percent lower. Avoid iron supplements for 24 hours before the test. Interpret alongside ferritin and TIBC for the full picture (a panel of serum iron + TIBC + transferrin saturation + ferritin is the standard UK iron studies).

Can I order a Serum Iron blood test privately in London?

Yes. WMG Health offers Serum Iron as part of bespoke panels and several pre-built panels at our 134 Harley Street clinic. Results are clinician-reviewed by a GMC-registered doctor within 4 hours for the most common assays. Bespoke panels from £180; bookings via /contact/ or 020 3239 3378.