My transferrin saturation value is high. What could be the reason?

Q. What are the conditions in which the transferrin saturation will be high?

Answered by
Dr. Goswami Parth Rajendragiri
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Jul 10, 2019

Hello doctor,

I am a 30-year-old female. I had a recent blood test and my iron studies from past four years till now has been attached. My main concern is my T Saturation. I have been genetically tested for hemochromatosis, which came back negative. I am also on zero supplements, multivitamins, etc. How can by T saturation be so high? Would I benefit from blood donation, and should I be concerned? What other conditions could it be? I am on no medications, nil symptoms, and having very good health. I would also like to know why my T Ferrin in slightly slow does this number decrease in correlation to saturation increase? Kindly help.



Welcome to the

I have read your question and report (attachment removed to protect patient identity). Your transferrin saturation is slightly high. It is usually high in case of hemochromatosis in which iron overload occurs. But serum ferritin is within range and not elevated. Serum ferritin reflects iron store if it is within limit like in your case than not suggestive towards iron overload.

So your elevated transferrin saturation finding can be non-specific. However, to give a detailed comment regarding phlebotomy needed or not can be provided only after checking full CBC (complete blood count). So kindly attach your CBC report as well. I hope I have answered your question.

Thank you doctor,

My hemoglobin is 152g/dl, HCT is 0.46.



Welcome back to

Now I can answer your questions after checking your hemoglobin and HCT level. Following is my opinion about your asked questions.

1. The high transferrin saturation is due to an iron overload condition. The various causes of iron overload include hemochromatosis, repeated blood transfusion, hemolytic anemia, thalassemia condition, liver disease, etc. But it does not seem to be the cause like in your case.

2. You should concern about your elevated transferrin saturation. The reason is your borderline high hemoglobin value as well. If your HB value would be within the limit, then we need not too concerned. But your value is borderline high so need to be concerned. No need for blood donation just now. It is advisable to drink lots of water, especially two to three-liter per days for 15 to 20 days. Avoid smoking if having a habit of it. After 15 days, you have to repeat your transferrin saturation and Hb value.

3. The causes of elevated transferrin saturation have been already mentioned.

4. The transferrin is negative phase acute reactant as well. The level can be low in iron deficiency anemia, infection, liver disease, etc...

The iron deficiency anemia is not the cause in your case. You should get investigated for liver profiles like sgot, sgpt, and protein level to rule out liver disease. So, in short, you should be concerned. You have to drink lots of water, and you need to repeat transferrin saturation and HB value after few days. If still elevated than you should consult nearby hematologist for your detailed evaluation and you need to donate blood if saturation is persistently high. Your serum ferritin value surprisingly within the limit and does not suit in iron overload case. So you need to follow-up with repeat CBC. I hope I have answered your question. Let me know if I can assist you further.

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