Which statement accurately compares iron studies in iron deficiency anemia and anemia of chronic disease?

Which statement accurately compares iron studies in iron deficiency anemia and anemia of chronic disease?

• A. TIBC is increased in iron deficiency anemia and decreased in anemia of chronic disease
• B. TIBC is decreased in iron deficiency anemia and increased in anemia of chronic disease
• C. TIBC is unchanged in both
• D. TIBC is not informative

Answer: (A)

Total iron-binding capacity reflects how much transferrin is available to carry iron. In iron deficiency anemia, the body ramps up transferrin production to maximize any remaining iron, so TIBC rises. In anemia of chronic disease, inflammation lowers hepatic transferrin synthesis and iron is sequestered, causing TIBC to fall. This is why the statement that TIBC is increased in iron deficiency anemia and decreased in anemia of chronic disease best fits the physiology. The other possibilities either reverse the pattern or imply no change, which doesn’t match how transferrin dynamics respond to iron status versus inflammation.

Total iron-binding capacity reflects how much transferrin is available to carry iron. In iron deficiency anemia, the body ramps up transferrin production to maximize any remaining iron, so TIBC rises. In anemia of chronic disease, inflammation lowers hepatic transferrin synthesis and iron is sequestered, causing TIBC to fall. This is why the statement that TIBC is increased in iron deficiency anemia and decreased in anemia of chronic disease best fits the physiology. The other possibilities either reverse the pattern or imply no change, which doesn’t match how transferrin dynamics respond to iron status versus inflammation.