Transferrin Saturation Calculator
Calculates transferrin saturation (TSAT) from serum iron and total iron-binding capacity (TIBC). Used to diagnose iron deficiency, iron overload, and anaemia of chronic disease.
Score interpretation
TSAT < 16%: Iron deficiency or functional iron deficiency. Iron supply to bone marrow inadequate.
→ Iron supplementation indicated. Check ferritin: if low → true iron deficiency (oral or IV iron). If ferritin normal/high + TSAT low → functional iron deficiency (anaemia of chronic disease or CKD). IV iron preferred in CKD/renal anaemia.
TSAT 16–45%: Normal range. Iron stores adequate.
→ Iron deficiency unlikely. Investigate other causes of anaemia if present (B12, folate, haemolysis, bone marrow).
TSAT 46–74%: Elevated. Possible iron overload or acute liver disease (ferritin release).
→ Check ferritin. If ferritin also elevated: investigate for hereditary haemochromatosis (HFE gene mutation), repeated transfusions, liver disease. Hepatology referral. Venesection if haemochromatosis confirmed.
TSAT ≥ 75%: Significant iron overload. Hereditary haemochromatosis or secondary siderosis.
→ Urgent hepatology/haematology review. HFE mutation testing. Liver MRI for iron quantification. Venesection programme (500 mL weekly until ferritin < 50 µg/L). Screen first-degree relatives.
Interpretation bands for the Transferrin Saturation. Apply clinical judgement and local guidance.
References
- European Association for the Study of the Liver. EASL Clinical Practice Guidelines for HFE Haemochromatosis. J Hepatol. 2010;53(1):3–22.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ferric Carboxymaltose (IV Iron — Pregnancy) · IV Iron Preparation — Iron Deficiency Anaemia in Pregnancy
- Iron Supplementation (Paediatric) · Iron Supplement — Iron Deficiency Anaemia in Children
- Ferric Carboxymaltose · IV Iron — Anaemia
- Iron Sucrose · IV Iron — Anaemia
- Deferoxamine (Iron/Aluminium Overload in Dialysis) · Iron/Aluminium Overload in Dialysis
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.