For adult patients (18 years and over). Answer each question and the next one will appear. You will finish with clear advice on further tests, whether and how urgently to refer, how to manage in primary care, and what should prompt you to look again.
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Use it alongside your own clinical experience and judgement, and seek specialist advice where needed. Reference ranges and referral routes vary — follow your local laboratory ranges and pathways.
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Version 1.1 · clinical content checked 6 November 2026 · next review due November 2027
Key point: most raised ferritins are not iron overload. Ferritin rises with inflammation, alcohol, fatty liver and metabolic syndrome, liver and kidney disease, and malignancy. The transferrin saturation helps tell genuine iron loading apart from these: a normal TSAT makes HFE-related iron overload much less likely, although it does not exclude every iron-loading disorder. (Ferritin units: 1 µg/L = 1 ng/mL.)
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Educational decision support from HaemAcademy (haemacademy.org), an independent educational website not endorsed by the NHS or any health organisation, professional body or royal college. Use with clinical judgement and local pathways; seek specialist advice where needed. Version 1.1 · clinical content checked 6 November 2026 · next review due November 2027.
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