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High TIBC Levels in the Blood: Causes and Treatment

Medically Approved by Dr. Edward Salko

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When your total iron binding capacity (TIBC) is elevated, it can be due to low amounts of iron in your blood. Such conditions can be associated with iron-deficiency anemia, excessive menstrual bleeding, pregnancy, and internal injuries. 

While lack of sufficient iron can be treated by taking iron supplements, if the high TIBC levels relates to a medical disorder, treating the condition becomes the first step to normalizing your serum iron. Read more about TIBC and learn how it affects your blood health and general wellness. 

What Is the Total Iron Binding Capacity (TIBC)Test? 

A total iron binding capacity (TIBC) test measures the amount of iron attached to the red blood cells. Iron is transported to various tissues in the body through a protein called transferrin. The TIBC blood test evaluates whether there’s sufficient iron binding to transferrin, allowing for the assessment of the serum iron concentration. 

When To Take the Test?

It’s best to take a TIBC blood test if you’re experiencing symptoms of iron deficiency or iron overload. These conditions must be detected, especially among women and people with poor diets. 

Your doctor may order the test if you experience conditions indicating iron deficiency, such as shortness of breath, chest pain, tongue soreness, chronic fatigue, frequent dizziness and headache, pale skin, brittle nails, and pica (craving for non-food items). 

The same goes for symptoms of iron overload, which include irregular heartbeat (arrhythmia), weakness, stomach pain, unexplained weight loss, as well as joint and knuckle pain.

However, a TIBC alone will not suffice to diagnose a specific medical condition. Hence, it is often taken along with other tests, such as a ferritin blood test and a complete blood count (CBC)

How Is It Done?

As a blood test, the TIBC lab work follows the standard venipuncture procedure, which involves taking a blood sample from the vein. Since the process requires expert hands and a sterile protocol, it has to be done in the laboratory, entailing that the test does not come as a do-it-yourself (at-home)kit.

Should I Fast Before the TIBC Blood Test? 

For accurate results, be sure to fast before having your blood sample collected. This means no food or drinks, except water, 12 hours before your laboratory appointment. 

In addition, consult your doctor about the medications you’re taking. Some drugs interact with iron, such as ranitidine, nizatidine, famotidine, cimetidine, and certain antibiotics.

Also, consider scheduling the blood collection in the morning, as iron levels are closer to normal during this time. If you’re anxious about the blood test, know the tips to prepare for getting your blood drawn

What High TIBC Levels Mean 

Elevated TIBC is indicated through test values going above the upper limit of the normal range – which is between 250 to 450 micrograms per deciliter (mcg/dL). High TIBC levels mean that your serum iron is low. 


When your TIBC test exceeds the normal range, it suggests iron deficiency. This condition can be associated with the following causes.

Iron-deficiency Anemia

You would have high TIBC levels if you developed iron-deficiency anemia, a blood disorder characterized by a lack of healthy red blood cells (RBCs) due to the low serum iron. As a result, your body receives less oxygen than it should have, which could impact your heart health.

Insufficient iron can be associated with several factors. For example, it could be due to poor diet with lack of iron-rich foods, or digestive malabsorption linked to a health condition, like Celiac disease.  


Pregnant women experience a higher blood volume demand as the fetus develops. As a result, more RBCs must be produced, requiring more iron. This leads to iron deficiency if the woman does not increase her iron intake or has low stores. 

Likewise, obstetricians often prescribe iron supplements and provide nutritional recommendations. This is because prenatal iron deficiency can have adverse perinatal outcomes, like low birth weight and delayed motor development.    

Excessive Menstrual Blood Loss 

Women experiencing heavy menstruation lose more blood and, with that, more iron. However, some symptoms go unchecked as they don’t seem to directly associate with iron deficiency. These symptoms include hair loss, pica (unusual cravings), inflammation of the lips (cheilitis), and restless leg syndrome. 

In a 2020 study published in the Women’s Health Reports, subjects with non hematological symptoms of iron deficiency showed improvement in their attention and cognitive processes when given oral iron supplements. Hence, if you’re having trouble with performance at work, for example, make sure to include an iron profile blood test in your next wellness checkup. 

Did You Know? Iron-deficiency can cause female hair loss. Find out what you can do to prevent his condition and other complications of having low iron levels.    

Internal bleeding 

Losing blood due to internal injuries also leads to elevated TIBC levels – most notably, gastrointestinal bleeding due to ulcers, polyps, and colon cancer. A common symptom of blood loss due to these disorders is blood in the stool. While you may not readily identify such blood, you can take a fecal occult blood test to confirm its presence.


In most cases, iron deficiency can be treated with iron supplements, allowing for its replenishment. Your doctor will set the dosage depending on the severity of the condition.

However, if the deficiency is due to a disorder that impacts iron absorption, addressing the medical condition should be the priority. For example, seek diagnosis for Celiac disease if you have iron deficiency on top of other symptoms. 

How To Reduce My TIBC Naturally 

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The simplest way to normalize your TIBC is to increase your intake of iron. Although iron supplements often remedy the deficiency, you can also take the natural route if recommended by your doctor. Include iron-rich foods in your diet, specifically the following.

Animal Sources (Heme Iron)

Meat and animal flesh provide heme iron, which is easily absorbed by the body. You can get the most iron from these foods.

  • Fish
  • Liver 
  • Eggs
  • Clams 
  • Turkey
  • Oysters
  • Mussels 
  • Chicken
  • Red meat, such as lean beef

Plant Sources (Non-heme Iron)

Non-heme iron can be found in plants. Although you get more heme than non-heme iron, you can improve its absorption as you get other nutrients that help the process, like vitamin C. Hence, it’s beneficial to get your iron from both animal and plant-based sources. 

Here are plant sources of iron to include in your meal plan.

  • Tofu
  • Chickpeas
  • Pumpkin seeds
  • Beans and lentils
  • Fortified breakfast cereals
  • Dark green leafy vegetables 

Pro Tip: If you are embracing a plant-based lifestyle, or planning to do so, make sure to take the optimal vegan/ vegetarian profile blood test. This allows your doctor to record baseline data and monitor nutritional changes that impact your health and wellness. Nutrients, including iron, can become inadequate when giving up meat and animal-based sources. Identifying the deficiencies will help you plan your proportions appropriately.   

Frequently Asked Questions 

Why is TIBC high in Iron deficiency?

With insufficient iron, transferrin is rendered unused and in excessive amounts. It’s comparable to empty seats in a stadium. As a result, TIBC measures high with low supplies of iron. For a more accurate diagnosis, it’s best to take additional tests designed to evaluate iron stores. 

What do low TIBC and high ferritin mean?

A TIBC blood test is supplementary to a ferritin test as it confirms lack of iron intake. To get high ferritin can mean many things, including inflammation and low serum iron. But if it occurs alongside low TIBC, inflammation and other possible causes can be ruled out and your doctor may look closely into iron deficiency as the possible culprit. 

What happens if TIBC is low?

To test for low TIBC could indicate too much iron. This means you have more iron than transferrin the blood, which can be caused by several factors – including hemochromatosis (iron overload), iron poisoning, hemolytic anemia, and cirrhosis. 

Bottom Line 

A total iron binding capacity high enough to exceed the normal range suggests inadequate serum iron, which can cause iron-deficiency anemia. Moreover, it could affect other areas of your health, especially if you’re pregnant. 

Additionally, if you’ve been experiencing consistent heavy menstruation, consider including a TIBC test in your annual checkup. Doing so, allows your doctor to prescribe iron supplements at the right dosage.   

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