Transferrin

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Normal: 250 to 300 mg/dL

Physiology:

Like albumin and prealbumin, transferrin is also synthesized by the liver. Transferrin is a visceral protein which serves as the transport protein for iron in the plasma. Transferrin has an intermediate half-life, 8 to 10 days, and therefore changes in nutrient intake or requirements, especially protein, are reflected in the transferrin level within a week.

Low transferrin levels: Less than 250 mg/dL

Causes:

•	Malnutrition, poor protein intake.

•	Transferrin levels are affected by fluid status but to a lesser degree than albumin.

•	Physiological stress causes a rapid decrease in transferrin levels,just as occurs with albumin. Therefore, transferrin levels obtained within a week of surgery, trauma or development of an acute infection, may be unreliable as an indicator of nutritional status.

Assessment:

Low transferrin levels are not associated with specific symptoms or signs.

Labs:

Mild deficit: <200 mg/dl

Moderate deficit: 100-199 mg/dl

Severe deficit: <100 mg/dl

TPN correction:

Optimal re-feeding leads to a gradual increase in serum transferrin.