Iron deficiency vs anemia of chronic disease — what's the difference?
Iron deficiency anemia shows low ferritin, low iron, and high TIBC. Anemia of chronic disease shows normal or elevated ferritin (acute-phase reactant) with low iron and low TIBC.
Full answer
Iron deficiency anemia (IDA) and anemia of chronic disease (ACD) can both present as a normocytic or microcytic anemia, but the iron studies differ. IDA shows low ferritin, low iron, high TIBC, and low transferrin saturation. ACD shows normal or elevated ferritin (because ferritin is an acute-phase reactant), low iron, low TIBC, and low or low-normal transferrin saturation. The two can coexist. Within oMeds review, the iron-study pattern and inflammatory markers (hs-CRP, ESR) are read together with the CBC to differentiate.
Educational. Not a substitute for individualized provider review.
- Ferritin — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29