Which lab finding typically indicates iron overload rather than deficiency?

In the context of iron metabolism, the laboratory finding that typically indicates iron overload is an increased level of ferritin. Ferritin is a protein that stores iron and releases it in a controlled manner; hence, elevated ferritin levels reflect higher stored iron in the body. When the body has an excess of iron, ferritin levels rise as the protein accumulates the surplus iron, signaling potential conditions like hemochromatosis or iron overload secondary to repeated blood transfusions.

In contrast, a decreased ferritin level typically signifies low iron stores, which is consistent with iron deficiency anemia. Increased total iron-binding capacity (TIBC) is often associated with iron deficiency as the body attempts to capture as much iron as possible in the absence of sufficient iron stores, making it a less relevant indicator for iron overload. Decreased mean corpuscular volume (MCV) suggests microcytic anemia, commonly seen in iron deficiency rather than overload. Thus, the increase in ferritin distinctly points towards iron overload.