Screening tests
Haematology:
- full blood count - macrocytosis suggests vitamin B12 or folate deficiency; microcytosis, iron deficiency
- folate - deficiency suggests proximal mucosal disease, as upper small intestine is main site of absorption, for example, coeliac disease
- vitamin B12 - dietary lack unlikely except in vegetarians; consider pernicious anaemia, Crohn's ileitis, pancreatic disease
- blood film e.g. Howell Jolly bodies in coeliac disease
Biochemistry:
- calcium - low in vitamin D deficiency
- albumin - protein losing enteropathy; for corrected calcium
- ferritin - low in malabsorption or due to menstruation
- zinc
Immunology:
- endomysial antibody in coeliac disease
Stool:
- Sudan stain for faecal fat
- microscopy - look for ova, cysts, parasites; Giardiasis is most likely infective cause in the UK
- pH - less than 6.0 indicates fermentation of unabsorbed carbohydrate
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