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A quick thank you for all postings. Clearly there is considerable variation in practice across the UK (and thats not counting variation within haematology departments). Conclusions Transferrin - rarely required. serum iron - essential for overdose in children, not usually required as well as ferritin (but iron has the benefit of being cheaper). Levels vary with recent iron intake but may still be useful in straight-forward iron deficiency anaemia. serum ferritin - usually a good guide to iron status - but is also a positive acute phase protein so care needed in inflammatory conditions. (note transferrin is a negative acute phase protein). serum B12 - you can (uncommonly) have neurological changes (subacute combined degeneration, ring any distant bells?) due to B12 deficiency without abnormalities of simple haematology ( anaemia, macrocytosis, multi lobed neutrophils etc). However not every stroke patient necessarily needs a serum B12. folate - deficiency is usually part of a broader nutritional lack, -- it seems rare without accompanying haematological changes. The problem with asking haematologists what is needed is a) they spend their time seeing problematic patients - who may well need thorough "work- up" who are not typical of GP workload and b) they are a bit like economists. Ask two their views and you get three opinions. ;-) I will see whether I can get more up to date advice from any other sources and will post again if I do. If any readers know of such a resource please let me know. many thanks to all james falconer smith ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/