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Dear Jonathan Yes, it was all gloom. England deserved to win. The All Blacks had not lost for 20 matches and had not lost in Europe since 2002. As you well know there is always reversion to the mean. Hope to see you at the next world cup match AB vs E. In Auckland community pathology we receive serum vitamin B12 requests: 1 B12 request for every 7 people pa, an enormous workload. Yes education is required but there is no medical political drive. 27% of results have a serum B12 110 - 240 pmol/L. 110 is the lower reference range and the cutoff 240 is derived from the data for the Siemens assay, interference due to IF Ab, see Carmel, R Failures of Cobalamin Assays in Pernicious Anemia NEJM 367; 4 July 26, 2012. 2.3% of the patients with B12 110 - 240 have a Hb < lower reference range. To provide an MMA assay for 27% of the B12 results would probably not receive funding from the commissioners. It is probably cheaper to prescribe B12. Jeff From: Jonathan Kay [mailto:[log in to unmask]] Sent: Friday, 7 December 2012 10:15 a.m. To: Jeffrey Barron Cc: <[log in to unmask]> Subject: Re: Folate/B12 More detail on that, please, Jeff. Jonathan PS: How did the England match go down in Auckland? On 6 Dec 2012, at 21:05, Jeffrey Barron wrote: It is impractical in current clinical practice to use MMA to diagnose B12 deficiency. IMPORTANT - LABTESTS is a division of Healthscope Limited. This email contains confidential information intended only for the person named above and may be subject to legal privilege. If you are not the intended recipient, any disclosure, copying or use of this information is prohibited. Healthscope provides no guarantee that this communication is free of virus or that it has not been intercepted or interfered with. If you have received this email in error or have any other concerns regarding its transmission, please notify [log in to unmask] You must destroy the original transmission and its contents. Any views expressed within this communication are those of the individual sender, except where the sender specifically states them to be the views of Healthscope. If this document is not required for record keeping purposes please consider the environment before storing or printing. This communication should not be copied or disseminated without permission. Please consider the environment before printing this message. ------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 Green Laboratories Work http://www.laboratorymedicine.nhs.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/