investigations
Last reviewed 01/2018
- blood film:
- hypersegmented polymorphs (vitamin B12 deficiency)
- target cells (liver disease)
- ESR - raised in malignancy
- serum B12
- red cell folate (more reliable than serum folate)
- liver function tests - including gamma GT
- bone marrow biopsy - only indicated if one of the above does not reveal cause of macrocytic anaemia
If tests indicate vitamin B12 deficiency then proceed to perform a Schilling test in order to help identify cause of deficiency.