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Best Tests March 2007

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BNP, Haemochromatosis, Vitamin D: Testing in Primary Care

BNP “…the best role of BNP is to rule out heart failure when symptoms are equivocal…”

Key recommendations:

  • BNP is useful as a ‘rule-out’ test of heart failure in acute dyspnoea.
  • The use of BNP in primary care is not yet established.

Haemochromatosis “…early detection of haemochromatosis can avoid development of significant liver pathology…”

Key recommendations:

  • Transferrin saturation and ferritin are the best initial tests.
  • Population screening is not currently recommended.
  • Gene testing of first degree adult relatives is recommended.
  • People with haemochromatosis should be monitored with transferrin saturation and ferritin.

Vitamin D “…supplementation of vitamin D without testing levels is a cost effective option for elderly people in rest homes: One year’s supplementation ~ $12.00 vs Vitamin D blood test ~ $50.00…”

Key recommendations:

  • Increased sun exposure is advisable for people at high risk of vitamin D insufficiency due to inadequate exposure.
  • Vitamin D and calcium supplementation is appropriate for people at high risk who cannot increase their sun exposure.
  • Testing of vitamin D levels is not usually necessary prior to or after starting vitamin D supplementation for elderly people.
  • Vitamin D testing is appropriate for people in specific situations.