Blood Testing in Eating Disorders and Dietetics

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Learning Aim

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The main leaning aim of all our courses is to keep it simple and clinically applied. Therefore, all our programmes link the blood tests back to the normal underlying anatomy and physiology, from where learners can add on a more complex case load of symptoms, co-morbidities and polypharmacy. 

 

Expected Learning Outcome

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For delegates to have the appropriate level of knowledge and confidence to interpret blood results in line with their scope.  Including the interpretation of “normal” results and appropriate action in the case of abnormal results.

 

What is covered?

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• Bloods specific to Eating Disorders and how these may affect the result - Purging, Re-feeding, water loading, malnutrition, potassium / glucose changes, drugs used etc.  

• Consider how dehydration and phlebotomy can affect the result 

• Review the 4 main categories of blood tests, linking them to anatomy and physiology and prescribing such as muscle mass (creatine kinase, ALT, Bilirubin, CRP & HBA1c) 

• Explore how to read the blood test results, the reference range “normal” and then define and refine clinical differential diagnosis, prescribing and decision making. Reflecting on how eating disorders can affect the “normal”. 

 

Overview of the following key blood tests:

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• Full Blood Count: 

  • Anaemia: tired all the time - iron studies, GI bleeds, B12 (pernicious anaemia, intrinsic factor and B12 injections) and folate. 

  • Complex anaemias of low iron, B12, Iron but normal Hb. 

  • Inflammation and infection by looking at CRP different types of white blood cells. Considering more complex ED patients with different CRP and WBC results. 

  • High and low platelets, clotting and bleeding. 

• Clotting 

  • Link to liver control of clotting Vitamin K, Factor Xa and Fibrinogen. 

• Liver Function Test :

  • ALT AST – link to B12 and LDL production in anorexia 

  • Bilirubin and jaundice 

  • Alkaline Phosphatase 

  • Albumin 

  • Jaundice 

• Kidney Function Test

  • Sodium and hydration, link to delirium 

  • Potassium – links to muscle mass, water loading, pulse rate, use of diorylate, laxatives, purging, re-feeding syndrome. 

  • Protein in the urine = ACR, swelling. 

  • Gout, Uric Acid, NSAIDs and Allopurinol 

  • Urea and Creatinine 

  • eGFR and creatinine clearance 

  • CKD and AKI 

• HBA1c and diabetic review 

• Lipids – LDL, non-HDL, TG ratio, QRISK and statins 

• Thyroid Function Tests. 

  • T4, T3, TSH 

  • Pituitary Gland 

  • Links to malnutrition and amenorrhea (and bone metabolism)

  • Effect of drugs like olanzapine

• Bone Profile 

  • Calcium, Alkaline Phosphate, Vitamin D, PTH

  • Link to malnutrition and amenorrhea 

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This course is available in the following formats:​