Dr. Dana Johnson outlines the important lab tests that should be completed at your child’s first doctor’s appointment.

Lab Tests for an Initial Checkup

The following list of lab tests is highly recommended for internationally adopted children at their initial check-up post-adoption to identify potential nutritional deficiencies. This list is based on new information now available on common nutrient deficiencies in adopted children.

NOTE: If a child has an infection at the time of testing, micronutrient levels may not be accurate.



Complete blood count (CBC) and differential count (diff), including red blood cell count, hemoglobin, hematocrit, and red blood cell indicies (including mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration)

Decreased levels may indicate anemia (including iron-, folate- and B12-deficiency anemia), chronic illness, lead poisoning, chronic diseases or nutritional deficiency. Note: High hemoglobin levels may be found in children who lived in high altitudes.

Serum Ferritin Transferrin Receptor

Checks for adequacy of iron stores (ferritin) and cellular iron status (transferrin receptor). Both can potentially detect iron deficiency before anemia occurs.

Thyroid Stimulating Hormone (TSH)

Tests whether the thyroid is being excessively stimulated, which presents as iodine and/or selenium deficiency.

25-hydroxy Vitamin D

Tests for vitamin D levels, which may demonstrate a risk for rickets.

Stool test for ova and parasites

Tests for infectious diseases of the gut; left untreated can inhibit nutrient absorption.

Antigen Heliobacter Pylorii

Tests for infectious diseases of the gut; left untreated can inhibit nutrient absorption.

Serum Zinc

Tests for zinc levels; can put children at great risk for infectious disease and atypical cognitive development.

Vitamin B12

Tests for vitamin B12; deficiency can increase risk for neuropsychiatric and neurologic complications.


Not available to all doctors, but should be done if available to test for iron deficiency. Iron deficiency without anemia is diagnosed by having 2 out of 3 abnormal tests besides hemoglobin. Those tests include ferritin, MCV, and ZnPP.

Standard Anthropometric

Indication of adequacy of protein and energy intake/uptake. Measures height/length, weight and head circumference. In general, it’s more important to maintain growth than to reach a certain percentile of growth, though this may differ according to each child’s unique needs.

Download a PDF of these lab tests to print and take to the doctor

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