Nutristasis Unit at St Thomas' Hospital

Laboratory overview

Our laboratory provides analysis of endogenous vitamins in body fluids.

Optimal vitamin status is required for maintenance of health, and sub optimal/deficient levels can lead to hastened progression of degenerative diseases, haemorrhage, anaemia, skeletal, neurological damage and vascular disease. Some neurodegenerative disorders can become irreversible, and so the aim is to provide detection at the earliest time point, where intervention can be effective.

Key features:

Our strategy is to provide paired sensitive laboratory-based assays (static and functional) wherever possible. The measurement of circulatory concentration (static marker) gives a good indication of current body stores and dietary exposure. Greater insight can often be gained when these assays are used in combination with functional biomarkers that directly reflect status within target tissues (functional markers).
We also provide analysis of some vitamin antagonists such as warfarin, for monitoring of efficacy and patient compliance of this therapy used in the treatment of e.g. thrombosis and atrial fibrillation. The same analysis is applied to cases of inadvertent or deliberate overdosing with warfarin/warfarin type compounds. Key customers: Hospitals, GPs, universities, private patients, private surgeries, research centres, – UK and worldwide.
We are also the provider of the Vitamin K External Quality Assurance Scheme (KEQAS) which now has participants from 15 different countries. The scheme, under the management of David Card, and the directorship of Dr Dominic Harrington, is UKNEQAS accredited. Through this scheme we assist in the development and harmonisation of methods for vitamin K analyses and their application to nutritional and clinical studies.

Last updated on 21/02/2017

KEQAS

KEQAS is an international scheme that monitors and reports on the accuracy of vitamin K1 (phylloquinone ) analysis.

KEQAS is overseen by a steering committee.

KEQAS steering committee members

Dr Dominic Harrington (scheme director)
Consultant clinical scientist, Human nutristasis unit, Centre for Haemostasis and Thrombosis
Email: dominic.harrington@viapath.co.uk

Dr Martin Shearer (chairman)
Consultant clinical scientist, Centre for Haemostasis and Thrombosis
Email: martin.shearer@viapath.co.uk

Dr Leon Schurgers (scientific director)
Senior Scientist, Department of Biochemistry, University of Maastricht, The Netherlands
Email: l.schurgers@bioch.unimaas.nl

Mr David Card MSc (scheme manager)
Centre for Haemostasis and Thrombosis
Email: david.card@viapath.co.uk

Background

At the 10th meeting of the European Fat-soluble Vitamins Group in 1996, it was agreed that a quality assurance scheme for the determination of vitamin K1 should be initiated since self “in-house” assessment of laboratory performance makes it difficult to identify systematic errors. It was decided that participation in an external quality assurance scheme would greatly assist the development and harmonisation of methods for vitamin K analyses and their application to nutritional and clinical studies.

Participating laboratories receive four batches of three samples annually and are required to analyse them during specific periods over the course of the year. When results are returned they are subjected to statistical analysis including an outliers test and a Z scoring system. Members then receive comprehensive reports detailing their performance.

KEQAS is a UKNEQAS affiliated EQA scheme. Viapath Analytics LLP, operating KEQAS, is a UKAS accredited proficiency testing provider (No. 7586). A standard reference material is now available and pilot schemes for menaquinone -4, menaquinone -7 and vitamin K1 -2,3- epoxide are now in place.

Join KEQAS

Please email David Card and include your contact name and address to which samples should be sent.

KEQAS participants area

This page is for KEQAS participants, providing the information needed for trouble free participation.

News

Investigation of bias (PDF 77Kb). At ISTH 2013 we presented a poster highlighting the major sources of methodological bias, and compared results from the novel tandem mass spectrometry method to that of the established fluorescence method
Pilot schemes for analysis of menaquinone-4, menaquinone-7 and vitamin K1 2,3-epoxide are now available (see below for results)
Standard reference material now available. For more information, email David Card - david.card@viapath.co.uk.
Join our KEQAS group on LinkedIn.

Documentation

Batch reports

Batch 66 (PDF 512Kb)

Pilot scheme results

Submit results

Email results to david.card@viapath.co.uk. When submitting results please include your group number, method used, and the results for all three samples. You can attach the results submission form (Word 162Kb) to the email if you wish.

view our tests

Thursday, 19 October, 2017

Establishing reference intervals for serum ferritin and vitamin B12 using a modified Hoffmann's approach

Dr Agata Sobczyńska-Malefora

Wednesday, 12 October, 2016

The Adverse Effects of an Excessive Folic Acid Intake.

Patel KR , Dr Agata Sobczyńska-Malefora

Tuesday, 4 October, 2016

A baby with severe vitamin B12 deficiency and heterozygosity in cubilin and MTHFR genes

Dr Agata Sobczyńska-Malefora , Radha Ramachandran , David Cregeen , Elizabeth Green , Dr Dominic Harrington , Hugh Lemonde

Thursday, 15 September, 2016

What’s in a name? The pharmacy of vitamin K

David Card , Martin J. Shearer , Leon J. Schurgers , Keith Gomez , Dr Dominic Harrington

Monday, 18 July, 2016

Elevated homocysteine with pseudo-homozygosity for MTHFR677T as predisposing factors for transient ischemic attacks: a case report.

Dr Agata Sobczyńska-Malefora , Jacky Cutler , Rahman Y

Friday, 1 January, 2016

Are vitamin supplements necessary for all? A role for vitamin status assessment

Are vitamin supplements necessary for all?

Dr Agata Sobczyńska-Malefora , Dr Dominic Harrington

Thursday, 17 September, 2015

The prevalence of low and very high vitamin B6 (Pyridoxal 5’-phosphate) concentrations in hospital patients

Critcher MS , Dr Agata Sobczyńska-Malefora

Thursday, 17 September, 2015

Prevalence and Risk Factors for Functional Vitamin B12 Deficiency in Patients with Crohn's Disease

Ward MG , Kariyawasam VC , Mogan SB , Patel KV , Pantelidou M , Dr Agata Sobczyńska-Malefora , Porté F , Griffin N , Anderson SH , Sanderson JD , Dr Dominic Harrington , Irving PM

Wednesday, 15 January, 2014

Plasma and Red Cell Reference Intervals of 5-Methyltetrahydrofolate of Healthy Adults in Whom Biochemical Functional Deficiencies of Folate and Vitamin B12 Had Been Excluded

5-Methyltetrahydrofolate (5-MTHF) is the predominant form of folate and a strong determinant of homocysteine concentrations.

Dr Agata Sobczyńska-Malefora , Dr Dominic Harrington , Kieran Voong , Martin J. Shearer

Wednesday, 12 June, 2013

Pain, purpura and curly hairs

This review follows a patient presenting with symptoms of Vitamin C deficiency (scurvy) at St. Thomas' Accident and Emergency Department, outlining symptoms, diagnosis and successful treatment.

J D Fleming, B Martin, David Card and J E Mellerio

Friday, 15 February, 2013

Warfarin accelerates ectopic mineralization in Abcc6-/- mice – Clinical relevance to pseudoxanthoma elasticum.

Pseudoxanthoma elasticum (PXE) is a multisystem ectopic mineralization disorder caused by mutations in the ABCC6 gene.

Qiaoli Li , Haitao Guo , David W Chou , Dr Dominic Harrington , Leon J Schurgers , Sharon F Terry , Jouni Uitto

Tuesday, 8 January, 2013

Vitamin K status in chronic kidney disease: a report of a study and a mini-review

Hepatic vitamin K-dependent proteins (e.g., Factors II, VII, IX and X) form part of the clotting cascade.

Kieran Voong , Dr Dominic Harrington , David Goldsmith

List Grid

Dr Agata Sobczyńska-Malefora

Principal Clinical Scientist

Dr Dominic Harrington

Chief Scientific Officer

Ashwenia Krishnan

Operations Manager