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.

• The Nutristasis Unit is host to the vitamin K External Quality Assurance Scheme (KEQAS) providing external quality assurance (EQA) for PIVKA-II (Protein Induced by Vitamin K Absence or Antagonism-II – undercarboxylated prothrombin). PIVKA-II has diagnostic value as a functional marker of vitamin K status and is used to diagnose and monitor hepatocellular carcinoma. The EQA scheme provides four distributions per year, with 4 specimens per distribution.

• KEQAS also provides serum Standard Reference Material-2 (SRM-2) for validation of methods measuring vitamin K1 (phylloquinone). For further information regarding the PIVKA-II EQA scheme or SRM-2 please contact Ella [dot] freke [at] gstt [dot] nhs [dot] uk (Ella Freke) or Nathan [dot] timbrell [at] gstt [dot] nhs [dot] uk (Nathan Timbrell)

• For any groups wishing to participate in EQA for vitamin K please contact UK NEQAS Birmingham Quality, see Vitamin K (birminghamquality.org.uk) for more information.