With many of us having to stay at home during the present Corona virus crisis, we are not being exposed to much in the way of sunlight and as a result our vitamin D levels are reduced.

Vitamin D is made in the skin with the help of sunlight. It has several important functions, including helping to regulate calcium and phosphate in the body to keep bones and teeth healthy. It is also important for good overall health and is an important factor in making sure your muscles, heart, lungs, brain and immune system work well. Vitamin D is particularly important in children, pregnant and breastfeeding women.In recent years, studies have linked vitamin D deficiency to a growing number of health concerns including heart disease, multiple sclerosis, Parkinson’s disease, stroke, diabetes, osteoporosis, prostate disease, some autoimmune conditions and depression.

Sunlight is our main source of vitamin D and requires bare skin and direct sunlight to work, however from October to April, 90% of the UK lies above the latitude that permits exposure to enough ultraviolet B light necessary for vitamin D synthesis. You can also get vitamin D from supplements and a small number of foods such as liver, oily fish and eggs are also good source of vitamin D, however, you would need to eat an enormous amount to keep your levels in the desired range. The farmed fish typically consumed in the UK may contain less vitamin D content than wild fish and in the UK, cows’ milk is generally not a good source of vitamin D because it isn’t fortified as it is in other countries. However, most people should be able to get all the vitamin D they need by eating a healthy balanced diet and by getting some summer sun. A simple blood test can be used to diagnose vitamin D deficiency and it can be treated with supplements. However the best and easiest way to increase your vitamin D level is to go out in the sun! Experts recommend we aim for 15 to 20 minutes of sun exposure a day, after which we should cover up or apply sunscreen. People with lighter skin may need less exposure than those with darker skin but everyone should be careful not to burn.

Vitamin D for cancer prevention?

In 2012 there were 14 million new cases of cancer worldwide and 8.2 million cancer related deaths with predictions of annual numbers of new cases rising to 22 million in the next two decades. With this in mind, prevention is key.

In a well publicised study published in April this year, researchers at the San Diego School of Medicine reported that higher levels of vitamin D (specifically serum 25-hydroxyvitamin D) were associated with a correspondingly reduced risk of cancer in women. The findings were published in PLOS ONE and can be read in full here. In 1980, 30 years earlier, one of the authors, Cedric Garland and his late brother, Frank, made the first connection between vitamin D deficiency and some cancers when they noted ‘populations at higher latitudes (with less available sunlight) were more likely to be deficient in vitamin D and experience higher rates of colon cancer.’ Subsequent studies by the Garlands and others found vitamin D links to other cancers such as breast, lung and bladder.

The new PLOS ONE study pooled analysis from two previous studies to obtain a larger sample size of over 2,300 women. The only accurate measure of vitamin D levels is a blood test and in this study, the researchers were looking for a greater range of blood serum levels of 25-hydroxyvitamin D or 25(OH)D. What they found was that women with 25(OH)D concentrations of 40 ng/ml (100nmol/L) or greater had a 67 percent lower risk of cancer than women with levels of 20 ng/ml (50nmol/L) or less.

What does this mean?

In the study, Garland and co. do not state whether the raised vitamin D levels should come from sunlight exposure, diet or supplements but they do state that an effort to increase vitamin D in the general population to a level of 40 ng/ml(100nmol/L) would likely and substantially reduce cancer incidence and associated mortality.

“Primary prevention of cancer, rather than expanding early detection or improving treatment, will be essential to reversing the current upward trend of cancer incidence worldwide,” the researchers wrote. “This analysis suggests that improving vitamin D status is a key prevention tool.”

We have to remember that this is just one study and that it has limitations but a 67% reduction in cancer risk is certainly interesting. Currently available data is not comprehensive enough to establish whether taking vitamin D can prevent cancer but several randomised trials need to be conducted. Several big scientific trials are underway including the Vitamin D/Calcium Polyp Prevention Study testing whether vitamin D supplements given alone or with calcium can prevent bowel polyps in patients who previously had a polyp removed. The Vitamin D and Omega 3 trial is looking at whether vitamin D can prevent the development of a variety of cancer types in healthy older men and women and should be reporting soon.

Recommended healthy blood serum levels of vitamin D have been a source of vigorous debate in recent years. In 2010, the Institute of Medicine (IOM) concluded that levels lower than 12 ng/ml (30nmol/L) represented a vitamin D deficiency and recommended a target of 20 ng/ml, (50mmol/L) which could be met in most healthy adults (ages 19 to 70) with the equivalent of 600 International Units of vitamin D each day.

As time goes on we may well see an increase in this recommended level as more research is published.

The National Institute for Health and Care Excellence (NICE) recommends that the following groups are particularly at risk of vitamin D deficiency:

  • Infants and children aged under 5
  • Pregnant and breastfeeding women, particularly teenagers and young women
  • People over 65
  • People who have low or no exposure to the sun, for example, those who cover their skin for cultural reasons, are housebound or confined indoors for long periods
  • People with darker skin, for example, people of African, African-Caribbean or South Asian family origin.

We know from analysis of our blood  results at Preventicum that vitamin D deficiency is very common in our clients who often work long hours indoors and many people are severely deficient particularly at this time of the year.

The advice from Public Health England is that adults and children over the age of one should consider taking a daily supplement containing 10mcg of vitamin D, particularly during autumn and winter.

CANCER 30 GENE PANEL

Overview

All of us have a 1 in 2 lifetime risk of cancer, but some common cancers – breast, melanoma, pancreatic, prostate and ovarian – are known to occur more frequently in families, passing from one generation to the next. This is because certain gene mutations can be inherited.

Perhaps the most commonly talked about are the BRCA 1 and BRCA 2 genes, where mutations can indicate increased risk of developing breast, melanoma, pancreatic, prostate and ovarian cancers.

The 30-gene Pan Cancer Panel test from Everything Genetic, examines BRCA1 and BRCA2 and an additional 28 genes which can also indicate risk in the areas of uterine, colorectal (bowel) and stomach cancer.

Why have this test?

Knowing you have a genetic mutation enables you to make sure you have the appropriate regular screening and investigations. Many mutations are known to be hereditary; if you have a mutation, there is a 50% chance that your siblings and children will have it too.

What genes are tested?

Genes APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4*, CDKN2A(p14ARF), CDKN2A(p16INK4a), CHEK2, EPCAM*, GREM1*, MITF*, MLH1, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2*, POLD1*, POLE*, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53.

What does the test involve?

This test is a simple saliva test that you can do in the clinic on the day of your assessment, or in your own home of you prefer – we do not need a blood sample. If you choose to add this test after your health assessment, you will receive a kit in the post with clear instructions on taking your sample, together with all the paperwork you need to sign and post to Everything Genetic.

How long does reporting take?

Once your sample is received at the US laboratory, it will be sequenced, and your genes analysed. A report is then generated, usually within 5 weeks of the laboratory receiving your sample.

How will I get my results?

Your Preventicum doctor will explain the process in your consultation, and you will also have a counselling session with a consultant (usually the day after your Preventicum assessment) so you understand this fully before consenting for the test.

Once your genes have been analysed, you will be sent your results from Preventicum. If there are any positive findings you will also be contacted by a Consultant Geneticist to discuss these, the implications, and next steps. If the results are negative but you still wish to discuss these further, a consultation can be arranged at no extra charge.

Discussing your results with a geneticist and Preventicum doctor will help you to:

  • Understand your risks
  • Monitor your health
  • Consider your lifestyle or diet
  • Protect your family

MUSCULOSKELETAL MOVEMENT SCREEN AND STRENGTH & CONDITIONING COACHING

Overview

Preventicum have partnered with Pure Sports Medicine (PSM), world-class sport and exercise medicine specialists to offer a musculoskeletal movement screen together with strength and conditioning coaching. PSM’s team will work with you to prevent, diagnose, treat and manage any injuries, bringing a multi-disciplinary, team-based approach to your health management.

Why have this test?

  • If you have an existing injury such as back or joint pain.
  • You want to improve or start a new exercise regime.
  • You are trying to improve your lifestyle.

What are the benefits of this screen?

  • Helps you to prevent injury and become injury resistant
  • Improve your ability to resist ailments
  • Improve and optimise your performance in your chosen sport

What can I expect?

This hour-long session starts with a specialist musculoskeletal physiotherapist consultation to determine injuries, exercise history and video gait analysis. All sessions are tailored to the individual and look at relevant lifestyle factors with a clinical assessment of any injuries.

Following this, you will meet a strength and conditioning coach for a full body movement screen and in-depth strength assessment, using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

You will leave with a management plan including any recommendations for further treatment and a letter from your physiotherapist, detailing your findings from the day will be included in your Preventicum final report.

ESSENTIAL

Consultation with a Preventicum doctor
Lasting up to 50 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have.

Detailed physical examination with a Preventicum doctor
An examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure

Over 45 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function in women, HbA1c (diabetes test), vitamin D, and PSA on men over 50 years.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

Echocardiogram
A non-invasive ultrasound examination using high-frequency sound waves to create detailed pictures of your heart. We look at the structure and function of your heart including the valves and can record dynamic changes within this moving organ to see how the heart is managing blood flow around the body.

Resting electrocardiogram (ECG)
ECG is used in diagnosing many electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Body Composition Analysis
The InBody 720 provides a detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Tonometry (glaucoma/eye test)

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 20-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.

ELITE

Consultation and physical examination with a Preventicum doctor
Lasting up to 60 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have. Your doctor will also carry out a physical examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure.

Over 50 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function, HbA1c (diabetes test), vitamin and mineral profile including vitamin D, and PSA on men over 50 years.

Magnetic Resonance Imaging (MRI)
MRI scans of your brain, heart, central arteries and organs of the abdomen and the pelvis as well as a whole spinal scan including your cervical, thoracic and lumber spine. Our two, state-of-the-art MRI scanners are equipped with ‘in-bore’ technology, ambient lighting and a choice of music or film to create an immersive audio video visual experience.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

VO2max*
Cardiopulmonary exercise testing, also known as VO2max, is a measure of aerobic, cardiac fitness and endurance capacity.
*Please note that during COVID-19 restrictions, this aerosol generating test is not being offered. You may book to return for this at a later date, or we will refund you the cost for this test.

Resting electrocardiogram (ECG)
ECG is used to diagnose electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Pure Sports musculoskeletal movement screen and strength & conditioning coaching
A consultation and movement screen with a specialist musculoskeletal physiotherapist at Pure Sports (on-site) to determine injuries, exercise history and gait analysis. A sports coach will then take you through an in-depth strength assessment using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

Body Composition Analysis
A detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Tonometry (glaucoma/eye test)

Radiologist consultation
A results consultation with one of our highly experienced consultant radiologists. A virtual tour viewing hundreds of your MRI scan images, including a video of your beating heart and you will be given a USB of your images to take away on the day.

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 30-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.