News articles since the start of the COVID-19 pandemic have hypothesised that you are more likely to suffer severe COVID-19 if your levels of vitamin D are low. Although more research must still be done, there is a striking overlap between risk factors for severe COVID-19 and vitamin D deficiency, including obesity, older age, and black or Asian ethnic origin.

The Lancet reports that the ‘interest in a potential role for vitamin D in the prevention or treatment of acute respiratory infections dates back to the 1930s, when cod liver oil was investigated as a means to reduce industrial absenteeism due to the common cold. Meta-analyses of randomised controlled trials conducted from 2007–20 reveal protective effects of vitamin D against acute respiratory infections, albeit these effects were of modest size and with substantial heterogeneity.’

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.

 

The Lancet reports that, ‘A number of hospital-based treatment trials have been registered to date, but it may prove challenging to detect a signal for vitamin D supplementation in severe COVID-19 for two reasons. First, patients tend to present to hospital in the hyperinflammatory stage of the disease, so it might be too late for them to benefit from any antiviral effects induced by vitamin D supplementation. Second, it could be hard to show the effect of a micronutrient over and above dexamethasone, which has potent anti-inflammatory actions and now represents the standard of care in severe disease. Prevention of SARS-CoV-2 infection also represents an ambitious target, given the highly infectious nature of the pathogen.’ More research is certainly needed and official bodes such as the Scientific Advisory Committee on Nutrition and the National Institute for Health Care and Excellence (NICE) are reviewing the role of vitamin D in the context of respiratory infections and coronavirus.

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. Public Health England say, ‘There is no evidence to support taking vitamin D supplements to specifically prevent or treat COVID‑19. However, all people should continue to follow UK Government advice on daily vitamin D supplementation to maintain bone and muscle health during the COVID‑19 pandemic’. To protect bone and muscle health, the UK Government advises that everyone needs vitamin D equivalent to an average daily intake of 10 micrograms (400 international units) during the autumn and winter months. They also advise that people whose skin has little to no exposure to sunlight and ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, should consider taking a vitamin D supplement all year round. This advice would also apply to people whose skin has little to no exposure to sunlight because they are indoors shielding or self-isolating. At the time of writing this article, scientists at Queen Mary Hospital  have launched a major new trial to discover whether the rrisks from the virus can be reduced by taking vitamin D, they are seeking over 5,000 people to take part in the trial over the winter months. On 15th October 2020, Health Secretary, Matt Hancock also urged people to take vitamin D to help boost their overall health amid mounting evidence it can protect against Covid-19.

Bibliography:

The Lancet

Public Health England

The British Heart Foundation

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.

Exercise Stress Echocardiogram
Preventicum are the first UK clinic to introduce this test as part of a screening health assessment. Stress echocardiography uses specialist ultrasound imaging combined with the exercise stress test to show how well your heart muscle is working to pump blood to your body, and it is most often used to detect a decrease in blood flow to the heart from narrowing of the coronary arteries. The test assesses heart function and structure, and can diagnose underlying heart disease.

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.