•We check the vitamin D public service every month using real people around the UK. This forms part of our quality assurance of the service and we hope is also of educational benefit to our users.March 2021Secret shopper JonathanA 64 year old Clinical Scientist recently retired from the NHS and now working on T cell Covid tests in Abingdon. Jonathan is the Father of Jen and Rach below who both had low levels. Jonathan is known to run a low vitamin D unless he takes supplements and especially for Secret Shopper he switched to D2 supplements in January, taking 6000 U a day for 5 weeks before this test. He had previously been taking 2000 U day of a D3 supplements.Comment:This is the first secret shopper we have tested with any measurable Vitamin-D2. All the others have been reported by the lab as 2.8 nmol/L (the limit of detection of the method). While the total level is reasonable at 70 nmol/L the D3 would have given Jonathan a low result. With two of Jonathan’s daughters having a low vitamin D as well once must consider a genetic link to their low vitamin D levels. Turn roundThe lab time was 9 working days which is on the longer edge of the target. In February a health care You Tube health presenter Dr John Campbell used the test on his channel and this has caused some pressure in the laboratory with a lot of extra work from the general public. Things should be back to normal over the next few weeks.February 2021Secret shopper RachA 37 year old hospital consultant living on the south coast with an outdoor lifestyle. The eldest sister of our DEFICIENT trainee anaesthetist Jen (see below - January secret shopper No. 1)Rach takes an oral supplement “when she remembers”.CommentRach has a low level of Vitamin D just getting to the ‘INSUFFICIENT’ level. Not as low as her younger sister below ,who had a level of just 23.4 nmol/L. Not great when you consider she does take some D3 oral tablets sporadically, and also spends weekends doing lots of things outside. This is an interesting finding as these two sisters have a father who has been shown to have very low vitamin D levels over many years. He has changed to D2 oral supplements for a couple of months to see what his natural D3 level is these days. Remember Vitamin D3 is made by your skin as well as being in food/supplements. Vitamin D2 is only obtained from vegetable products and most people have an undetectable level. Rach and Jen have another sister - currently six months pregnant, and she will be our second secret shopper for February in a few days time.Turn RoundThe in-lab time of 5 working days is better than the ‘up to 10 working days’ lab target. However the laboratory saw huge demand for test packs towards the end of February which may impact on turn-round in early March. If you are missing a result do check your spam folders, as the automated system sending the emails is sometimes considered as spam by local systems.January 2021 No.3Secret shopper KarenA 61 year old Solihull resident who has kept strictly to lock-down rules over the last 10 months. Karen is aware of the interest in Vitamin D and possible severity of Covid-19 infection. She takes four oral supplements daily, two of which contain Vitamin D: Boots ‘High Strength Vitamin D3’ and Aldi ‘ Heart Health, Omega 3 fish oil’.CommentKaren has achieved the highest level of Vitamin D of all our secret shoppers to date. It is a level often seen in the laboratory and and such levels are associated with Vitamin D3 supplements being taken. The Boots tablet has 25 ug Vitamin D3 but the amount in the fish oil is not stated - but looks like it does the job!•Do remember there are two oral supplements on the market. D3 comes from animal sources - often extracted from sheep’s wool. D2 is extracted from vegetable sources. •The body also produces D3 in your skin due to UV light. Unless you take a Vitamin D2 supplement your D2 level is usually low. The 2.8 nmol/L you see in all the reports so far is actually the ‘detection limit’ of the method.•We have an upcoming secret shopper who has switched from D3 to D2 supplements to demonstrate this. Please do not ‘do this at home’ though as D3 is thought to be better to supplement, unless advised otherwise by a health care professional.Turn roundKaren posted her sample on a Sunday night in the reply paid first class post pack supplied. It arrived in the laboratory fast. Analysis was prompt with a turn round of 5 working days. The laboratory is to be complimented - the staff are working in very different ways with social distancing and face masks mandatory, and the workload is very high with NHS and research samples and our service to the public.January 2021 No. 2Secret Shopper AudreyAn 89 year old great grandmother who after a stroke a year ago has been a care-home resident in the South-West. She takes a daily Vitamin D supplement, and has done so for many years. She has hardly been outside for over a year.Comment: Audrey’s daily supplements are clearly working well for her. She has achieved a level not only of over 50 nmol/L but also over 75 nmol/L, which is a level that many suggest we should all be aspiring to. She did better than Jen, the junior doctor below and one of her six grandchildren!Turn round:Considering the laboratory has had Christmas and New Year, not to mention special working for social distancing, the turn-round of 4 working days is exceptionally good.
January 2021 No. 1
Secret Shopper JenA 31 year old hospital doctor in London currently working extra shifts in the back of an ambulance helping transfer Covid-19 patients between ITUs. She is vegetarian and spends a lot of time outdoors. She does not take vitamin supplements.
Jen was surprised that she was deficient. She intends taking several 25 ug (1,000 IU) vitamin D3 tablets/day to get her level up. We have offered her a retest next month.Turn round:The service is hugely busy at present. Considering this sample arrived just two days before Christmas, a turn-round of 10 working days is pretty good. We have set up a second secret shopper in January to see how things are going.
Secret Shopper ChrisChris was our second secret shopper from November. He sent his sample back the same time as his wife, whose results are below. Unfortunately his spots were not very good and the laboratory was not happy to analyse them and sent Chris a free of charge pack to try again. Second time round his spots were just as bad - there was not enough blood to go right through the filter paper. So…… the laboratory kindly sent Chris a third test pack, again free of charge. This time Chris went the extra mile and there was enough blood on the card to analyse!Comments: •Chris has a reasonable level of Vitamin D at 56.1 nmol/L. However he does take two daily supplements containing Vitamin D and he was a bit surprised it was not higher.•The laboratory does not analyse samples that might give misleading results, but rather sends out a fresh pack if there are concerns about the blood spot appearance. This can be for samples that are insufficient, and also where it looks like there has been ‘overspotting’, that is several drops of blood placed on top of each other.Turn round - the return of the sample by first class post from Chris was reasonable considering it was the week before Christmas. The laboratory turned the result round in less than 3 working days which is excellent considering how busy they are with their work tripling over the last year due to concerns about getting Vitamin D levels right during the pandemic.November 2020Secret Shoppers Judith & Chris•We have two secret shoppers this month. Judith and Christopher live together in Kent and are retired. They both take cod liver oil every day and also a multi-vitamin tablet. They put their samples in the post at the same time in separate pre-paid envelopes.Comments:•Judith’s sample took over a week to arrive - the lab is experiencing some postal delays at present. Once in the laboratory the sample was analysed in 4 working days and reported back by email the same day. Considering the laboratory staff are all coping with the second lock-down and a huge growth in workload, this is extremely impressive. Judith has a good level of Vitamin D which would be expected from her long-term oral supplementation.•Chris’s results have not come back yet which is not unusual. Chris and Judith’s samples may have been on separate runs, or the lab may have needed to reanalyse Chris’s sample as they wanted to check the result.
Secret shopper Sue•Su is a 28 year old female engineer who has worked mainly from home in Birmingham since lock-down. She takes a 25ug (1,000 IU) tablet of Vitamin D3 daily.Comments:•Su has an adequate level but without her supplement she would almost certainly have been in the ‘insufficiency’ category.•Turn-round is at the upper end of the laboratory target, at 9 working days. The laboratory had some machine problems in mid-October requiring a service engineer for the LC-MS/MS equipment.
Secret shopper Richard•Richard is a 61 year old male, who works outdoors as a lawn care expert in Warwickshire, and has never taken vitamin D supplements. Comments: •Laboratory: Turn round excellent at <2 working days in lab. •Result: Richard’s level is in the ADEQUATE category. He was slightly underwhelmed, as he thought his Vitamin D would be higher with all his time outdoors over a sunny summer. He intends to take a supplement now through the winter. We might use him again in March and see how his level kept up without the sun.
BCPS-V. 2020/18/2Last Updated:4th March 2021Review Date: 4th March 2021
•The lab reports below state the date the sample was taken, received in the laboratory and tested. In blue we have added the date the emailed result got back to the Secret Shopper.•Each report comes with a clear interpretation as shown here.