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Practice Protocol for Vitamin D Treatment

Whenever a vitamin D level of less than 50 nmol/L is discovered there should be a review of the patient’s past medical history including drug history. The BMI should be measured as well as checking renal function (including urinalysis for nephrotic syndrome), calcium and phosphate, liver function, thyroid function, full blood count, ferritin, ESR and CRP. The medical history should consider the possibility of autoimmune disease as well as malabsorption and if appropriate tests for these conditions should be undertaken as well. A PTH level should be considered according to calcium levels.

Treatment should be Colecalciferol (vitamin D3) unless the patient is a vegan when Ergocalciferol (vitamin D2) can be used. Vitamin D3 is available as Fultium-D3 capsules at either 800, 3,200 or 20,000 IU (N.B. excipients include peanut oil). Vitamin D2 is available as either 10,000 or 50,000 IU tablets.

If the vitamin D level is less than 30 than a fixed loading dose of 300,000 IU over 6 – 10 weeks should be prescribed. Schedules may be according to patient preference as daily 4,000 IU for ten weeks, once weekly 50,000 IU for six weeks, or twice weekly 20,000 IU for seven weeks. This should be followed by 1,000 IU daily for life although this should be discontinued if the patient is breastfeeding.

If the vitamin D level is 30 – 50 nmol/L then the dose is 1,000 IU daily for life without a loading dose.

The management in chronic renal failure or severe liver disease or in the presence of an elevated parathyroid hormone should be with specialist assistance.

The parathyroid hormone should be checked six months after starting treatment.

The dietary calcium intake should be calculated and addressed by diet using the calculator available at www.cgem.ed.ac.uk/research/rheumatological/calcium-calculator. If dietary change is not possible then a supplement should be given but this should not be Calcichew D3.

All residents in the UK are currently advised to take a vitamin D supplement of 400 IU daily.

Dr Sophia Khalique

Nick and Sophia are top professionals with a comprehensive network of specialists, should they be needed, in the vicinity of Harley street. I have seen a number of them and all have been “top quartile” in my opinion.
Jim Ratcliffe, INEOS
48 Wimpole Street practice has taken outstanding care of my family for three generations. They are a fantastic team, from the doctors to the practice staff. I am always confident that we receive the best of care and advice.
Shrai Madhvani
I have been visiting the Wimpole Street practise for 10 years now and can honestly say the level of service I have received is second to none. Sophia and her team always go above and beyond to ensure their patients receive the warmest welcome and …
James Myers, Group Managing Director TVC Group
I have been both a patient of Dr Khalique’s and she has worked with us in our business for a number of years. I and my team have been constantly impressed with her medical expertise, professionalism and caring manner. She is supported by terrific staff …
Sara Geater
Dr Khalique provides invaluable professional support to Thames. The Practice at 48 Wimpole Street is integral to the screening and welfare of contributors taking part in our highest profile television programmes. The consultancy provided to our productions ensures that we can offer the best and …
Dean Jones. Director of Production, Thames
I have and our company has been a patient of Dr Sophia Khalique’s and ’48 Wimpole Street’ for 15 years. She and her team are fantastic; they have a wonderful manner, truly care about their patients, are totally professional and give great advice. We use all their facilities …
Nick True Chairman TLC Marketing Worldwide
As a family, we are very content with the services we have received from the practice of Dr Sawyer and Dr Khalique. The caring and accommodating staff have always been assuring to any urgent need we have had in the past. For a small practice …
Fauziah and Jeremy Robinow
For me Sophia has been a constant presence and support through a couple of particularly torrid and potentially (but not yet!) terminal years. Consultants are highly focused and knowledgeable doctors, but they cannot generally, and do not, provide the sort of constant holistic care that …
John Stephens, Barrister, Lincoln’s Inn
Having known Dr Khalique for fifteen years, we have developed a great relationship as she has seen me grow up and been with me every step of the way to make sure I became the healthy, happy person I am today. Most people my age …
Yasmin, First year student at Bristol University
Having experienced the service provided by Nick and Sophia, Timothy James & Partners recommend all important clients’ medicals be carried out by their practice. It is efficient and we stay in control of the paperwork and medical underwriting. Many of those clients that have been …
Timothy Whiting, Timothy James & Partners
Dr. Nick Sawyer has kept us in good health for more than 15 years. He has always been kind and caring and referred us to top specialists whichever care has been our need. We are always confident that whatever the reason for our visit we …
Philipa and Michael Bradley
Sophia Khalique has been our family doctor for the past fourteen years. She has not only seen us through the birth of my youngest son and the usual childhood and adult ailments but also through major illnesses, both chronic and acute. Sophia has been our …
Mrs M Jay and Mr R Pyke
I have known Dr Khalique for many years. She has all the qualities of a top doctor. She has compassion and sympathy in addition to being extremely competent professionally. She is a joy to work with and has a lovely bedside manner. I would heartily …
Dr Charlie Cockerell
The Bechtel Corporation have relied upon Dr. Sawyer for the past 25 years and Dr. Khalique for 15 years for medical services that include pre foreign assignment medicals, executive medical evaluation, preventative services, medical risk assessments and all manner of GP services. We work all …
Rob Bull, HR Manager, Bechtel Corporation
I have the great pleasure in being both a personal patient of Dr Sophia Khalique and of having a professional relationship with her and her practice at 48 Wimpole street for Medical and psychiatric pre-care and after care for the contestants that audition and appear …
Richard Holloway, M.D. Thames Television. Interim C.E.O. Fremantle Media U.K.