Test Id : VITK1
Vitamin K1, Serum
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Assessment of circulating vitamin K1 concentration.
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
    
        NY State Available
            
                
                
                    
                    Indicates the status of NY State approval and if the test is orderable for NY State clients.
                
            
    
    
    
        Reporting Name
            
                
                
                    
                    Lists a shorter or abbreviated version of the Published Name for a test
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    Phylloquinone
Phytonadione
Mephyton
Phytomenadione
Synthex
Konakion
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Serum
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Patient Preparation:
Fasting: 12 hours, required; Infants should have specimen collected before next feeding
Supplies: Amber Frosted Tube, 5 mL (T915)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Amber vial
Specimen Volume: 2 mL
Collection Instructions:
1. Within 2 hours of collection, centrifuge the specimen.
2. For red top tubes, immediately aliquot serum into an amber vial (preferred). Serum may sit on whole blood cells up to a maximum of two hours before aliquoting.
3. For serum gel tubes, immediately aliquot serum into an amber vial (preferred). Serum may sit on gel at ambient temperature for a maximum of 24 hours or refrigerated for a maximum of 7 days before aliquoting.
    
        Forms
    
    If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    0.75 mL
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | Gross hemolysis | OK | 
| Lipemia | Reject | 
| Gross icterus | OK | 
    
        Specimen Stability Information
            
                
                
                    
                    Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
                
            
    
    | Specimen Type | Temperature | Time | Special Container | 
|---|---|---|---|
| Serum | Refrigerated (preferred) | 30 days | |
| Ambient | 30 days | ||
| Frozen | 30 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Assessment of circulating vitamin K1 concentration.
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    Vitamin K1, or phylloquinone, is part of a group of similar fat-soluble vitamins in which the 2-methyl-1,4- naphthoquinone ring is common. Phylloquinone is found in high amounts in leafy green vegetables and some fruits (avocado, kiwi). It is a required cofactor involved in the gamma-carboxylation of glutamate residues of several proteins. Most notably, the inactive forms of the coagulation factors prothrombin (factor II), factors VII, IX, and X, as well as protein S and protein C are converted to their active forms by the transformation of glutamate residues to gamma-carboxyglutamic acid (Gla). Other proteins such as those involved in bone metabolism, cell growth and apoptosis also undergo this Gla transformation. Thus, vitamin K plays a critical role in hemostasis (blood clotting) and acute deficiency is characterized by defective blood coagulation. In neonates, low vitamin K levels in breast milk, inadequate placental transport, and hepatic immaturity leading to insufficient synthesis of coagulation proteins can result in the bleeding disorder hemorrhagic disease of the newborn. To minimize this risk, Vitamin K is commonly administered prophylactically immediately after birth. Other at-risk groups for vitamin K deficiency include those with insufficient dietary intake, malabsorption disorders, cystic fibrosis, cholestasis, and alcoholism, as well as liver and pancreatic disease. Several drugs such as coumarin anticoagulants (ie, warfarin) and antibiotics (ie, cephalosporin) have also been shown to interfere with vitamin K metabolism. High doses of vitamin K have not been shown to produce toxicity. Direct measurement of vitamin K1 by liquid chromatography tandem mass spectrometry has been established as a highly effective strategy to assess status and intake.
    
        Reference Values
            
                
                
                    
                    Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
                
            
    
    <18 years: Not established
> or =18 years: 0.10-2.20 ng/mL
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    Low vitamin K1 concentrations in the serum are indicative of insufficiency and poor vitamin K1 status.
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    Testing of nonfasting specimens or the use of vitamin K1 supplementation can result in elevated serum vitamin K1 concentrations.
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Vitamin K-Fact Sheet for Health Professionals. US Department of Health and Human Services, National Institutes of Health. Office of Dietary Supplements. Updated March 29, 2021. Accessed April 9, 2025. Available at: https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
2. Zhang Y, Bala V, Mao Z, Chhonker YS, Murry DJ. A concise review of quantification methods for determination of vitamin K in various biological matrices. J Pharm Biomed Anal. 2019;169:133-141. doi:10.1016/j.jpba.2019.03.006
3. Sodi R, Taylor A. Vitamins and trace elements In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. 8th ed. Elsevier; 2020:466-487
4. Booth SL. Vitamin K: food composition and dietary intakes. Food Nutr Res. 2012;56 :10.3402/fnr.v56i0.5505. doi:10.3402/fnr.v56i0.5505
5. Shearer MJ, Newman P. Metabolism and cell biology of vitamin K. Thromb Haemost. 2008;100(4):530-547
6. Mladenka P, Macakova K, Kujovska Krcmova L, et al. Vitamin K - sources, physiological role, kinetics, deficiency, detection, therapeutic use, and toxicity. Nutr Rev. 2022;80(4):677-698. doi:10.1093/nutrit/nuab061
7. Card DJ, Gorska R, Harrington DJ. Laboratory assessment of vitamin K status. J Clin Pathol. 2020;73(2):70-75. doi:10.1136/jclinpath-2019-205997
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    Deuterated stable isotope (vitamin K1-d7) is added to a serum sample as an internal standard. Protein is precipitated from the mixture by the addition of ethanol. Vitamin K1 and internal standard are extracted from the resulting supernatant by solid-phase extraction. Vitamin K1 and internal standard are then separated utilizing high-throughput liquid chromatography with analysis on a tandem mass spectrometer equipped with a heated nebulizer ion source using multiple-reaction monitoring.(Unpublished Mayo method)
    
        PDF Report
            
                
                
                    
                    Indicates whether the report includes an additional document with charts, images or other enriched information
                
            
    
    
    
        Day(s) Performed
            
                
                
                    
                    Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
                
            
    
    Monday through Friday
    
        Report Available
            
                
                
                    
                    The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        Fees :
            
                
                
                    
                    Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
                
            
    
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        Test Classification
            
                
                
                    
                    Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
                
            
    
    This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
    
        CPT Code Information
            
                
                
                    
                    Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
                
            
    
    CPT codes are provided by the performing laboratory.
84597
    
        LOINC® Information
            
                
                
                    
                    Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
                
            
    
    | Test Id | Test Order Name | Order LOINC Value | 
|---|---|---|
| VITK1 | Vitamin K1, S | 9622-2 | 
| Result Id | Test Result Name | 
                            Result LOINC Value
                                 
                                        
                                        Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
                                     
                                 | 
                    
|---|---|---|
| 62167 | Vitamin K1, S | 9622-2 |