Medical test · Vitamins, minerals & nutrition · full clinical detail

Vitamin D test

Also known as: 25-hydroxyvitamin D test, vitamin D blood test, calcidiol

Measures 25-hydroxyvitamin D, the storage form the liver makes from vitamin D obtained from sunlight on skin and from food or supplements. It is the best single measure of vitamin D status and is used when bone pain, muscle weakness, osteoporosis, malabsorption or a low calcium make deficiency likely.

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Canonical name
25-hydroxyvitamin D
Abbreviations
25-OH D, 25(OH)D
Kind
Laboratory test
Categories
Vitamins, minerals & nutrition, Endocrine & hormone, Bone, joint & musculoskeletal
Specimen
Serum
Method
Immunoassay, Chromatography and mass spectrometry
Terminology
LOINC 62292-8
Type
Blood test
Sample
Blood from a vein
Used for
Suspected vitamin D deficiency, bone disease, malabsorption, before bone treatments
Measures
25-hydroxyvitamin D, the storage form of vitamin D
Result
Numeric, read against deficiency and adequacy cut-offs

Why is it used?

  • Bone pain, muscle weakness or unexplained fatigue when deficiency is suspected
  • Osteoporosis, fractures and before starting bone treatments
  • Low calcium or a raised alkaline phosphatase or parathyroid hormone
  • Conditions that impair absorption: coeliac disease, inflammatory bowel disease, after bariatric surgery
  • Chronic kidney disease and some other long-term conditions

What does it measure?

ComponentWhat it measuresA higher value may be seen inA lower value may be seen in
25-hydroxyvitamin DThe storage form of vitamin DExcess supplementsLittle sunlight, low intake, malabsorption, kidney or liver disease

A high or low value can be associated with several different situations; the result is interpreted with other results, symptoms, history and clinical findings.

How is it performed?

A venous blood sample.

Specimen. Venous blood (serum)

Do I need to prepare?

None.

What do the results generally mean?

FindingWhat it may indicate
DeficientLevels at which bone softening (rickets in children, osteomalacia in adults) becomes likely; treatment with vitamin D is usually given
InsufficientBelow the level considered adequate for bone health; supplementation is often advised, particularly in groups at risk
AdequateSufficient for bone health in most people
Very highUsually from excess supplements; can cause a high calcium and is reviewed
Read against guideline thresholds, not a laboratory range. Vitamin D is read against widely used cut-offs for deficiency, insufficiency and adequacy that differ slightly between countries and professional bodies, not against a population reference interval. The laboratory reports the cut-offs it applies, and the assay method affects the value.

What can affect the result?

  • Season and latitude: levels fall in winter and in people who cover their skin or stay indoors
  • Skin pigmentation, age and body weight
  • Supplements and fortified foods
  • Liver and kidney disease, which affect the conversion of vitamin D
  • The assay method, which changes results between laboratories

Medicines. Vitamin D supplements raise it; some antiepileptics, glucocorticoids, orlistat and cholestyramine lower it.

What can the test not tell you?

  • Bone density, which needs a DXA scan
  • Whether symptoms are caused by the deficiency, which is common and often coincidental
  • The active hormone level (1,25-dihydroxyvitamin D), a separate test used only in specific disorders

Population screening is not recommended; the test is for people with symptoms or risk factors. Assays vary and the value moves with the seasons, so a single result is interpreted with the time of year and the person's circumstances.

Other tests commonly used with it

Catalogued concepts this page covers

Concepts of the master test taxonomy that resolve to this page; each links to its category.

Educational content. Reference ranges differ between laboratories, methods, ages and sexes, and results are always read against the person, the question asked and other findings. This page cannot interpret an individual result.