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Serum 25-OH Vitamin D

Specimen Required

3-5cc Clotted Blood or Serum

Fasting Required

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Purpose of the Test

To investigate a problem related to bone metabolism or parathyroid function, possible vitamin D deficiency, malabsorption, before commencing specific bone treatment and to monitor some patients taking vitamin D.

When this test is required

25-hydroxyvitamin D may be requested: If there is evidence of a defect in bone metabolism reflected by an abnormal calcium, phosphate or PTH concentration in the blood. If a patient has symptoms of vitamin D deficiency, such as bone malformation in children (rickets) and bone weakness, softness, or fracture in adults (osteomalacia). If a patient may need supplementation of vitamin D prior to starting a specific form of treatment for bone disease. If a patient suffers from malabsorption. Malabsorption, causing vitamin D deficiency may occur in individuals following a gastric bypass or in patients with fat malabsorption such as in cystic fibrosis or Crohn’s disease. If a patient that is supplemented with vitamin D continues to experience symptoms of vitamin D deficiency.1,25 dihydroxyvitamin D may be requested if the calcium concentration is high or the patient has a disease that might produce excess amounts of 1,25 dihydroxyvitamin D, such as sarcoidosis or some forms of lymphoma.

What the Test Detects

The main role of vitamin D is to help regulate the absorption of calcium, phosphate and (to a lesser extent) magnesium from the gut. Vitamin D is vital for the growth and health of bone; without it, bones will be soft, malformed, and unable to repair themselves normally, resulting in the disease called rickets in children and osteomalacia in adults. Vitamin D also plays an important role in musculoskeletal health. There are two…The main role of vitamin D is to help regulate the absorption of calcium, phosphate and (to a lesser extent) magnesium from the gut. Vitamin D is vital for the growth and health of bone; without it, bones will be soft, malformed, and unable to repair themselves normally, resulting in the disease called rickets in children and osteomalacia in adults. Vitamin D also plays an important role in musculoskeletal health. There are two forms of vitamin D that can be measured in the blood – 25 hydroxyvitamin D and 1,25 dihydroxyvitamin D. 25 hydroxyvitamin D is the major form of vitamin D and is the relatively inactive component from which the active hormone, 1,25 dihydroxyvitamin D is made. 25 hydroxyvitamin D is the most useful indicator of vitamin D status in individuals, and is the form most commonly measured. It is the best way of estimating vitamin D status. This is because 25 hydroxyvitamin D remains in the blood longer and is present at much higher concentrations than 1,25 dihydroxyvitamin D. Occasionally it may be necessary to measure 1,25 dihydroxyvitamin D to find out whether the kidney is converting an appropriate amount of inactive 25-hydroxyvitamin D to the active 1,25 dihydroxyvitamin D. Vitamin D comes from 2 sources: It is 1) produced in the skin following exposure to sunlight (endogenous source 80%-90% of the total) and 2) ingested from foods and supplements (exogenous source 10%-20% of the total). The chemical structures of these types of vitamin D are slightly different. Vitamin D2 (ergocalciferol) is the form found in foods of vegetable origin and vitamin D3 (cholecalciferol) is the form produced in the skin and is also found in foods of animal origin. Both forms of vitamin D may be present in vitamin preparations and supplements. For most people, the majority (up to 90%) of vitamin D is formed following the action of sunlight upon the skin. Both vitamin D2 and vitamin D3 are converted to 25-hydroxyvitamin D and then to 1,25 dihydroxyvitamin D. Some vitamin D blood tests do not distinguish D2 and D3 forms of the vitamin and the result therefore gives an indication of the total amount of vitamin D present within the bloodstream. How is the sample collected for testing? A blood sample is obtained by inserting a needle into a vein in the arm. Is any test preparation needed to ensure the quality of the sample? No test preparation is needed. See MoreSee Less

Preparation for the Test

None required

Sample Requirements

A blood sample taken from a vein in your arm

Additional Notes

High levels of vitamin D and calcium can lead to the calcification and damage to organs particularly the kidneys and blood vessels. If magnesium levels are low, they can cause a low calcium level that is resistant to vitamin D and parathyroid hormone regulation. It may be necessary to supplement both magnesium and calcium to regain normal function.