Biomarkers · Vitamins & Endocrine
Serum 25-Hydroxyvitamin D
Higher values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 16% lower risk of death. We found the same pattern in NHANES
Serum 25-Hydroxyvitamin D and risk of death
Published curve higher than the NHANES fitNHANES fit higher
Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
Serum 25-Hydroxyvitamin D by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 26.5 | 45.7 | 59.7 | 74.4 | 101 | 1,447 | NHANES 2017-2018 |
| All | 40-59 | 29.7 | 54.3 | 70.8 | 88.2 | 126 | 1,572 | NHANES 2017-2018 |
| All | 60+ | 36.9 | 63.8 | 87.0 | 107 | 148 | 1,917 | NHANES 2017-2018 |
| All | all | 29.7 | 52.1 | 69.8 | 90.9 | 128 | 4,936 | NHANES 2017-2018 |
| Men | 20-39 | 26.3 | 45.4 | 58.4 | 71.5 | 95.7 | 693 | NHANES 2017-2018 |
| Men | 40-59 | 31.0 | 54.5 | 69.6 | 83.8 | 119 | 736 | NHANES 2017-2018 |
| Men | 60+ | 37.4 | 60.4 | 79.0 | 102 | 136 | 972 | NHANES 2017-2018 |
| Men | all | 30.7 | 51.0 | 67.3 | 85.2 | 120 | 2,401 | NHANES 2017-2018 |
| Women | 20-39 | 26.6 | 46.7 | 61.4 | 76.9 | 106 | 754 | NHANES 2017-2018 |
| Women | 40-59 | 29.0 | 53.7 | 72.0 | 91.9 | 130 | 836 | NHANES 2017-2018 |
| Women | 60+ | 35.5 | 69.1 | 92.3 | 110 | 156 | 945 | NHANES 2017-2018 |
| Women | all | 29.1 | 54.2 | 72.9 | 94.3 | 132 | 2,535 | NHANES 2017-2018 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in Serum 25-Hydroxyvitamin D, study by study
9 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| diet | Dietary fatty fish consumption (salmon) | Salmon 3 x 150 g/wk for 8 wk increased serum 25-hydroxyvitamin D (P < 0.01; effect size not reported) | RCT | Lucey AJ, et al. Influence of moderate energy restriction and seafood… |
| environmental | Sensible solar ultraviolet B (UVB) exposure (15-20 min midday during summer) | Simulated summer sunlight (1.3 SED three times weekly for 6 weeks): 90% reached 25(OH)D of 20 ng/ml and 26.2% reached 32 ng/ml | non-randomised trial | Rhodes LE, et al. Recommended summer sunlight exposure levels can produce… |
| environmental | Solar ultraviolet B (UVB) exposure (week-long sun holiday) | 1-week sun holiday raised serum 25(OH)D3 by 13·0-28·0 nmol L-1 (by sunscreen use) vs a 2·5 nmol L-1 fall in non-holiday group | RCT | Young AR, et al. Optimal sunscreen use, during a sun holiday with a very high… |
| nutraceutical | Oral Vitamin D3 (Cholecalciferol) supplementation | Raised serum 25(OH)D by 37 nmol/L (95% CI 33-41); 39.3 nmol/L with doses ≥800 IU/d (33 RCTs) | meta-analysis | Shab-Bidar S, et al. Serum 25(OH)D response to vitamin D3 supplementation: a… |
| supplement | Vitamin D3 4000 IU daily for 3 years in community-dwelling healthy adults aged 55-70 with baseline 25(OH)D 30-125 nmol/L | 25(OH)D 81.3 -> 115.3 nmol/L at 3 months and 132.2 nmol/L at 3 years with 4000 IU/day (400 IU group: 76.3 -> 77.4) | RCT | Burt LA, Billington EO, Rose MS, et al. Effect of High-Dose Vitamin D… |
| supplement | Vitamin D3 4000 IU daily in adults with prediabetes not selected for vitamin D insufficiency | Mean 25(OH)D rose from 27.7 to 54.3 ng/mL by month 24 with vitamin D vs 28.2 -> 28.8 ng/mL with placebo | RCT | Pittas AG, Dawson-Hughes B, Sheehan P, et al. Vitamin D Supplementation and… |
| supplement | Vitamin D 4000 IU daily for up to 90 days until trigger day in women with PCOS undergoing IVF | 25(OH)D on trigger day 32.3 vs 18.2 ng/mL with placebo; adjusted mean difference 13.6 ng/mL (95% CI 10.9-16.3) | RCT | Hu KL, Liao T, Wu Q, et al. Vitamin D supplementation before in vitro… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Intestinal malabsorption (pediatric celiac disease) | Celiac disease: 25(OH)D3 lower by 5.77 nmol/L (95% CI -10.86 to -0.69) vs controls; deficiency OR 2.20 (1.19-4.08) | meta-analysis | Sun Y, et al. Relationship between vitamin D levels and pediatric celiac… |
| lifestyle | Sun avoidance and indoor confinement (frequent sunscreen use, pandemic restrictions) | Reduced days outdoors (COVID-19) lowered 25OHD to 13.2 vs 21.7 ng/mL; deficiency (<20 ng/mL) in 62.5-91.3% by season | cross-sectional | Tsugawa N, et al. Vitamin D Status in Japanese Young Women in 2016-2017 and… |
What else moves this marker
They describe those study groups, not an individual, and an association is not a cause.
Diseases and conditions
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↓ Vitiligo · serum 25(OH)D in vitiligo patients vs controls | SMD -0.94 (95% CI -1.39 to -0.48) | vitiligo vs controls · 17 studies | meta analysis · PMID 30024533 |
Sources
- Risk curve: Garland CF 2014 (PMID 24922127): all-cause HR 1.9 (1.6-2.2) lowest (0-9 ng/mL) vs highest (> 30 ng/mL) category of 25(OH)D. Scaled to US values (NHANES).
- Garland CF, et al. Meta-analysis of all-cause mortality according to serum 25-hydroxyvitamin D. Am J Public Health. 2014;104(8):e43-e50.
- NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Serum 25-Hydroxyvitamin D against another biomarker.
Related markers: Adiponectin · C-peptide · Dehydroepiandrosterone Sulfate (DHEA-S) · Estradiol-to-SHBG Ratio · Free Triiodothyronine (Free T3) · Insulin-like Growth Factor 1 (IGF-1) · Serum Cortisol · Serum Folate