25OH Vitamin D2/D3

Alternative Names
  • Vitamin D2
  • 25-hydroxy
  • 25-Hydroxyergocalciferol (25OHD2)
  • Vitamin D3
  • 25-hydroxy
  • D2 Vitamin
  • 25-Hydroxyvitamin D3
  • 25-OH-D3
  • 25-Hydroxycholecalciferol (25OHD3)
  • Vit D
  • LC/MS/MS
  • 25-OH-D2
  • D3 Vitamin
  • 25-Hydroxyvitamin D2
  • 25-Hydroxy Vitamin D (D2+D3 Fractionated)

Test Code: 3005

CPT: 82306
Tests Included 25-OH Vitamin D, Total; Vitamin D, 25-OH, D3; Vitamin D, 25-OH, D2
Use Vitamin D levels are monitored for a number of uses ranging from dietary absorption, parathyroid function, bone weakness/malformation, metabolism of calcium, and to help with measuring Vitamin D treatment effectiveness.
Clinical Utility Vitamin D is a fat soluble vitamin that is important in the regulation of calcium and phosphorous in the body. Vitamin D deficiency has been linked to rickets, osteoporosis and osteomalacia. It has also been associated with many other diseases such as cancer, cardiovascular disease, diabetes, and autoimmune disorders.

There are two biologically active forms of Vitamin D, the D2 (ergocalciferol) and D3 cholecalciferol). Both forms are commonly found in fortified foods and commercially available supplement products. The D2 and D3 products have been used in high potency pharmaceutical grade formulations used to treat specific conditions. Vitamin D2 is derived from plant or fungal sources, while Vitamin D3 is derived from animal sources and is the form synthesized in the skin following exposure to sunlight.

Vitamin D is converted into the 25-hydroxy Vitamin D (25-OHD) metabolite in the liver, which is the major circulating form of Vitamin D used for assessing Vitamin D status. Liquid chromatography coupled with mass spectrometry (LC/MS/MS) is the gold standard technique for measuring D2 and D3. It is the only technique that is able to measure both D2 and D3 concentrations individually.

By comparison, immunoassay-based Vitamin D tests can only provide indirect measurements and produce inaccurate results for patients taking supplements containing D2.
Intended Patient Population 18+ and Older Adult Males & Females
Patient Preparation None Specified
Sample Serum, Plasma
Tube Red, Green, Tiger
Volume 4mL Whole Blood (100 µL Serum/Plasma)
Min Sample Volume 0.05 mLs
Reference Ranges Total Vit D - M & F ≥ 18 yrs old; 30-50 ng/mL
Analytical Measurement Range 1.5-100.00 ng/mL
Critical Values > 80 ng/mL
Units ng/mL
Test Methodology LC/MS/MS
Test Turnaround Time 5 Days
Limitations Values of vitamin D vary with exposure to sunlight and dietary supplementation.
Shipping Room Temperature
Specimen Stability 8 Days RT
Reject Criteria Gross Hemolysis, Expired Sample, Insufficient Quantity
Laboratory Developed Test (LDT) Yes
CMS Guidance LCD L36692
References
  1. Holick MF (2007) Vitamin deficiency. N Engl J Med 357: 266 -281.
  2. Abrams SA (2011) Vitamin D supplementation during pregnancy. J Bone Mineral Res 26: 2338 – 2340.
  3. Holick MF et al (2011) Evaluation, treatment and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 96: 1911 -1930.
  4. Watts NB, Bilezikian JP, Camacho PM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract. 2010;16(Suppl 3):1-37.

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