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home:tests:25d [10.12.2018] – [Read more] sallieqhome:tests:25d [09.14.2022] (current) – external edit 127.0.0.1
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 <relatedarticle> [[home:pathogenesis:vitamind:low25d|Diseases associated with low levels of 25-D]] </article> <relatedarticle> [[home:pathogenesis:vitamind:low25d|Diseases associated with low levels of 25-D]] </article>
  
-Lower than normal levels of 25-D have been independently associated both with all-cause mortality(({{pubmed>long:18695076}})) and dozens of chronic inflammatory diseases ranging from alcoholism (({{pubmed>long:11005548}})) to allergies(({{pubmed>long:19154546}})) to prostate cancer.(({{pubmed>long:15663995}}))+Lower than normal levels of 25-D have been independently associated both with all-cause mortality(({{pmid>long:18695076}})) and dozens of chronic inflammatory diseases ranging from alcoholism (({{pmid>long:11005548}})) to allergies(({{pmid>long:19154546}})) to prostate cancer.(({{pmid>long:15663995}}))
  
 For this reason, low levels of 25-D can be used (in countries that supplement) as a [[home:pathogenesis:epidemiology#low_levels_of_25-d_as_a_proxy_for_disease|proxy for chronic disease]]. For this reason, low levels of 25-D can be used (in countries that supplement) as a [[home:pathogenesis:epidemiology#low_levels_of_25-d_as_a_proxy_for_disease|proxy for chronic disease]].
 ===== Not a simple fat-soluble vitamin ===== ===== Not a simple fat-soluble vitamin =====
  
-A recent analysis concluded that surrogate markers for vitamin D exposure including age, vitamin D intake, supplement use, latitude, etc. taken together, could explain only 21 percent of the variation in vitamin D levels between people.(({{pubmed>long:20219959}}))+A recent analysis concluded that surrogate markers for vitamin D exposure including age, vitamin D intake, supplement use, latitude, etc. taken together, could explain only 21 percent of the variation in vitamin D levels between people.(({{pmid>long:20219959}}))
  
-As a 2010 Tasmanian study demonstrated, body fat is not simply a passive reservoir for 25-D. The study showed that the associations between body adiposity (fat) measures and change in 25-D completely disappeared after adjustment for leptin (an appetite hormone), diminished after adjustment for IL-6 (a cytokine), but remained unchanged after adjustment for total cholesterol/HDL ratio. Therefore, in addition to season and sun exposure, 25-D levels appear to be determined by metabolic and, to a lesser extent, inflammatory factors, and these appear to mediate the effects of adiposity (body fat) on change in 25-D.(({{pubmed>long:20804516}}))+As a 2010 Tasmanian study demonstrated, body fat is not simply a passive reservoir for 25-D. The study showed that the associations between body adiposity (fat) measures and change in 25-D completely disappeared after adjustment for leptin (an appetite hormone), diminished after adjustment for IL-6 (a cytokine), but remained unchanged after adjustment for total cholesterol/HDL ratio. Therefore, in addition to season and sun exposure, 25-D levels appear to be determined by metabolic and, to a lesser extent, inflammatory factors, and these appear to mediate the effects of adiposity (body fat) on change in 25-D.(({{pmid>long:20804516}}))
  
 ===== Reference range for 25-D ===== ===== Reference range for 25-D =====
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 Observational studies show that populations which avoid vitamin D consumption have naturally low levels of 25-D and remain healthy with such levels.  Observational studies show that populations which avoid vitamin D consumption have naturally low levels of 25-D and remain healthy with such levels. 
  
-  * A study which tested the level of 25-D in 90 “healthy, ambulatory Chilean women” showed that 27% of the premenopausal and 60% of the postmenopausal women had 25-D levels under 20 ng/ml. (({{pubmed>long:17290161}}))      +  * A study which tested the level of 25-D in 90 “healthy, ambulatory Chilean women” showed that 27% of the premenopausal and 60% of the postmenopausal women had 25-D levels under 20 ng/ml. (({{pmid>long:17290161}}))      
-  * A study on healthy Bangladeshi women found that approximately 80% of the women had a level of 25-D under 16 ng/ml. (({{pubmed>long:16500882}}))  +  * A study on healthy Bangladeshi women found that approximately 80% of the women had a level of 25-D under 16 ng/ml. (({{pmid>long:16500882}}))  
-  * In a 1992 study, healthy full-term infants from China had serum concentrations of 25-D ranging from an average of 5 ng/ml to 14 ng/ml.  (({{pubmed>long:1578308}}))+  * In a 1992 study, healthy full-term infants from China had serum concentrations of 25-D ranging from an average of 5 ng/ml to 14 ng/ml.  (({{pmid>long:1578308}}))
 ==== Patients with chronic diseases naturally downregulate levels of 25-D ==== ==== Patients with chronic diseases naturally downregulate levels of 25-D ====
  
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-There are several molecular pathways activate in chronic inflammatory disease, which cause levels of 25-D to fall to "deficient" levels. (For example, Reid //et al.// showed that blood levels 25-D decrease after an inflammatory insult such elective knee arthroplasty.(({{pubmed>long:21411617}}))) It is in the interest of such patients to have low levels of 25-D, as low levels increase the activity of the VDR – a receptor which, when activated, plays a key role in innate immune function.+There are several molecular pathways activate in chronic inflammatory disease, which cause levels of 25-D to fall to "deficient" levels. (For example, Reid //et al.// showed that blood levels 25-D decrease after an inflammatory insult such elective knee arthroplasty.(({{pmid>long:21411617}}))) It is in the interest of such patients to have low levels of 25-D, as low levels increase the activity of the VDR – a receptor which, when activated, plays a key role in innate immune function.
  
 Under such circumstances, a patient who supplements with vitamin D may see a rise in 25-D. However, the increase in serum levels of 25-D would not be quite as high as it otherwise would be in a healthy person. Under such circumstances, a patient who supplements with vitamin D may see a rise in 25-D. However, the increase in serum levels of 25-D would not be quite as high as it otherwise would be in a healthy person.
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-The rate at which 25-D declines in Marshall Protocol patients tends to vary. Adams //et al.// (right) showed that the rate of at which 25-D declined among people who taken high amounts of vitamin D supplements and subsequently abstained from supplements is approximately 10.7 ± 3.0 nmol/L per month.(({{pubmed>long:9245225}}))+The rate at which 25-D declines in Marshall Protocol patients tends to vary. Adams //et al.// (right) showed that the rate of at which 25-D declined among people who taken high amounts of vitamin D supplements and subsequently abstained from supplements is approximately 10.7 ± 3.0 nmol/L per month.(({{pmid>long:9245225}}))
 ===== Recalcitrant 25-D – why 25-D could remain high over the course of several years ===== ===== Recalcitrant 25-D – why 25-D could remain high over the course of several years =====
  
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 Here are several factors may play a role in contributing to unexpected levels of 25-D: Here are several factors may play a role in contributing to unexpected levels of 25-D:
  
-  * **Yeast may be able to produce a 25-D precursor** – Patients who have large yeast overgrowth such as //Candida// may have elevated levels of 25-D as //Candida// produces ergosterol, a Vitamin D2 precursor.(({{pubmed>long:6016607}})) (({{pubmed>long:8561481}})) If this is the case, one would expect a large D2 contribution to total 25-D. This could be assessed if the test is broken down in this fashion, which it not always is.+  * **Yeast may be able to produce a 25-D precursor** – Patients who have large yeast overgrowth such as //Candida// may have elevated levels of 25-D as //Candida// produces ergosterol, a Vitamin D2 precursor.(({{pmid>long:6016607}})) (({{pmid>long:8561481}})) If this is the case, one would expect a large D2 contribution to total 25-D. This could be assessed if the test is broken down in this fashion, which it not always is.
  
 <blockquote>I have found elevated levels of 25-D in compliant patients. It is usually due to an intestinal //Candida// overgrowth or biofilm. I have found treating with Nystatin, a non-absorbable antifungal azole effective in reducing //Candida// load and with resultant marked reduction in 25-D levels, often within 1 to 2 months. <blockquote>I have found elevated levels of 25-D in compliant patients. It is usually due to an intestinal //Candida// overgrowth or biofilm. I have found treating with Nystatin, a non-absorbable antifungal azole effective in reducing //Candida// load and with resultant marked reduction in 25-D levels, often within 1 to 2 months.
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 {{tag>tests}}   {{tag>tests}}  
  
 +<nodisp>
 ===== Notes and comments ===== ===== Notes and comments =====
  
-  * Vitamin D: More May Not Be Better; Benefits in Healthy Adults Wear Off at Higher Doses, Research Suggests ... http://www.sciencedaily.com/releases/2013/05/130501192929.htm ... +  * Vitamin D: More May Not Be Better; Benefits in Healthy Adults Wear Off at Higher Doses, Research Suggests ... https://www.sciencedaily.com/releases/2013/05/130501192929.htm ... 
 "Above 21 nanograms per milliliters, the data suggest that the protective effect appears to wear off" "Above 21 nanograms per milliliters, the data suggest that the protective effect appears to wear off"
  
   * Need to find page to put link to for the d-metabolite feedback diagram.   * Need to find page to put link to for the d-metabolite feedback diagram.
   * Legacy content    * Legacy content 
-    * http://www.curemyth1.org/view_topic.php?id=670&forum_id=2 how to post your d test results  e21  e28 +    * https://www.curemyth1.org/view_topic.php?id=670&forum_id=2 how to post your d test results  e21  e28 
-    * http://www.marshallprotocol.com/forum32/2019.html how often should I test d levels?  f214 +    * https://www.marshallprotocol.com/forum32/2019.html how often should I test d levels?  f214 
-    * http://www.marshallprotocol.com/forum32/1756.html can my 25-d be too low? +    * https://www.marshallprotocol.com/forum32/1756.html can my 25-d be too low? 
-    * http://www.marshallprotocol.com/forum32/1599.html importance of reducing 25-d f338+    * https://www.marshallprotocol.com/forum32/1599.html importance of reducing 25-d f338
  
 Question, when both D2 & D3 are measured, is the D3 result alone considered the 25D value? Question, when both D2 & D3 are measured, is the D3 result alone considered the 25D value?
-  * http://www.questdiagnostics.com/vitamind/index.html +  * https://www.questdiagnostics.com/vitamind/index.html 
-  * http://www.questdiagnostics.com/hcp/topics/endo/vitamin_d.html+  * https://www.questdiagnostics.com/hcp/topics/endo/vitamin_d.html
        
 Also, what about claims that Quest's new testing is creating false "high" results... Also, what about claims that Quest's new testing is creating false "high" results...
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 I'm really surprised that this kind of thing is going on! I'm really surprised that this kind of thing is going on!
  
-Zeta brought the Cannell/Quest info to a discussion here http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/v itamin-d-testing-problem/ I didn't read it closely then because I don't use Quest.+Zeta brought the Cannell/Quest info to a discussion here https://www.inspire.com/groups/national-osteoporosis-foundation/discussion/v itamin-d-testing-problem/ I didn't read it closely then because I don't use Quest.
  
 I'm going to find out about the method used by my Lab, and Jacqueline I really appreciate that you brought this topic up again! I'm going to find out about the method used by my Lab, and Jacqueline I really appreciate that you brought this topic up again!
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 Here are some of the links I checked: Here are some of the links I checked:
  
-http://laboratory-manager.advanceweb.com/Editorial/Content/Editorial.aspx?C C=191618+https://laboratory-manager.advanceweb.com/Editorial/Content/Editorial.aspx?C C=191618
  
-http://mbnpa.org/files/documents/VitaminD/AccuracyInTestingVitaminD.pdf+https://mbnpa.org/files/documents/VitaminD/AccuracyInTestingVitaminD.pdf
  
-http://www.questdiagnostics.com/hcp/topics/endo/vitamin_d.html+https://www.questdiagnostics.com/hcp/topics/endo/vitamin_d.html
  
-http://www.curezone.com/forums/fm.asp?i=1345487 (or perhaps see http://articles.mercola.com/sites/articles/archive/2009/01/20/the-overwhelm ing-evidence-that-sunlight-fights-cancer.aspx )+https://www.curezone.com/forums/fm.asp?i=1345487 (or perhaps see https://articles.mercola.com/sites/articles/archive/2009/01/20/the-overwhelm ing-evidence-that-sunlight-fights-cancer.aspx )
  
-http://www.ajcn.org/cgi/reprint/87/4/1087S.pdf+https://www.ajcn.org/cgi/reprint/87/4/1087S.pdf
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 Roux-en-y gastric bypass (RYGB) surgery is associated with dramatic improvements in obesity-related comorbidity, but also with nutritional deficiencies. Vitamin D concentrations are depressed in the severely obese, but the impact of weight loss via RYGB is unknown. We determined associations between adiposity and systemic 25-hydroxyvitamin D (25(OH)D) during weight loss and the immediate and longer-term effects of RYGB. Plasma 25(OH)D concentrations and fat mass (FAT) were determined by immunoassay and air displacement plethysmography, respectively, at 0 (before RYGB surgery), and at 1, 6, and 24 months in severely obese white and African American (AA) women (n = 20). Decreases in adiposity were observed at 1, 6, and 24 months following RYGB (P < 0.05). Plasma 25(OH)D concentrations increased at 1 month (P = 0.004); a decreasing trend occurred over the remainder months after surgery (P = 0.02). Despite temporary improvement in vitamin D status, a high prevalence of vitamin D insufficiency was observed (76, 71, 67, and 82%, at baseline, 1, 6, and 24 months, respectively), and plasma 25(OH)D concentrations were lower in AA compared to white patients (P < 0.05). Strong positive baseline and 1 month cross-sectional correlations between FAT and plasma 25(OH)D were observed, which remained after adjustment for age and race subgroup (β = 0.76 and 0.61, respectively, P = 0.02). In conclusion, 25(OH)D concentrations increased temporarily and then decreased during the 24 months following RYGB. The acute increase and the positive associations observed between adipose tissue mass and systemic 25(OH)D concentrations suggest storage in adipose tissue and release during weight loss</blockquote>. Roux-en-y gastric bypass (RYGB) surgery is associated with dramatic improvements in obesity-related comorbidity, but also with nutritional deficiencies. Vitamin D concentrations are depressed in the severely obese, but the impact of weight loss via RYGB is unknown. We determined associations between adiposity and systemic 25-hydroxyvitamin D (25(OH)D) during weight loss and the immediate and longer-term effects of RYGB. Plasma 25(OH)D concentrations and fat mass (FAT) were determined by immunoassay and air displacement plethysmography, respectively, at 0 (before RYGB surgery), and at 1, 6, and 24 months in severely obese white and African American (AA) women (n = 20). Decreases in adiposity were observed at 1, 6, and 24 months following RYGB (P < 0.05). Plasma 25(OH)D concentrations increased at 1 month (P = 0.004); a decreasing trend occurred over the remainder months after surgery (P = 0.02). Despite temporary improvement in vitamin D status, a high prevalence of vitamin D insufficiency was observed (76, 71, 67, and 82%, at baseline, 1, 6, and 24 months, respectively), and plasma 25(OH)D concentrations were lower in AA compared to white patients (P < 0.05). Strong positive baseline and 1 month cross-sectional correlations between FAT and plasma 25(OH)D were observed, which remained after adjustment for age and race subgroup (β = 0.76 and 0.61, respectively, P = 0.02). In conclusion, 25(OH)D concentrations increased temporarily and then decreased during the 24 months following RYGB. The acute increase and the positive associations observed between adipose tissue mass and systemic 25(OH)D concentrations suggest storage in adipose tissue and release during weight loss</blockquote>.
  
-The study discussed here: [[http://marshallprotocol.com/view_topic.php?id=8252&forum_id=39&jump_to=257136#p257136|Tea and coffee consumption in relation to vitamin D and calcium levels in Saudi adolescents]] provides additional evidence that non-supplemented populations have low 25D. 330 Saudi adolescents with average 25D levels of 8-10ng/mL. +The study discussed here: [[https://marshallprotocol.com/view_topic.php?id=8252&forum_id=39&jump_to=257136#p257136|Tea and coffee consumption in relation to vitamin D and calcium levels in Saudi adolescents]] provides additional evidence that non-supplemented populations have low 25D. 330 Saudi adolescents with average 25D levels of 8-10ng/mL. 
-===== References =====+===== References =====</nodisp> 
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