Abstract
Vitamin D is important for bone health and, while controversial, may play a role in multiple acute and chronic diseases. As a result, 25-hydroxyvitamin D [25(OH)D] testing is commonly performed, and, when low, supplement recommendations made or prescriptions written to correct hypovitaminosis D. Multiple supplementation options exist including various doses of cholecalciferol (vitamin D3). However, in the United States, hypovitaminosis D treatment often entails prescribing high-dose (50,000 IU) ergocalciferol (vitamin D2) ( 1. Holick M.F. Binkley N. Bischoff-Ferrari H.A. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011; 96 (et al): 1911-1930 Crossref PubMed Scopus (6809) Google Scholar ). Such treatment occurs despite lack of consensus regarding the optimal 25(OH)D level for health; is it >15 ng/mL, >20 ng/mL, or >30 ng/mL? A major contributor to the lack of clarity regarding what constitutes “low” vitamin D status is inability of routine 25(OH)D assays to provide accurate results. Indeed, despite strides to improve 25(OH)D measurement, spearheaded by the Vitamin D Standardization Program (VDSP), substantial inaccuracy persists in clinical and research laboratories ( 2. Carter G.D. Berry J. Durazo-Arvizu R. Hydroxyvitamin D assays: An historical perspective from DEQAS. J Steroid Biochem Mol Biol. 2018; 177 (et al): 30-35 Crossref PubMed Scopus (62) Google Scholar , 3. Sempos C.T. Betz J.M. Camara J.E. General Steps to Standardize the Laboratory Measurement of Serum Total 25-Hydroxyvitamin D. J AOAC Int. 2017; 100 (et al): 1230-1233 Crossref PubMed Scopus (35) Google Scholar ). Why is this so?
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