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Vitamin D Advanced (D2, D3 & D Total)

Also known as Ergocalciferol test, Cholecalciferol test, Calcidiol test, Vitamin D panel, Vitamin D assay, Vitamin D2+D3 test
Vitamin D Advanced (D2, D3 & D Total) Includes 3 testsView All
18002000 10% Off
You need to provide
Blood
This test is for
Male, Female
Test Preparation
  1. No special preparation is required.

Understanding Vitamin D Advanced (D2, D3 & D Total)


What is Vitamin D Advanced (D2, D3 & D Total)?

A Vitamin D Advanced (D2, D3 & D Total) is a blood test that measures the levels of various forms of 25-hydroxy Vitamin D (25-OH D2, 25-OH D3 and D total) in the body. This test is a valuable indicator of osteoporosis (bone weakness), rickets (bone malformation), and osteomalacia (bone softening). It can also be used to diagnose/monitor problems with the functioning of the parathyroid gland since the parathyroid hormone (PTH) is essential for vitamin D metabolism.

Vitamin D is a fat-soluble essential nutrient. It exists in two primary forms: Vitamin D3 (Cholecalciferol) derived from animal sources and vitamin D2 (Ergocalciferol) derived from plant sources; both perform similar functions. The main sources of vitamin D3 are certain foods, dietary supplements, and exposure to ultraviolet B (UVB) radiation from sunlight. while vitamin D2 is derived from products or supplements of plant origin and mushrooms etc. Both these forms are converted into 25-hydroxy D2 or D3 respectively in the liver. The levels of 25-hydroxy Vitamin D in blood is considered the best parameter to assess vitamin D status of the body. 

As per a study by NCBI (National Center for Biotechnology Information), vitamin D deficiency is highly prevalent across all age groups in India. Low vitamin D levels can lead to many disorders, such as an increased risk of fractures, muscle weakness and lethargy, dysfunction of the immune system, and an increased risk of chronic diseases like diabetes. A Vitamin D Advanced (D2, D3 & D Total) can help determine its deficiency, and sometimes it may also help determine if you have too much vitamin D in your body (most likely from excessive supplements). 

The Vitamin D Advanced (D2, D3 & D Total) offers a more detailed assessment of vitamin D status in your body as it evaluates Total 25-OH D as well as 25-OH metabolites of vitamin D2 and vitamin D3 using the highly specialized LC-MS/MS technique. On the other hand a routine Vitamin D (25-OH) test measures only the Total 25-OH D vitamin  (i.e D2+D3) and does not differentiate between the two forms. Measuring vitamin D by LC-MS/MS method is considered as the gold standard for vitamin D evaluation because it is a highly specialized and sensitive method that can help differentiate between various forms of vitamin D,25(OH)D and also substrates, D2 and D3. Additionally, LC-MS/MS can detect very small amounts of vitamin D and its byproducts. 

Your doctor may suggest the Vitamin D Advanced (D2, D3 & D Total) if you show symptoms suggestive of vitamin D deficiency or excess such as bone deformities, immune system dysfunction, muscle cramps and weakness, dental abnormalities, bone pain, fatigue, loss of appetite, increased thirst, nausea, frequent urination, etc.

No special preparation is required for this test. Consume a regular diet before taking the test. However, it is generally recommended to stop taking vitamin D supplements before this test, as they may affect the accuracy of the test results. Also, let your doctor know about all your other medications, as some can affect the test results.

Lab test result ranges are approximate and may differ slightly between labs depending on the methodology and laboratory guidelines. Talk to your doctor about your specific test results. The test results will help them determine your medical condition, make recommendations for lifestyle modifications such as diet and exercise, prescribe medication if required to manage your condition and formulate your overall treatment plan.

What is Vitamin D Advanced (D2, D3 & D Total) used for?

A Vitamin D Advanced (D2, D3 & D Total) can be done:

  • To determine deficient, insufficient, or toxic vitamin D levels in the body.

  • For routine checkups in individuals with vitamin D deficiency risk factors, including obesity, limited sun exposure, weight loss surgery, digestive disorders like Crohn’s disease, kidney or liver disease, and certain medicines like phenytoin.

  • In individuals with vitamin D deficiency symptoms, such as bone deformities, immune system dysfunction, muscle cramps, and dental abnormalities.

  • To monitor the adequacy of treatment in individuals who are receiving vitamin D supplements.

  • To diagnose/monitor problems with the functioning of the parathyroid gland that affects vitamin D metabolism.

What does Vitamin D Advanced (D2, D3 & D Total) measure?

Contains 3 tests

A Vitamin D Advanced (D2, D3 & D Total) measures all forms of 25-hydroxy Vitamin D (25-OH D2, 25-OH D3 and D total).Vitamin D is an essential nutrient that can be synthesized in the body upon healthy exposure to sunlight or absorbed from dietary sources. It majorly exists in the form of vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 (ergocalciferol) is largely human-made and can be obtained from plant sources and fortified foods. In contrast, the body produces vitamin D3 (cholecalciferol) when your skin is exposed to sunlight. It can also be absorbed by eating animal-sourced foods. 

Both forms of vitamin D (D2 and D3) need to undergo some chemical changes before being available for use in the body. They are absorbed equally well from your small intestine, metabolized in the liver or kidneys, and converted to measurable substances called 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. Vitamin D Total is the summation of both vitamins.  

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Vitamin D3

The Vitamin D3 test measures the amount of vitamin D3, also known as cholecalciferol, a type of vitamin D. Vitamin D3 is naturally found in animal-derived products like milk and may be consumed in certain fortified foods or dietary supplements. It is directly synthesized in the skin when exposed to the sun. The Vitamin D3 test determines whether you have enough vitamin D3 in your body to support normal bodily functions.

Know more about Vitamin D3

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Vitamin D Total

The Vitamin D Total test measures the levels of vitamin D2 and D3 in your body. This test is an appropriate indicator of the total Vitamin D storage in the body. A vitamin D total test is also recommended in case of abnormal calcium, phosphorus, and parathyroid hormone levels. Individuals with abnormal vitamin D levels become prone to heart diseases, high blood pressure, immune system disorders, different types of cancers (prostate, breast, and colon), and various infectious diseases like influenza, tuberculosis, sepsis, etc. All these reasons make it more important for individuals to check their vitamin D levels.

Know more about Vitamin D Total

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Vitamin D2

The Vitamin D2 test measures the amount of vitamin D2, also known as ergocalciferol, which is a type of vitamin D. It is usually found in plant-based sources such as mushrooms and in some fortified foods. The Vitamin D2 test is ordered to determine if a deficiency, insufficiency, or abnormally high level of vitamin D is present in the body, or to monitor ongoing treatment for a previously diagnosed deficiency.

Know more about Vitamin D2

Interpreting Vitamin D Advanced (D2, D3 & D Total) results


Interpretations

Vitamin D level below the normal reference range indicates vitamin D deficiency. This can be because of less sun exposure, dietary lack, or decreased absorption from the intestine.

Vitamin D level above the normal reference range indicates vitamin D intoxication. This is usually due to excess supplementation of the vitamin.

Range:

The normal range of vitamin D Total is measured as nanograms per milliliter (ng/mL) or nmol/L and can vary from lab to lab.

Level

Reference range (ng/mL)

Deficiency

<20 ng/mL

Insufficiency 

20-30 ng/mL

Sufficiency

30-100 ng/mL

Toxicity

>100 ng/mL

 Note:

  • The assay measures vitamin D2 (Ergocalciferol) and vitamin D3 (Cholecalciferol) metabolites of vitamin D.
  • There can be seasonal variation in 25 (OH) vitamin D levels, with values being 40-50% lower in winter than in summer. It is also influenced by sunlight, latitude, skin pigmentation, sunscreen use, and hepatic function.
  • 25 (OH) vitamin D levels can vary with age
  • 25 (OH) vitamin D level is increased in pregnancy.

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Vitamin D Advanced (D2, D3 & D Total)


Frequently Asked Questions about Vitamin D Advanced (D2, D3 & D Total)

Q. What is a Vitamin D Advanced (D2, D3 & D Total), and why is it important?

A Vitamin D Advanced (D2, D3 & D Total) measures your vitamin D levels, which are crucial for bone health, immune function, and overall well-being. It helps identify deficiencies that can lead to bone pain, arthralgias, myalgias, fatigue, muscle twitching (fasciculations), weakness, etc. If left untreated, this vitamin deficiency can lead to fragility fractures or osteoporosis.

Q. What are the signs and symptoms of vitamin D deficiency?

Signs and symptoms of vitamin D deficiency may include fatigue, bone pain, depression, hair loss, muscle weakness, appetite loss, pale skin, and sleep disturbances.

Q. What can cause vitamin D deficiency?

The primary causes of vitamin D deficiency are insufficient sunlight exposure or a vitamin D-deficient diet.

Q. Who should get a Vitamin D Advanced (D2, D3 & D Total) done?

Anyone at risk of vitamin D deficiency, including individuals over 45 years and those with limited sun exposure; dark skin; digestive diseases, such as celiac disease and Crohn’s disease; and other specific health conditions, should consider getting this test.

Q. How is a Vitamin D Advanced (D2, D3 & D Total) performed?

A phlebotomist (a trained professional to perform blood draws) will clean your skin using an antiseptic alcohol cotton swab or wipe and take a blood sample from your vein using a needle. The blood sample will be stored safely and transported to the laboratory for analysis.

Q. What is the right time to get a Vitamin D Advanced (D2, D3 & D Total) done?

This profile test can be done at any time of the day. However, one should stop taking vitamin D supplements before giving the test sample to get accurate results.

Q. Are there any risks associated with this test?

No. Usually, there are no risks associated with this test. The blood sample is withdrawn with the help of a needle, and the process is reasonably fast and relatively painless. Very rarely, you may experience excessive pain, bleeding, hematoma (blood collection under the skin), bruising, or infection at the site of the needle prick. Consult the doctor if you experience any of these symptoms.

Q. What do different vitamin D levels mean in the test results?

Based on specific ranges, test results are categorized as deficient, insufficient, sufficient, or toxic.

Q. What happens if my vitamin D is low?

Low vitamin D can have adverse effects on the whole body. It can increase the risk of heart disease, high blood pressure, diabetes, infections, immune system disorders, multiple sclerosis, and colon, prostate, and breast cancers.

Q. Can vitamin D deficiency be corrected through diet alone?

Though some food items such as fortified foods, green vegetables, mushrooms, egg yolks, and fatty fish contain vitamin D, supplements are often necessary to reach adequate levels.

Q. How much sun exposure is sufficient to get adequate vitamin D?

Regular sun exposure is the most natural way to get enough vitamin D. Usually, you need the afternoon sun for about 10 to 30 minutes several times weekly. However, people with darker skin may need a little longer than this. Your exposure time depends on how sensitive your skin is to sunlight.

Q. How much vitamin D is needed daily?

The recommended daily amount of vitamin D is 400 international units (IU) for children up to 12 months of age, 600 IU for people aged 1 to 70 years, and 800 IU for people aged over 70 years. For adults with vitamin D levels below 30 ng/mL, the Endocrine Society guidelines recommend a daily intake of 1,500–2,000 IU to restore healthy vitamin D levels.

Q. What other tests can be ordered along with a vitamin D profile?

Serum calcium, phosphorus, and parathyroid hormone can be ordered in addition to vitamin D profile.

Q. What are the differences between Vitamin D2 and Vitamin D3?

Vitamin 25-OH D2 (ergocalciferol) is found in some plant-based foods and is used in some supplements. Vitamin 25-OH D3 (cholecalciferol) is produced by the skin in response to sunlight and is also found in animal-based foods and supplements. Vitamin 25-OH D3 is generally considered more effective in raising blood levels of Vitamin D.

Q. What is the difference between Vitamin D2, Vitamin D3, and Total Vitamin D?

Vitamin 25-OH D2 (ergocalciferol) is found in plant-based foods and certain supplements but is less effective than Vitamin 25-OH D3 in increasing and maintaining blood levels of Vitamin D. Vitamin 25-OH D3 (cholecalciferol) is produced by the skin in response to sunlight and is also present in animal-based foods and supplements; it is more effective at raising blood levels of Vitamin D compared to D2. The Total Vitamin D measurement combines both Vitamin 25-OH D2 and 25-OH D3 levels in your blood, providing an overall assessment of your Vitamin D status.
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Vitamin D Advanced (D2, D3 & D Total) test price for other cities


Price inMumbaiRs. 1800
Price inBangaloreRs. 1800
Price inPuneRs. 1800
Price inNew DelhiRs. 1800
Price inKolkataRs. 1800
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References

  1. Garland CF, Garland FC, Gorham ED, et al. The role of vitamin D in cancer prevention. Am J Public Health. 2006 Feb;96(2):252-61.[Accessed 20 Sept. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470481/ External Link
  2. Gröber U, Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 2012 Apr 1;4(2):158-66. [Accessed 20 Sept. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427195/ External Link
  3. Religi A, Backes C, Chatelan A, et al. Estimation of exposure durations for vitamin D production and sunburn risk in Switzerland. J Expo Sci Environ Epidemiol. 2019 Oct;29(6):742-752. [Accessed 20 Sept. 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/30992519/#:~:text=In%20summer%20and%20spring%2C%20with,of%20sun%20exposure%20for%20adults. External Link
  4. Iraj B, Ebneshahidi A, Askari G. Vitamin d deficiency, prevention and treatment. Int J Prev Med. 2012 Oct;3(10):733-6. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483003/ External Link
  5. Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc. 2010 Aug;85(8):752-7; quiz 757-8. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912737/ External Link
  6. Vitamin D [Internet]. NIH; 12 Aug. 2022 [Accessed 20 Sep. 2023]. Available from: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/External Link
  7. Aparna P, Muthathal S, Nongkynrih B, Gupta SK. Vitamin D deficiency in India. J Family Med Prim Care. 2018 Mar-Apr;7(2):324-330. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060930/External Link
  8. Vitamin D [Internet]. Boston, USA: Harvard T.H. Chan; March 2023 [Accessed 20 Sep. 2023]. Available from: https://www.hsph.harvard.edu/nutritionsource/vitamin-d/External Link
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