Vitamin D Plus Report

Referral: ABC Clinic

Name: Sarah Mitchell

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: ng/mL

TEST0051

Status Reference: Low Suboptimal Optimal Elevated High

Vitamin D Level

Accredited By

38.5

OPTIMAL

ng/mL (96.25 nmol/L)

Target: 30 – 50 ng/mL

(Based on your current level)

38.5

0 20 30 80 100 120

Optimal

Reference range (ng/mL): 20 – 80. Desirable range: 30 – 50 ng/mL.
Reference range (nmol/L): 50 – 200. Desirable range: 75 – 125 nmol/L.
Elevated: 80 – 100 ng/mL. High: >100 ng/mL.

Summary

Current Level

38.5 ng/mL

96.25 nmol/L

Optimal Range

30 – 50 ng/mL

75 – 125 nmol/L

Current Status

Optimal

Within desirable range

📅 Monitoring & Retesting

Low/Suboptimal: Retest in 3–4 months after starting supplementation.
Optimal: Retest in 6 months to ensure levels remain stable.
Elevated/High: Retest in 3 months after reducing intake.
Results reflect average levels over the previous 3–4 months.

📍 Recommended Retest: April – May 2026

Vitamin D Plus Report

Referral: ABC Clinic

Name: Sarah Mitchell

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: ng/mL

TEST0051

Vitamin D Metabolite Ratio (VMR)

3.2%

LOW

Ratio of 24,25(OH)₂D₃ to 25(OH)D₃

Target: 4.3 – 14.4 %

(Based on your current level)

3.2

0 4.3 5.7 14.4 17 20

Optimal

Reference range: 4.3 – 14.4 %. Low VMR may indicate impaired Vitamin D metabolism.
Optimal VMR indicates your body is effectively converting and regulating Vitamin D.

● What is the Vitamin D Metabolite Ratio?

The Vitamin D Metabolite Ratio (VMR) measures the ratio of 24,25(OH)₂D₃ to 25(OH)D₃ in your blood, expressed as a percentage. While the standard 25(OH)D test tells you how much Vitamin D is circulating, the VMR reveals how well your body is metabolising and regulating it.

A healthy VMR (5.7–14.4%) indicates that your body’s Vitamin D metabolism pathway (CYP24A1 enzyme) is functioning correctly. A low VMR (<4.3%) may suggest impaired catabolism — meaning your body isn’t efficiently processing Vitamin D, which can indicate genetic variants affecting CYP24A1, kidney dysfunction, or other metabolic issues. This is particularly useful for patients who have persistently low Vitamin D levels despite adequate supplementation.

Why VMR Matters

🔬

Metabolism Insight

Reveals how well your body processes Vitamin D beyond just levels

🧬

CYP24A1 Function

Evaluates the enzyme responsible for Vitamin D catabolism

🫘

Kidney Health

Low VMR may indicate renal issues affecting Vitamin D conversion

💊

Supplementation Guide

Helps identify patients not responding to standard supplementation

Vitamin D Plus Report

Referral: ABC Clinic

Name: Sarah Mitchell

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: ng/mL

TEST0051

Your Progress Over Time

Tracking your last 3 Vitamin D results | ▲ +26.5 ng/mL since first test

Test-by-Test Breakdown

TEST 1 — 10/03/2024

12.0

ng/mL

LOW

Severely deficient. Immediate supplementation recommended under clinical guidance.

TEST 2 — 13/06/2024

24.0

ng/mL

SUBOPTIMAL

Improved (↑12.0). Approaching sufficiency but not yet optimal. Continue supplementation.

TEST 3 — 01/10/2024

38.5

ng/mL

OPTIMAL

Improved (↑14.5). Now within the optimal range. Maintain current regimen.

Understanding Your Vitamin D Zones

LOW

Below 20

Deficient. Immediate supplementation and sun exposure recommended.

SUBOPTIMAL

20 – 30

Insufficient. Increase supplementation and dietary vitamin D intake.

OPTIMAL

30 – 80

Supports bone health, immune function, and overall wellbeing.

ELEVATED

80 – 100

Above optimal. Consider reducing supplementation.

HIGH

Above 100

Potential toxicity risk. Seek medical guidance.

Vitamin D Plus Report

Referral: ABC Clinic

Name: Sarah Mitchell

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: ng/mL

TEST0051

What We Test & Why It Matters

● Vitamin D

The Vitamin D test measures 25(OH)D (25-hydroxyvitamin D) in your blood, the most stable marker of your Vitamin D status. This reflects your Vitamin D intake from diet, supplementation, and sun exposure, and is the gold standard for assessing your nutritional Vitamin D levels.

Vitamin D is unique among vitamins because your body can synthesise it from sunlight exposure (UVB radiation converts cholesterol in the skin to Vitamin D3). However, many people are deficient due to limited sun exposure, geographic location, darker skin pigmentation, use of sunscreen, and seasonal variation. Dietary sources include oily fish, egg yolks, fortified foods, and supplements.

Once produced or ingested, Vitamin D is converted in the liver to 25(OH)D and then activated in the kidneys to its hormone form, 1,25(OH)₂D, which regulates calcium absorption, bone mineralisation, and immune cell function. Optimal levels (30–50 ng/mL) are associated with improved bone health, immune function, mood stability, and reduced risk of chronic diseases including cardiovascular conditions and autoimmune disorders.

Why Optimal Vitamin D Levels Matter

🦴

Bone Health

Supports calcium absorption and bone mineral density

🛡️

Immune System

Enhances innate and adaptive immune defences

🙂

Mood & Wellbeing

Linked to mood regulation and reduced risk of depression

💪

Muscle Function

Supports muscle strength and reduces fall risk

🫀

Heart Health

Associated with cardiovascular health and blood pressure regulation

🦷

Teeth & Jaw

Essential for dental health and calcium metabolism

🧬

Cell Growth

Supports healthy cell growth and differentiation

⚡

Energy & Fatigue

Adequate levels help reduce fatigue and improve energy

Common Causes of Low Vitamin D

Limited Sun Exposure

Living at higher latitudes, spending most time indoors, or wearing covering clothing reduces UVB-driven Vitamin D synthesis in the skin.

Darker Skin Pigmentation

Higher melanin levels reduce the skin’s ability to produce Vitamin D from sunlight, requiring longer exposure times.

Dietary Insufficiency

Few foods are naturally rich in Vitamin D. Limited intake of oily fish, egg yolks, fortified foods, and mushrooms contributes to low levels.

Obesity & Malabsorption

Vitamin D is sequestered in adipose tissue in overweight individuals. Conditions like coeliac or Crohn’s disease also impair absorption.

Vitamin D Plus Report

Referral: ABC Clinic

Name: Sarah Mitchell

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: ng/mL

TEST0051

How To Improve Your Results

☀️

Sunlight Exposure

Aim for around 30 minutes of sun exposure on arms and legs, several times per week. Be sun-safe — in hot climates such as Australia, the southern United States, and the Middle East, avoid the middle of the day and opt for early morning or late afternoon instead.
UV intensity varies by latitude, season, skin tone, and time of day. In northern latitudes (above 37°N) during winter, UVB levels may be insufficient for Vitamin D synthesis — supplementation is recommended during these months.
Individuals with darker skin tones require more sun exposure to produce the same amount of Vitamin D, as higher melanin levels reduce UVB absorption. Supplementation is particularly important for these individuals.

🐟

Dietary Sources

Eat oily fish (salmon, mackerel, sardines) 2–3 times per week. These are among the few food sources naturally high in Vitamin D.
Include egg yolks, fortified milk and plant-based milks, and UV-exposed mushrooms in your diet.
Note: typical diet provides 100–300 IU of Vitamin D per day, which is insufficient for most people to reach optimal levels without additional sun or supplementation.

Fish & Seafood (per 100g serving, cooked)

Species	Vitamin D (IU)	Vitamin D (µg)	Content	Notes
Cod Liver Oil (1 tbsp)	1,360	34.0	High	Richest natural source
Herring (Atlantic)	1,628	40.7	High	Fresh, pickled, or smoked
Rainbow Trout	645	16.1	High	Farmed or wild
Salmon (wild)	600–1,000	15–25	High	Wild higher than farmed
Swordfish	566	14.2	High	Excellent source
Mackerel	360	9.0	High	Also rich in Omega-3s
Sardines (canned)	272	6.8	High	Affordable, with bone for calcium
Tuna (canned)	236	5.9	Moderate	Light or white varieties
Mushrooms (UV-exposed)	400–1,000	10–25	High	Best plant-based source
Egg Yolks (2 large)	80	2.0	Low	Varies by feed & sun exposure

* Values approximate. 1 µg = 40 IU. Source: USDA FoodData Central, peer-reviewed literature. High (>200 IU) Moderate (50–200 IU) Low (<50 IU)

💊

Supplementation

The standard dose is 1,000 IU (25 µg) of Vitamin D3 (cholecalciferol) per day. Higher doses only under HCP guidance.
Take with a meal containing dietary fat to enhance absorption.
Be consistent – it takes 2–3 months of daily supplementation for levels to stabilise.

Vitamin D Supplements (typical strengths)

Supplement Type	Strength (IU)	Form	Notes
Vitamin D3 Tablets	1,000	D3 (cholecalciferol)	Recommended daily dose
Higher Strength D3	2,000–4,000	D3 (cholecalciferol)	Only under HCP guidance
Liquid D3 Drops	400–1,000/drop	D3 (cholecalciferol)	Easy dosing, suitable for children
D3 + K2 Combination	1,000	D3 + Vitamin K2	K2 directs calcium to bones
D3 + Calcium	400–1,000	D3 + Calcium	Supports bone mineralisation
D3 Oral Spray	1,000	D3 (cholecalciferol)	Fast absorption via oral mucosa

* Values approximate. 1 µg = 40 IU. Source: USDA FoodData Central.

Vitamin D Plus Report

Referral: ABC Clinic

Name: Sarah Mitchell

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: ng/mL

TEST0051

Important Information

🔬

About Vitamin D Plus Testing

METHODOLOGY

Our Vitamin D Plus test measures 25-hydroxyvitamin D [25(OH)D] and the Vitamin D Metabolite Ratio (VMR) from a dried blood spot (DBS) sample using isotope dilution liquid chromatography with tandem mass spectrometry (ID LC-MS/MS). Two 3mm discs of capillary blood are extracted using a sequential extraction and derivatisation procedure with a Cookson-type reagent (PTAD), ensuring highly accurate and reproducible quantitation of 25(OH)D3, 25(OH)D2, and 24,25(OH)₂D₃.
The VMR is calculated as the ratio of 24,25(OH)₂D₃ to 25(OH)D₃, expressed as a percentage. This marker evaluates how effectively your body metabolises Vitamin D via the CYP24A1 enzyme pathway. A low VMR may indicate impaired catabolism, genetic CYP24A1 variants, or kidney dysfunction.
The assay has been clinically validated against serum reference methods in 96 patients, demonstrating a correlation of R² = 0.974. Diagnostic performance at a cut-off of 20 ng/mL shows a sensitivity of 96.9% and specificity of 97.2%. The analytical sensitivity (LOD) is 0.1 ng/mL with a dynamic range of 1–150 ng/mL for 25(OH)D3.

📚

References & Quality Assurance

EVIDENCE BASE

Our laboratory participates in DEQAS (Vitamin D External Quality Assessment Scheme), the world’s leading quality assurance programme for Vitamin D measurement with over 1,200 laboratories across 54 countries. Quarterly samples are assigned values by the CDC Reference Measurement Procedure, and a proficiency certificate is issued annually to laboratories meeting DEQAS performance targets.
Holick, M. F., et al. (2011). Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism, 96(7), 1911–1930.
Ross, A. C., et al. (2011). The 2011 Dietary Reference Intakes for Adequacy of Vitamin D. Nutrients, 3(4), 412–427.
Cashman, K. D., et al. (2016). Standardized Reference Intervals for Blood 25-hydroxyvitamin D in Adults. European Journal of Clinical Nutrition, 70(4), 428–434.
Berg, A. H., et al. (2021). The Vitamin D Metabolite Ratio is Associated with Changes in Bone Density and Fracture Risk in Older Adults. Journal of Bone and Mineral Research, 36(12), 2343–2350.
Denburg, M. R., et al. (2023). The Vitamin D Metabolite Ratio (VMR) is a Biomarker of Vitamin D Status That is Not Affected by Acute Changes in Vitamin D Binding Protein. Clinical Chemistry, 69(7), 718–728.
Cavalier, E., et al. (2024). Investigation of the Vitamin D Metabolite Ratio (VMR) as a Marker of Functional Vitamin D Deficiency: Findings from the SarcoPhAge Cohort. Nutrients, 16(19), 3399.

Questions About Your Results?

CONTACT US

If you have any questions about your results, would like help interpreting your report, or need guidance on next steps, our team is here to help. Please don’t hesitate to reach out — we’re happy to assist you on your health journey.

📧 support@masdiag.com

We aim to respond within 1–2 business days.