title: Does vitamin D sufficiency equate to a single serum 25-hydroxyvitamin D level or are different levels required for non-skeletal diseases?
abstract: OBJECTIVE
  Clarify the concept of vitamin D sufficiency, the relationship between efficacy and vitamin D status and the role of Vitamin D supplementation in the management of non-skeletal diseases. We outline reasons for anticipating different serum vitamin D levels are required for different diseases.
  
  
  METHODS
  Review the literature for evidence of efficacy of supplementation and minimum effective 25-hydroxyvitamin D (25-OHD) levels in non-skeletal disease.
  
  
  RESULTS
  Evidence of efficacy of vitamin supplementation is graded according to levels of evidence. Minimum effective serum 25-OHD levels are lower for skeletal disease, e.g., rickets (25 nmol/L), osteoporosis and fractures (50 nmol/L), than for premature mortality (75 nmol/L) or non-skeletal diseases, e.g., depression (75 nmol/L), diabetes and cardiovascular disease (80 nmol/L), falls and respiratory infections (95 nmol/L) and cancer (100 nmol/L).
  
  
  CONCLUSIONS
  Evidence for the efficacy of vitamin D supplementation at serum 25-OHD levels ranging from 25 to 100 nmol/L has been obtained from trials with vitamin D interventions that change vitamin D status by increasing serum 25-OHD to a level consistent with sufficiency for that disease. This evidence supports the hypothesis that just as vitamin D metabolism is tissue dependent, so the serum levels of 25-OHD signifying deficiency or sufficiency are disease dependent.
authors.affiliation: Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia. spedding@adam.com.au.
authors.forename: Simon
authors.initials: S
authors.lastname: Spedding
authors.forename: Simon
authors.initials: S
authors.lastname: Vanlint
authors.forename: Howard
authors.initials: H
authors.lastname: Morris
authors.forename: Robert
authors.initials: R
authors.lastname: Scragg
mesh_terms: D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D050723:Fractures, Bone / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012279:Rickets / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy*
chemical_list: D014807:Vitamin D