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HelpTest Code DHVD 1,25-Dihydroxyvitamin D, Serum
Reporting Name
1,25-Dihydroxyvitamin D, SUseful For
Evaluation of selected patients with disorders of calcium and phosphate metabolism
Evaluation of chronic kidney disease with suspected abnormalities of vitamin D metabolism
Investigation of suspected hereditary disorders of vitamin D metabolism, including vitamin D-dependent rickets
Evaluation of parathyroid hormone-independent hypercalcemia, particularly when granulomatous disease, lymphoma, or CYP24A1 deficiency is suspected
As a second-line test following measurement of 25-hydroxyvitamin D when clinically indicated
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
The 25-hydroxyvitamin D test (25HDN / 25-Hydroxyvitamin D2 and D3, Serum) in serum is the preferred initial test for assessing vitamin D status and most accurately reflects the body's vitamin D stores. In the presence of renal disease or hypercalcemia, testing of 1,25-dihydroxy vitamin D (DHVD) may be needed to adequately assess vitamin D status.
Specimen Required
Patient Preparation:
Fasting: 4 hours, preferred but not required
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL Serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
Serum: 0.7 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 30 days |
| Frozen | 30 days | |
| Ambient | 7 days |
Reference Values
Males:
<16 years: 24-86 pg/mL
≥16 years: 18-64 pg/mL
Females:
<16 years: 24-86 pg/mL
≥16 years: 18-78 pg/mL
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Day(s) Performed
Monday through Friday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82652
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DHVD | 1,25-Dihydroxyvitamin D, S | 62290-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8822 | 1,25-Dihydroxyvitamin D, S | 62290-2 |
Interpretation
Decreased concentrations are observed in:
-Chronic kidney disease
-Hypoparathyroidism
-Hereditary deficiency of renal CYP27B1 (vitamin D-dependent rickets type 1)
Increased concentrations are observed in:
-Primary hyperparathyroidism
-Secondary hyperparathyroidism
-Granulomatous diseases (eg, sarcoidosis)
-Certain lymphomas
-Rare disorders with increased extrarenal CYP27B1 activity
Normal or low 1,25-dihydroxyvitamin D (DVHD) concentrations do not exclude vitamin D intoxication because circulating DHVD concentrations remain under physiologic regulation despite markedly elevated 25-hydroxyvitamin D concentrations.
Clinical Reference
1 Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2024;109(8):1907-1947. doi:10.1210/clinem/dgae290
2. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. In: Ross AC, Taylor CL, Yaktine AL, Del Valle HB, eds.Washington, Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press: 2011. Available at www.ncbi.nlm.nih.gov/books/NBK56070.
3. Vitamin D-Fact Sheet for Health Professionals. US Department of Health and Human Services, National Institutes of Health. Updated June 27, 2025. Accessed September 15, 2026. Available at https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
4. Fraser W. Bone and Mineral Metabolism. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. 8th ed. Elsevier; 2020:466-487
5. Strathmann FG, Laha TJ, Hoofnagle AN. Quantification of 1a,25-dihydroxy vitamin D by immunoextraction and liquid chromatography-tandem mass spectrometry. Clin Chem. 2011;57(9):1279-1285. doi:10.1373/clinchem.2010.161174
6. Herrmann M. Assessing vitamin D metabolism - four decades of experience. Clin Chem Lab Med. 2023;61(5):880-894. doi:10.1515/cclm-2022-1267
7. Biancuzzo RM, Clarke N, Reitz RE, Travison TG, Holick MF. Serum concentrations of 1,25-dihydroxyvitamin D2 and 1,25-dihydroxyvitamin D3 in response to vitamin D2 and vitamin D3 supplementation. J Clin Endocrinol Metab. 2013;98(3):973-9. doi:10.1210/jc.2012-2114
8. Shah AD, Hsiao EC, O'Donnell B, et al. Maternal Hypercalcemia Due to Failure of 1,25-Dihydroxyvitamin-D3 Catabolism in a Patient With CYP24A1 Mutations. J Clin Endocrinol Metab. 2015;100(8):2832-2836. doi:10.1210/jc.2015-1973
Report Available
2 to 5 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
-Renal Diagnostics Test Request (T830)