Test Id : DHVD
1,25-Dihydroxyvitamin D, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
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
Method Name
A short description of the method used to perform the test
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
1,25-Dihydroxy Vitamin D
1,25-Dihydroxycholecalciferol
1,25-Dihydroxyvitamin D3
Calcitriol
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering 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
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
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.
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)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
Serum: 0.7 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 30 days | |
| Ambient | 7 days | ||
| Frozen | 30 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
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
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Vitamin D is a generic designation for a group of fat-soluble, structurally similar steroids which act as hormones. Vitamin D is obtained through dietary intake as ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) and is also synthesized in the skin following ultraviolet light exposure. Both forms are converted in the liver by CYP2R1 to 25-hydroxyvitamin D (25HDN), the major circulating form and the best indicator of total body vitamin D stores.
The biologically active hormone, 1,25-dihydroxyvitamin D (DHVD), is produced primarily in the kidneys by 1alpha-hydroxylation of 25HDN through CYP27B1. Renal production is tightly regulated by parathyroid hormone (PTH), serum calcium and phosphate concentrations, and fibroblast growth factor-23. DHVD promotes intestinal calcium and phosphate absorption, as well as renal calcium and phosphate reabsorption resulting in a net positive calcium balance that supports skeletal mineralization and suppresses PTH synthesis. In addition to its effects on calcium and bone metabolism, DHVD regulates the expression of a multitude of genes in many other tissues including immune cells, muscle, vasculature, and reproductive organs.
Measurement of 25-hydroxyvitamin D is the preferred laboratory test for assessment of vitamin D status because it most accurately reflects total body vitamin D stores. Measurement of DVHD should be reserved for selected clinical situations involving disorders of calcium metabolism, chronic kidney disease, hereditary disorders of vitamin D metabolism, granulomatous disease, lymphoma, or unexplained hypercalcemia. DVHD levels are decreased in hypoparathyroidism and in chronic renal failure. DHVD levels may be high in primary hyperparathyroidism and in physiologic hyperparathyroidism secondary to low calcium or vitamin D intake or absorption. Some patients with granulomatous diseases (eg, sarcoidosis) and malignancies containing nonregulated 1-alpha hydroxylase in the lesion might have hypercalcemia that appears vitamin D mediated with normal or high serum phosphate (hyperphosphatemia) and hypercalcemia (both of which might be severe) in addition to low PTH and absent parathyroid hormone-related peptide (PTHRP). Assessment of 24,25-dihydroxyvitamin D might also be required in patients with hypercalcemia that does not appear to be driven by PTH or PTHRP and may be helpful in assessment of patients with loss of function inactivating CYP24A1 mutations.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Males:
<16 years: 24-86 pg/mL
> or =16 years: 18-64 pg/mL
Females:
<16 years: 24-86 pg/mL
> or =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
Interpretation
Provides information to assist in interpretation of the test results
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.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
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
Method Description
Describes how the test is performed and provides a method-specific reference
Deuterated isotopically labeled 1,25-dihydroxyvitamin D2 and D3 are added to the sample as internal standards. 1,25-Dihydroxyvitamin D2 and D3 and the internal standards are extracted using immunopurification. Extracts are then derivatized and analyzed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
82652
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| DHVD | 1,25-Dihydroxyvitamin D, S | 62290-2 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 8822 | 1,25-Dihydroxyvitamin D, S | 62290-2 |