Test ID 2425D 25-Hydroxyvitamin D:24,25-Dihydroxyvitamin D Ratio, Serum
Ordering Guidance
Please consider the 25HDN or DHVD tests for Vitamin D assessment. 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) might be needed to adequately assess vitamin D status.
Specimen Required
Container/Tube:
Preferred: Red top
Specimen Volume: 3 mL
Collection Instructions: Spin down within 2 hours of draw.
Useful For
As a screening test for inactivating CYP24A1 mutations in patients with symptoms, signs, or biochemical findings of parathyroid hormone (PTH)-independent hypercalcemia or hypercalciuria
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
2425R | 24,25 Dihydroxy Vitamin D | No | Yes |
25HDN | 25-Hydroxyvitamin D2 and D3, S | Yes | Yes |
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Portions of this test are covered by patent(s) held by Quest Diagnostics
Reporting Name
25HDN:24,25 Dihydroxy VitD Ratio, SSpecimen Type
SerumSpecimen Minimum Volume
1.1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 30 days | ||
Ambient | 7 days |
Reference Values
Interpretative commentary provided based on 25-hydroxyvitamin D (25HDN) to 24,25-dihydroxyvitamin D (24,25D) ratio result.
25HDN to 24,25D ratio less than 25*
*Interpretation: Normal (Ratio of less than 25 may also be observed in heterozygous carriers of CYP24A1 mutations)
25HDN to 24,25D ratio between 25-80**
**Interpretation: Ratios in the 25 to 80 range can be seen in patients with low vitamin D or heterozygous CYP24A1 mutations. Confirmation with molecular testing is recommended.
25HDN to 24,25D ratio greater than 80***
***Interpretation: Ratios greater than 80 indicate probable biallelic CYP24A1 mutation or deletion. Confirmation with molecular testing is recommended.
Reference values not applicable for 24,25 Dihydroxyvitamin D Total result.
Results should be interpreted in the context of other biochemical findings including serum calcium, parathyroid hormone, and 1,25 dihydroxyvitamin D concentrations. If 25-OH-D is less than 20 ng/ml the ratio of 25-OH-D to 24,25-dihydroxyvitamin D will be falsely elevated since there is no inactivation 25-OH-D to 24,25-dihydroxyvitamin D.
Day(s) Performed
Tuesday
Report Available
2 to 6 daysPerforming Laboratory

Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82306
82542
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
2425D | 25HDN:24,25 Dihydroxy VitD Ratio, S | 94674-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
2897 | 25-Hydroxy D2 | 49054-0 |
63416 | 25HDN:24,25 Dihydroxy VitD Ratio, S | 94673-1 |
2898 | 25-Hydroxy D3 | 1989-3 |
83670 | 25-Hydroxy D Total | 62292-8 |
90601 | 24,25-Dihydroxy VitD Total | 94672-3 |