Vitamin D: 23 ng/mL
Elle Penner, MPH, RD
5 mins
What does a vitamin D level of 23 mean? Are there any symptoms associated with this vitamin D level?
A vitamin D level of 23 ng/mL is considered low. Low levels of vitamin D can occur from prolonged, inadequate intake through diet, limited exposure to midday sunlight, poor kidney function resulting in impaired conversion of 25(OH)D, or inadequate vitamin D absorption.
Low vitamin D can negatively impact your health and put you at increased risk for, and severity of COVID-19, diabetes, and cancer. Having low levels of vitamin D may also increase your risk for certain autoimmune and neurodegenerative diseases like multiple sclerosis and Alzheimer’s.
Factors that could contribute to a vitamin D level of 23
- Diet low in vitamin D
- Older age (partly due to a decline in the skin’s ability to synthesize vitamin D with age)
- Dark complexion
- Living in cold or northern climates (those who live above 37°N latitude cannot synthesize vitamin D year-round)
- Limited sun exposure (such as those who spend the majority of their time indoors or are covered when outside)
- Pregnancy and breastfeeding
- Cystic fibrosis, Crohn's, celiac, kidney, and liver disease, or other conditions that interfere with vitamin D absorption or synthesis
- Obesity (greater amounts of subcutaneous fat sequester more of the vitamin)
- Gastric bypass surgery (from reduced absorption)
What to do if your vitamin D level is 23?
To improve vitamin D levels:
- Increase consumption of vitamin D-rich foods like salmon, herring, canned tuna, eggs (with the yolk), and fortified foods like milk, yogurt, and breakfast cereals
- Get 10–30 minutes of unprotected midday sunlight most days of the week
- Take a vitamin D supplement. How much you should take depends on your level of deficiency. For a level of 23, you will likely need to take 5,000 IU daily for several months to significantly improve your vitamin D status.
- If levels do not improve after 3 months, review your supplements with an expert or talk to your doctor.
Supplements used to improve vitamin D test results
If you are vitamin D deficient, a daily supplement is typically needed to get levels into the optimal range (40-80 ng/mL) over time.
For levels of 23 ng/mL, talk to your healthcare provider. Daily supplementation of vitamin D3 (cholecalciferol) should be considered to achieve adequate body stores of vitamin D.
References
- National Institutes of Health. (2021, March 26). Office of Dietary Supplements - Vitamin D. National Institutes of Health – Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
- Alshahrani, F., & Aljohani, N. (2013). Vitamin D: deficiency, sufficiency, and toxicity. Nutrients, 5(9), 3605–3616. https://doi.org/10.3390/nu5093605
- Holick M. F. (2009). Vitamin D status: measurement, interpretation, and clinical application. Annals of epidemiology, 19(2), 73–78. https://doi.org/10.1016/j.annepidem.2007.12.001
- Demir, M., Demir, F., & Aygun, H. (2021). Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease. Journal of medical virology, 93(5), 2992–2999. https://doi.org/10.1002/jmv.26832
- Kayaniyil, S., Vieth, R., Retnakaran, R., Knight, J. A., Qi, Y., Gerstein, H. C., Perkins, B. A., Harris, S. B., Zinman, B., & Hanley, A. J. (2010). Association of vitamin D with insulin resistance and beta-cell dysfunction in subjects at risk for type 2 diabetes. Diabetes care, 33(6), 1379–1381. https://doi.org/10.2337/dc09-2321
- Examine.com. (2019, April). A D-fence against cancer? https://examine.com/members/deep-dives/article/a-d-fence-against-cancer/
- Yang, C. Y., Leung, P. S., Adamopoulos, I. E., & Gershwin, M. E. (2013). The implication of vitamin D and autoimmunity: a comprehensive review. Clinical reviews in allergy & immunology, 45(2), 217–226. https://doi.org/10.1007/s12016-013-8361-3
