This document presents evidence that higher serum 25(OH)D levels are associated with reduced risk of various diseases. It shows that levels above 30 ng/mL are linked to substantially lower rates of breast cancer, colorectal cancer, non-Hodgkin's lymphoma, multiple sclerosis, and falls in women. Levels between 40-60 ng/mL may be needed to prevent most chronic diseases, as this range is associated with significantly reduced incidence of cancer, cardiovascular disease, diabetes, and autoimmune conditions. Reference data is provided on average 25(OH)D levels in different populations, with tribal East Africans having the highest at 115 nmol/L.

1. Disease Incidence Prevention by Serum 25(OH)D Level
Serum 25(OH)D, ng/ml 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68
Studies of Individuals
Cancers, all combined
Breast Cancer X X X X X X X X
Ovarian Cancer
Colon Cancer X X X X
Non-Hodgkins Lymphoma
Type 1 Diabetes
Fractures, all combined
Falls, women
Multiple Sclerosis X X X
Heart Attack (Men)
Natural Experiments
Kidney Cancer
Endometrial Cancer
Rickets
X X X
X X X X
72%
50%
99%
37%
23% 49%
12% 17%
25% 66%
25%
12% 18%
31% 38% 60%
77% with calcium
Legend:
All percentages reference a common baseline of 25 ng/ml as shown on the chart.
%’s reflect the disease prevention % at the beginning and ending of available data.
Example: Breast cancer incidence is reduced by 30% when the serum level is 34 ng/ml vs the baseline of 25 ng/ml.
There is an 83% reduction in incidence when the serum level is 50 ng/ml vs the baseline of 25 ng/ml.
The x’s in the bars indicate ‘reasonable extrapolations’ from the data but are beyond existing data.
References:
All Cancers: Lappe JM, et al. Am J Clin Nutr. 2007;85:1586-91. Breast: Garland CF, Gorham ED, Mohr SB, Grant WB, Garland FC. Breast cancer risk according to serum 25-Hydroxyvitamin D: Meta-analysis of Dose-Response
(abstract).American Association for Cancer Research Annual Meeting, 2008. Reference serum 25(OH)D was 5 ng/ml. Garland, CF, et al. Amer Assoc Cancer Research Annual Mtg, April 2008,. Colon: Gorham ED, et al. Am J Prev
Med. 2007;32:210-6. Diabetes: Hyppönen E, et al. Lancet 2001;358:1500-3. Endometrium: Mohr SB, et al. Prev Med. 2007;45:323-4. Falls: Broe KE, et al. J Am Geriatr Soc. 2007;55:234-9. Fractures: Bischoff-Ferrari HA, et al. JAMA.
2005;293:2257-64. Heart Attack: Giovannucci et al. Arch Intern Med/Vol 168 (No 11) June 9, 2008. Multiple Sclerosis: Munger KL, et al. JAMA. 2006;296:2832-8. Non-Hodgkin’s Lymphoma: Purdue MP, et al. Cancer Causes Control.
2007;18:989-99. Ovary: Tworoger SS, et al. Cancer Epidemiol Biomarkers Prev. 2007;16:783-8. Renal: Mohr SB, et al. Int J Cancer. 2006;119:2705-9. Rickets: Arnaud SB, et al. Pediatrics. 1976 Feb;57(2):221-5. Canadians: Janz T.
Pearson C. Vitamin D blood levels of Canadians. Statistics Canada. 2013 January; ISSN 1925-6493. US: Al-khalidi et al., Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease
in U.S. adults: a cross-sectional analysis of NHANES, 2001-2010. Nutrition Journal. 2017, 16:16. Tribal Africans: Luxwolda M.F. et al. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration
of 115 nmol/L. Br J Nutr. 2012 November; 108(9):1557-61. Outdoor Workers: Barger-Lux M.J. Heaney R.P. Effects of Above Average Summer Sun Exposure on Serum 25-Hydroxyvitamin D and Calcium Absorption. J Clin Endocrinol
Metab. 2002 November. 87(11):4952-6
33% 54%46%
SerumReferenceLevel
Chart prepared by: Garland CF, Baggerly CACopyright GrassrootsHealth, 05/11/2017 www.grassrootshealth.net
30% 83%
50%
30%
X X X X X X X X
40-60 ng/ml suggested range
Serum Level
1
Only Rickets Prevented
at 20 ng/ml
2
40-60 ng/ml to Prevent
Majority of Diseases
3
US & Canadian Average Outdoor Workers
in Late Summer
Tribal East
Africans