24/05/2026
Es correcto 🙌
There is no single vitamin D number that means "optimal." Different studies have linked different ranges to different outcomes, and the evidence behind those links is not equally strong.
Here is what the actual evidence ladder looks like.
Below 20 ng/mL: bone problems. Rickets, osteomalacia, accelerated bone loss. This is the floor the Institute of Medicine set based on randomized trials. If you are below it, fix it. This is the only threshold the bone literature really argues about, and even the Endocrine Society's 2024 guideline keeps it as the line for clinical deficiency.
At 40 to 50 ng/mL: the VITAL trial, the largest vitamin D randomized trial ever run (25,871 adults, 2000 IU daily for five years), showed a 22% reduction in autoimmune disease incidence (Hahn 2022 BMJ) and a 17% reduction in advanced or fatal cancer (Chandler 2020 JAMA Network Open) at this typical-supplementation range. These were secondary endpoints, not the primary ones. The primary endpoints (total cancer incidence, cardiovascular events, all-cause mortality) were null. But the secondary signals are still randomized trial data. That is a different kind of evidence than a correlation from a database, and it deserves to be reported as such rather than buried.
Above that: things get observational. The "sufficiency" target of 30 ng/mL that older guidelines pushed. The "lowest mortality" range of 40 to 60 you see in dose-response meta-analyses. The chase toward 70 or 80 ng/mL in online protocols and concierge practices. These all come from studies where people with higher vitamin D had lower disease rates. The problem is that healthier people also have higher vitamin D. They go outside more. They exercise more. They have less inflammation, less obesity, less of the chronic illness that suppresses 25(OH)D in the first place. Reverse causation and confounding are real, and randomized trials at these higher target ranges have not been done.
Above 150 ng/mL: symptomatic toxicity has been reported in case series. Hypercalcemia, kidney injury, hospitalization. Galior's 2018 case review found symptomatic intoxication occurred at 25(OH)D between 150 and 1220 ng/mL. The 100 ng/mL figure that circulates online is a laboratory "high range" cutoff, not a clinical toxicity threshold. The actual upper bound where harm has been documented is higher and the gap matters when people see a result of 90 or 110 and panic.
The honest framing: 20 ng/mL is the floor with the strongest evidence. 40 to 50 is where the autoimmune and advanced cancer signal lives in randomized data. Everything above that is a guess refined by observation, and most of those guesses came from companies and clinics selling tests, protocols, or both.
If your 25(OH)D is below 20, that is the only level the evidence is actually unanimous about. If it is in the 30 to 50 range, you are in territory where the strongest signal exists for autoimmune disease and advanced cancer at the high end of that band. If you are above 60 and chasing 80, you are operating on observational inference, not trial evidence. None of those choices are unreasonable. They are just not equally supported.
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Demay et al., J Clin Endocrinol Metab 2024 · Ross et al., J Clin Endocrinol Metab 2011 · Manson et al., NEJM 2019 · Hahn et al., BMJ 2022 · Chandler et al., JAMA Network Open 2020 · Galior et al., Nutrients 2018
