Lab Explainer

Why Is My Vitamin D Low?

Vitamin D deficiency affects an estimated 1 in 5 people in the UK. It's tested infrequently, misunderstood often, and treated inconsistently. If your level came back low — or "borderline" — here's what you need to know.

Medical disclaimer: This page is for educational purposes only. It does not constitute medical advice. Always discuss your results with a qualified healthcare professional before making any health decisions.

What do the numbers mean?

25-OH Vitamin D (nmol/L)LabelWhat it means
Below 25 nmol/LDeficientHigh risk of bone disease, immune dysfunction, depression
25–50 nmol/LInsufficientSymptoms likely — fatigue, low mood, muscle weakness
50–75 nmol/LAdequateNHS minimum, but many feel better above 75
75–150 nmol/LOptimalMost research supports this range for overall health
Above 250 nmol/LToxicity riskSupplement-induced excess — rare but possible

Vitamin D is technically a hormone, not just a vitamin. It regulates calcium absorption, immune function, mood, and over 200 genes. Its effects are systemic — which is why deficiency shows up in so many different ways.

Normal vs Optimal — there is a difference

The NHS classifies 50 nmol/L as adequate. Many vitamin D researchers and endocrinologists argue the optimal range for immune function, mood, and bone health is 75–120 nmol/L.

A result of 52 nmol/L passes as normal. Yet a meaningful number of people at that level report fatigue, seasonal depression, and frequent infections. This gap between "not deficient" and "thriving" is where most people fall through the cracks.

Common symptoms you might notice

Fatigue and low energy
Low mood or depression
Frequent infections
Bone or muscle pain
Hair loss
Slow wound healing
Brain fog
Seasonal mood changes

Common causes

  1. Limited sun exposure — the primary source of vitamin D (UK winters especially)
  2. Dark skin — melanin reduces UV absorption, requiring more sun exposure
  3. Obesity — vitamin D is fat-soluble and sequestered in adipose tissue
  4. Gut malabsorption — Crohn's, coeliac disease, bariatric surgery
  5. Kidney or liver disease — impairs conversion to the active form
  6. Strict vegan or vegetarian diet with no fortified foods

Questions to ask your doctor

Copy these before your next appointment. Your doctor will appreciate that you came prepared.

  • My vitamin D is {value} nmol/L — what level are you aiming to get me to?
  • What dose of D3 do you recommend, and should I take it with K2?
  • How long until we retest, and what level would you consider optimal for me?
  • Is there an underlying absorption issue we should rule out?
  • Are my calcium and PTH levels normal given this vitamin D result?

Have this marker in your results?

Get your vitamin D result contextualised alongside your calcium, PTH, and other markers. Upload your full report and get a plain-English breakdown of every value — plus a personalised question list for your doctor.