Interpreting Vitamin ADE Levels in Serum: A Guide for Researchers and Clinicians

Vitamins A, D, and E play critical roles in various physiological processes, including vision, immune function, bone health, and antioxidant defense. Measuring serum levels of these vitamins is essential for diagnosing deficiencies, monitoring treatment efficacy, and conducting research in both human and veterinary medicine. This guide provides an overview of the importance of vitamins A, D, and E, methods for measuring serum levels, and considerations for interpretation.

Importance of Vitamins A, D, and E

Vitamin A is crucial for maintaining healthy vision, immune function, and cellular growth. It exists in two primary forms in the diet: retinol (preformed vitamin A) and beta-carotene (provitamin A). Retinol is directly used by the body, while beta-carotene is converted into retinol in the intestines.

how the different forms of Vitamin A relate to each other . Vitamin A can get from either plant food source or from animal food source. Both have different ways of being converted

Vitamin D is vital for calcium and phosphorus metabolism, which are critical for bone health. It also modulates immune function and reduces inflammation. Vitamin D can be synthesized in the skin upon exposure to sunlight or ingested through diet and supplements.

Autocrine and Endocrine Functions of Vitamin D

Vitamin E acts as a powerful antioxidant, protecting cell membranes from oxidative damage. It is essential for immune function and skin health and exists in various forms, with alpha-tocopherol being the most biologically active.

Methods for Measuring Serum Levels

Accurate measurement of vitamin A, D, and E levels in serum is crucial for proper diagnosis and research. The following methods are commonly used:

  1. High-Performance Liquid Chromatography (HPLC): This technique is considered the gold standard for measuring serum levels of vitamins A and E. It provides high specificity and sensitivity by separating and quantifying individual vitamin components.

Schematic Representation of High-Performance Liquid Chromatography

2. Liquid Chromatography-Mass Spectrometry (LC-MS/MS): This method is highly accurate and can simultaneously measure multiple vitamins and their metabolites, including vitamin D. It is particularly useful for research settings due to its ability to handle complex biological samples.

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) workflow for data-dependent analysis (DDA) phosphoproteomics.

3.Immunoassays: Enzyme-linked immunosorbent assays (ELISAs) and radioimmunoassays are commonly used for vitamin D measurement. These methods are less labor-intensive and suitable for high-throughput clinical settings but may lack the specificity of HPLC and LC-MS/MS.

Interpretation of Serum Levels

Interpreting serum levels of vitamins A, D, and E involves understanding reference ranges, potential confounding factors, and the clinical context.

Reference Ranges:

  • Vitamin A (Retinol): 20-80 µg/dL. Levels below 20 µg/dL indicate deficiency, while levels above 80 µg/dL may suggest toxicity.
  • Vitamin D (25-hydroxyvitamin D): 30-100 ng/mL. Levels below 30 ng/mL are considered insufficient, and levels below 20 ng/mL indicate deficiency. Levels above 100 ng/mL may be toxic.
  • Vitamin E (Alpha-tocopherol): 5-20 mg/L. Levels below 5 mg/L suggest deficiency, and levels above 20 mg/L can indicate excessive supplementation.

Confounding Factors:

  • Age and Sex: Reference ranges may vary with age and sex. For example, vitamin D levels tend to decrease with age.
  • Season and Geographic Location: Vitamin D synthesis depends on sunlight exposure, which varies by season and location.
  • Diet and Supplementation: Dietary intake and the use of supplements can significantly impact serum levels.
  • Health Conditions: Chronic diseases, liver and kidney disorders, and malabsorption syndromes can affect vitamin levels.

Clinical Context: Interpreting vitamin levels should always consider the patient's clinical context, including symptoms, dietary habits, and medical history. For instance:

  • Low vitamin A levels in a patient with night blindness and frequent infections may indicate a deficiency requiring supplementation.
  • Elevated vitamin D levels in a patient taking high-dose supplements could suggest the need for dosage adjustment to avoid toxicity.
  • Low vitamin E levels in a patient with cystic fibrosis might necessitate increased supplementation due to malabsorption.


Understanding and accurately interpreting serum levels of vitamins A, D, and E is essential for diagnosing deficiencies, monitoring treatment, and conducting research. High-performance techniques like HPLC and LC-MS/MS provide precise measurements, while immunoassays offer practicality for clinical settings. Researchers and clinicians must consider reference ranges, confounding factors, and the clinical context to make informed decisions about patient care and research outcomes.

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Interpreting Vitamin ADE Levels in Serum: A Guide for Researchers and Clinicians
Gentaur Bvba, Lieven Gevaert June 20, 2024
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Améliorer l'efficacité de la recherche sur la vitamine D : Avantages du kit d'analyse LC-MS/MS APCI du sérum 25-OH vitamine D2-D3