Is vitamin D3 better than vitamin D2?
Short answer
What the two forms are
Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) differ only in one part of the molecule, the side chain.[2] Most steps of how the body activates and uses them are the same.[2]
- D2 is made by shining UV light on a compound from yeast. Mushrooms treated with UV light also contain D2.[2]
- D3 is the form the skin makes. Supplements make it from lanolin, the fat of sheep's wool. A vegan D3 from lichen is also sold.[2]
- Beef liver, egg yolks and cheese contain small amounts, mostly as D3.[2]
What the trials found
A 2012 review of trials that compared the two forms found that D3 raised the blood level of 25(OH)D more than D2.[3] The difference was clear when people took one large dose. With daily doses, that review found no clear difference.[3]
A 2024 review looked again at daily and weekly doses, in 20 trials that compared the forms. D3 still raised total 25(OH)D more.[1] In 12 daily comparisons measured with the same lab method (liquid chromatography-tandem mass spectrometry), the rise with D2 was 10.39 nmol/L smaller. That is 40% less than with D3.[1]
The NIH Office of Dietary Supplements comes to the same view. D3 raises the blood level more and keeps it high for longer, although the gut absorbs both forms well.[2]
Body weight changes the difference
In the 2024 review, body mass index (BMI) explained most of the differences between trials.[1] In people with a BMI above 25, the difference between D2 and D3 was no longer significant.[1] People with obesity may need more vitamin D of either form to reach the same blood level, because body fat holds on to it.[2]
Each form raises its own 25(OH)D
The liver turns D2 into 25(OH)D2 and D3 into 25(OH)D3. In the 2024 review, each form raised its own type by a similar amount. The difference was in the total.[1]
A third form: calcifediol
Some studies used 25(OH)D3 itself, also called calcifediol.[4] Per microgram, it is 3 to 5 times as strong as vitamin D3 at raising the blood level.[2] For food labels in the EU, EFSA proposed counting 1 µg of calcifediol monohydrate as 2.5 µg of vitamin D3.[4] According to NIH ODS, no calcifediol supplements appear to be sold to consumers in the US.[2]
What is still unknown
The two reviews measured blood levels, not health outcomes such as fractures or infections.[3][1] Whether a higher blood level from D3 also means a better health result is not known from these trials.[1] The EU upper limit of 100 µg a day for adults counts D2, D3 and calcifediol together.[4]
Sources (4)
- Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH)D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis. van den Heuvel EG, Lips P, Schoonmade LJ, Lanham-New SA, van Schoor NM Adv Nutr, 2024. PMID 37865222
- Vitamin D: Fact Sheet for Health Professionals. NIH Office of Dietary Supplements. ods.od.nih.gov
- Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis. Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, et al. Am J Clin Nutr, 2012. PMID 22552031
- Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) European Food Safety Authority, 2023. efsa.onlinelibrary.wiley.com
More about vitamin d
What is vitamin D?How do you get vitamin D from sunlight and food?What is vitamin D used for?What vitamin D blood level is too low?Is vitamin D safe?Does vitamin D prevent fractures?For education; not medical advice. Talk to a doctor before you start, stop or change a supplement.