Association between plasma 25-OH vitamin D and testosterone levels in men

Objective: A small randomized controlled trial suggested that vitamin D might increase the production of testosterone in men, which is supported by experimental studies in animals and a cross-sectional study showing positive associations between plasma 25-hydroxyvitamin D [25(OH)D] and testosterone and concordant seasonal variation of both biomarkers. Design and Measurements: We investigated the cross-sectional association of plasma 25(OH)D levels and total and free testosterone measured by immunoassay in 1362 male participants of the Health Professionals Follow-up Study who were selected for a nested case-control study on prostate cancer using multivariate-adjusted linear and restricted cubic spline regression models. Results: 25(OH)D was positively associated with total and free testosterone levels. From the lowest to the highest 25(OH)D quintile, multivariate-adjusted means (95% confidence interval) were 18.5 (17.7; 19.4), 19.4 (18.6; 20.2), 19.6 (18.8; 20.4), 20.1 (19.3; 20.9) and 20.0 (19.1; 20.8; P-trend = 0.003) for total testosterone and 97.7 (93.9; 101.5), 98.2 (94.1; 102.2), 99.2 (95.2; 103.2), 100.7 (96.9; 104.5) and 101.5 (97.6; 105.4; P-trend = 0.03) for free testosterone. The shapes of the dose-response curves indicate that the association between 25(OH)D and total and free testosterone is linear at lower levels of 25(OH)D (below approximately 75-85 nmol/l), reaching a plateau at higher levels. Unlike for 25(OH)D, we did not observe any seasonal variation of testosterone concentrations. Conclusion: This study supports previously reported positive associations between vitamin D and testosterone although we did not observe parallel seasonal variation patterns. Possible causality and direction of the vitamin D-testosterone association deserve further scientific investigation.