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Whether such an association exists in multiple chemical sensitivity (MCS) has not been clarified. This study aimed to compare serum 25-hydroxyvitamin D (25[OH]D) concentrations between patients with MCS and healthy controls. We conducted a case\u2013control study including 80 patients with physician-diagnosed MCS and 5,518 controls. Serum 25(OH)D concentrations were compared using a general linear model with bias-corrected and accelerated bootstrap resampling (1,000 iterations), adjusting for age, sex, season of blood collection, smoking status, body mass index, alcohol intake, and physical activity. Vitamin D deficiency (&lt;\u200920 ng\/mL) was highly prevalent in both groups (78.8% in MCS vs. 75.3% in controls). Median serum 25(OH)D concentrations did not differ significantly between groups (14.6 vs. 15.6 ng\/mL,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.622). Adjusted analyses confirmed no statistically significant difference (adjusted difference\u2009=\u20091.07 ng\/mL, 95% CI: \u22120.18 to 2.46,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.119). Despite the high prevalence of vitamin D deficiency, patients with MCS did not differ significantly from controls in serum 25(OH)D concentrations. Although serum 25(OH)D concentrations did not differ significantly between groups, the findings do not exclude a mechanistic role of vitamin D. Local dysregulation of vitamin D receptor signaling or tissue-specific activation may contribute to neuroimmune sensitization in MCS, highlighting the need for system-level investigations.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-44643-w","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:50:57Z","timestamp":1773773457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of serum 25-hydroxyvitamin D levels between patients with multiple chemical sensitivity and healthy controls: A case\u2013control study"],"prefix":"10.1038","volume":"16","author":[{"given":"Kentaro","family":"Watai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sae","family":"Ochi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomokazu","family":"Matsuura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Azuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"44643_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/s12199-018-0715-2","volume":"23","author":"K Nakamura","year":"2018","unstructured":"Nakamura, K. et al. 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