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dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Endo Against 25ohd Test 50 74 by dromlakhani

Name: Endo Against 25ohd Test 50 74
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo Against 25ohd Test 50 74

Recommends against routine 25(OH)D testing in the general population aged 50 to 74 years. Triggered when a clinician considers ordering 25(OH)D for asymptomatic adults aged 50-74 without established indications such as hypocalcemia, malabsorption, or chronic kidney disease.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Against routine 25(OH)D testing in adults 50-74

STEP 1 — Gather Information

Collect patient age, presence of symptoms suggestive of vitamin D deficiency (e.g., bone pain, proximal myopathy), history of conditions that alter vitamin D metabolism (e.g., CKD, malabsorption, bariatric surgery, medications causing catabolism), and current supplement/diet intake.

STEP 2 — Rule In / Rule Out

Is the patient aged 50-74 years, asymptomatic, and lacking established indications for 25(OH)D testing? If yes, proceed to Step 3. If no (outside age range, symptomatic, or has established indication), consider testing per other indications.

STEP 3 — Classify or Stratify

Classify the request as routine screening (no indication) versus indicated testing. For routine screening in this age group, the recommendation is against testing.

STEP 4 — Decide

Do not order a routine 25(OH)D test; instead, discuss that empiric vitamin D supplementation beyond dietary reference intakes is not recommended for this age group without established indications, and focus on adequate calcium intake and lifestyle.

Clinical Guardrails / Mimics / Pitfalls

Do not use 25(OH)D levels to guide supplementation in asymptomatic adults 50-74; avoid testing in dark complexion, obesity, or pregnancy unless specific indications exist; recognize that testing may lead to unnecessary costs and potential over-treatment; do not apply this recommendation to individuals with malabsorption, CKD, osteoporosis, or other conditions affecting vitamin D metabolism.

Concrete Clinical Example

A 62-year-old man with no bone pain, fractures, or gastrointestinal surgery requests a vitamin D level after reading about deficiency online. He takes a standard multivitamin. According to the guideline, advise against routine 25(OH)D testing; explain that empiric supplementation above DRI is not recommended and that maintaining adequate calcium and weight-bearing activity is sufficient.

Source: Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2024, https://doi.org/10.1210/clinem/dgae290

---name: endo-against-25ohd-test-50-74description: Recommends against routine 25(OH)D testing in the general population aged 50 to 74 years. Triggered when a clinician considers ordering 25(OH)D for asymptomatic adults aged 50-74 without established indications such as hypocalcemia, malabsorption, or chronic kidney disease.---# Against routine 25(OH)D testing in adults 50-74## STEP 1 — Gather InformationCollect patient age, presence of symptoms suggestive of vitamin D deficiency (e.g., bone pain, proximal myopathy), history of conditions that alter vitamin D metabolism (e.g., CKD, malabsorption, bariatric surgery, medications causing catabolism), and current supplement/diet intake.## STEP 2 — Rule In / Rule OutIs the patient aged 50-74 years, asymptomatic, and lacking established indications for 25(OH)D testing? If yes, proceed to Step 3. If no (outside age range, symptomatic, or has established indication), consider testing per other indications.## STEP 3 — Classify or StratifyClassify the request as routine screening (no indication) versus indicated testing. For routine screening in this age group, the recommendation is against testing.## STEP 4 — DecideDo not order a routine 25(OH)D test; instead, discuss that empiric vitamin D supplementation beyond dietary reference intakes is not recommended for this age group without established indications, and focus on adequate calcium intake and lifestyle.## Clinical Guardrails / Mimics / PitfallsDo not use 25(OH)D levels to guide supplementation in asymptomatic adults 50-74; avoid testing in dark complexion, obesity, or pregnancy unless specific indications exist; recognize that testing may lead to unnecessary costs and potential over-treatment; do not apply this recommendation to individuals with malabsorption, CKD, osteoporosis, or other conditions affecting vitamin D metabolism.## Concrete Clinical ExampleA 62-year-old man with no bone pain, fractures, or gastrointestinal surgery requests a vitamin D level after reading about deficiency online. He takes a standard multivitamin. According to the guideline, advise against routine 25(OH)D testing; explain that empiric supplementation above DRI is not recommended and that maintaining adequate calcium and weight-bearing activity is sufficient.**Source:** Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2024, https://doi.org/10.1210/clinem/dgae290

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