# Endo Against 25ohd Test Pregnancy

> Recommends against routine 25(OH)D testing during pregnancy. Use when a clinician considers ordering 25(OH)D tests for pregnant patients lacking established indications such as hypocalcemia or malabsorption.

- Skill: `dromlakhani/endo-against-25ohd-test-pregnancy` (Agent Skill)
- Install (CLI): `npx skillmds@latest add dromlakhani/endo-against-25ohd-test-pregnancy`
- Raw SKILL.md: https://api.skillmd.com/api/skills/dromlakhani/endo-against-25ohd-test-pregnancy/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: dromlakhani (https://skillmd.com/u/dromlakhani)
- Updated: 2026-09-08
- Page: https://skillmd.com/skills/dromlakhani/endo-against-25ohd-test-pregnancy

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# Against routine 25(OH)D testing during pregnancy

## STEP 1 — Gather Information
Confirm pregnancy and gestational age; assess for established indications for 25(OH)D testing (e.g., hypocalcemia, malabsorption syndromes, chronic kidney disease, osteoporosis treatment, prior bariatric surgery) and review symptoms suggestive of vitamin D deficiency.

## STEP 2 — Rule In / Rule Out
If an established indication is present, proceed to 25(OH)D testing; if no established indication is identified, rule out routine testing.

## STEP 3 — Classify or Stratify
Classify patients without indications as “routine testing not indicated”; those with indications proceed to testing per clinical judgment.

## STEP 4 — Decide
For patients without indications, do not order routine 25(OH)D testing; consider empiric vitamin D supplementation per Recommendation 8 if desired, but do not base dosing on 25(OH)D levels.

## Clinical Guardrails / Mimics / Pitfalls
Do not use 25(OH)D results to guide vitamin D supplementation dosing in pregnancy; avoid testing low‑risk pregnant individuals solely for deficiency screening; recognize that empiric supplementation may be beneficial but testing adds cost and may exacerbate inequities; do not interpret 25(OH)D levels using non‑pregnancy‑specific thresholds.

## Concrete Clinical Example
A 30‑year‑old patient at 16 weeks gestation requests a vitamin D level after reading online; she has no history of hypocalcemia, bariatric surgery, chronic kidney disease, or other indications. Clinician advises against routine testing, discusses empiric vitamin D supplementation (e.g., 600–2000 IU daily) if she wishes, and documents that testing is not required.

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