Joint position on vitamin D prescription in the adult Mexican population by AMMOM, AMEC, AMG, CMIM, CMO, CMR, CONAMEGER, FEMECOG, and FEMECOT.

Abstract

Background: Vitamin D deficiency remains a critical health concern linked to skeletal disorders such as osteoporosis, osteomalacia, and fractures. Recent evidence highlights the broader role of vitamin D in preventing chronic conditions, including autoimmune diseases, diabetes, and cardiovascular events. However, inconsistencies in clinical practice across Mexico and limited population-specific data necessitate standardized guidelines to address diagnostic and therapeutic challenges.

Objective: To establish evidence-based recommendations for diagnosing and prescribing vitamin D supplements tailored to the Mexican adult population, reducing practice variability while promoting optimal health outcomes.

Methods: A multidisciplinary panel comprising specialists from nine leading Mexican medical organizations conducted a consensus process using the Delphi methodology. The recommendations were developed using a combined approach, integrating extensive literature reviews with expert consensus to address areas where empirical evidence is limited. The process informed guidelines for vitamin D supplementation, measurement criteria, and therapeutic monitoring.

Results: Key recommendations include: Measuring 25(OH)D levels in adults with risk factors or conditions associated with hypovitaminosis D, avoiding routine screening in healthy individuals. Defining vitamin D deficiency as < 20 ng/mL, insufficiency as 20-29 ng/mL, and sufficiency as 30-100 ng/mL. Preferring cholecalciferol for supplementation, with calcifediol reserved for specific cases requiring rapid correction or compromised hepatic hydroxylation. Regularly monitor serum 25(OH)D concentrations to achieve and maintain levels between 30 and 60 ng/mL, ensuring safety and therapeutic efficacy.

Conclusion: This joint position provides a comprehensive framework for managing hypovitaminosis D in Mexican adults. The recommendations aim to harmonize clinical practices, improve patient outcomes, and inform public health strategies for equitable resource allocation. Ongoing evaluation and stakeholder feedback will ensure adaptability and relevance as new evidence emerges.