Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
163 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Suggest treatment for hyperparathyroidism

Answered by
Dr. Mirjeta Guni


Practicing since :2006

Answered : 2278 Questions

Posted on Thu, 16 Feb 2017 in Thyroid Problem and Hormonal Problems
Question: I have high PTH levels 2 readings 116 and 106 4 months apart, but normal calcium 8.9-9.6 and Vitamin D levels (40-46). My renal function is slightly decreased with CrCl .9-1.1, EGFR 45-60
Past Results
Graph of Past Results
Standard Range. 14-72pg/ml
10/26/16     116. 1/18/17      106

Calcium, Ionized
1.15 - 1.32 mmol/L. 1.17     
Answered by Dr. Mirjeta Guni 45 minutes later
Brief Answer:
About secondary hyperparathyroidism;

Detailed Answer:
Thanks for the query.

From the results you reported secondary hyperparathyroidism is suspected.
Calcium is commonly low-normal or low in moderate renal failure and high PTH is a physiological response to low calcium, and to the phosphate retention that occurs in renal failure.

You checked calcium levels but not phosphates.

However, the aim is to keep PTH lower than twice normal ranges and you are at these limits.

Vitamin D derivatives (alfacalcidol, calcitriol) are used to correct hypocalcaemia resulting from reduced renal activation of vitamin D, and also have a direct suppressive effect on PTH secretion.

Often dietary advice and phosphate binders taken with food are needed to keep phosphate within acceptable limits.
So, your treating physician will advice you rather to start phosphate binders and active Vit D.

Wishing you good health.

Best wishes,
Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. Mirjeta Guni 13 minutes later
I did check my phosphorus and that is 2.7 -3.5 (2.3-4.5 mg/do) so they are WNL
Answered by Dr. Mirjeta Guni 4 minutes later
Brief Answer:
About high PTH;

Detailed Answer:
Welcome back,
Did you ever check PTH early in your life, before the renal function was impaired and did you check urinary calcium?

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Mirjeta Guni 9 hours later
Urine calcium 6.3 (mg/dl)
24 hour calcium 126 mg24 hr (100-300 mg/dl)

I did not have any PTH previous readings that I am aware of.

Thyroid Stimulating Hormone (TSH)     2.82 µIU/mL     0.34 - 5.66 µIU/mL
Thyroxine, Free (FT4). 2.68 ng/dL      0.52 - 1.21 ng/dl
Answered by Dr. Mirjeta Guni 3 hours later
Brief Answer:
About high PTH level:

Detailed Answer:
At this point the only cause of raised PTH level is the impaired renal function.
There is nothing to do for the moment, just to keep the calcium, phosphates, PTH and VitD level under close monitoring.
Wish you good health!
Kind regards,

Above answer was peer-reviewed by : Dr. Remy Koshy

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Medical Topics ,   ,  

Recent questions on  Calcitriol

doctor1 MD

Dr. Ditah, Four weeks ago I wrote about my 92 yo mother that I was rehabbing for a fractured femur . She was crashing from low BP . We ended up...

doctor1 MD

My mother is 92 and is 4 months post hip surgery for a displaced fracture . Five weeks ago I kid napped her from the rehab center to truly rehab at...

doctor1 MD

Hi My wife who is 30 years old( 65 KG;5ft 2 inch) is suffering from ankle joint pain for last few months. Recently as per doctor's advice she had...

doctor1 MD

Hey there. Have some questions about hypopara. I had a total thyroidectomy 6 years ago and I have one partially working parathyroid. was fine for a...

doctor1 MD

My daughter has been sober for one year from methamphetamine! Three months ago she was diagnosed with thyroid cancer and had her thyroid removed...

doctor1 MD

Is it OK for me to be taking Amlodipine even though I'm hypoparathyroid? I am hypoparathyroid due to the inadvertant removal of 3 of my parathyroid...