30 year old male. Osteoporosis. PTH fluctuates.

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ive felt really bad for about 3 years. ive had many tests for stomach pain, headaches, fatigue and weakness. For 3 months my knee has been hurting so i had xrays. they showed osteoporosis and im being evaluated for tears etc. In april of 2017 my PTH was 42 pg/ml and as of last week my PTH is 66 pg/ml lab range is 12-76 pg/ml. I've had low vitamin d for over 2 years now even with supplementation and my calcium is always perfect. usually about 9.3. Is the large increase in PTH alarming? Its not normal to have osteoporosis at this age.

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  • Posted

    Hello, please go to parathyroid , it will give you information on hyperparathyroidism, this could be a possible reason for your diagnosis.

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  • Posted

    Hi Shadowsfall47, have you ever had a scan of your thyroid and parathyroids? A parathyroid adenoma, for example, can secrete PHT in an unregulated manner and may lead to hyperparathyroidism. In that case, Ca is released from your bones into the blood stream and the bone density decreases.

    Btw, hyperthyroidism can also lead to bone density loss by increasing the bone turnover rate. But I assume your doctors already checked your thyroid hormone levels.

  • Posted

    my thyroid blood tests come back normal. my pth was mid range a year and a half ago and is now at the top of the normal scale. i dont think this fluctuation in pth is normal but that's what im asking

    • Posted

      Hyperparathyroidism leads to an elevated PTH level but usually also causes a high (serum) Ca level. This article might be of interest to you:

      Does vitamin D affect calcium levels and the parathyroid glands?

      Vitamin D helps the intestines absorb calcium. However, the vitamin D must first be activated or "turned on" by parathyroid hormone (PTH). Once activated, vitamin D acts to greatly increase the amount of calcium that the intestines can absorb from food, sometimes by as much as two to four times. The body can either make its own vitamin D using a process that requires sunlight or obtain vitamin D directly from the diet (e.g. in fortified milk or vitamins). Many people across the world have vitamin D deficiency — experts estimate that one-third of Americans are vitamin D deficient.

      For patients with vitamin D deficiency, it is difficult for the body to obtain calcium from the diet. This often leads to a rise in the PTH level, since the parathyroid glands must increase the PTH production in order to increase calcium levels by "stealing" it from the bones. Therefore, people with a normal blood calcium levels and a high PTH level may have secondary hyperparathyroidism(see Special Cases: Secondary Hyperparathyroidism), which means that the high PTH level is a normal response of healthy parathyroids glands to another problem (like vitamin D deficiency or kidney failure).

      It is quite common for a person to have both primary hyperparathyroidism and vitamin D deficiency, since primary hyperparathyroidism can lead to decreased vitamin D stores. This can sometimes make it difficult to establish the diagnosis of primary hyperparathyroidism. It is generally advisable to have the blood vitamin D levels checked during the work-up of parathyroid disease. For people who may have both primary hyperparathyroidism and vitamin D deficiency, some are best treated with surgery first, and others are best treated with vitamin D first. This decision should be made with your physician. (source: American Association of Endocrine Surgeons)

    • Posted

      im not really sure what to make of my vitamin D. if you can figure anything out of this i would appreciate. as i said my PTH and calcium levels have increased steadily over the past year as well bit are both still within normal range

    • Posted

      The column on the left refers to calcidiol, a vitamin precursor. It is produced from Vit D in the liver and is an indicator of your term Vit D level.

      The column on the right refers to calcitriol. This is the active form of the vitamin. Calcidiol is converted to calcitriol in the kidneys. A high or low calcitriol level is less significant since it varies rapidly after ingestion of Vit D or exposure to the sun.

    • Posted

      I meant to write: indicator of your * long* term Vit D level.

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