High PTH

 I have been taking prescription Vit D and Calcium supps for over 1.5 years now looking to bring down my extremely high PTH; it's 142 and the normal range is 10-65. I've done a 24 hr urine collection to make sure my body is keeping the calcium I'm taking and it is. Nobody can seem to figure out why my PTH stays so high and my Vit D levels are normal though on the lower end. My calcium is also normal; 9.5 and normal is 8.6-10.2. I've seen an Endocrinologist as well as my PCP and surgeon who did my DS. Not sure what to do now. Any advice? Seen anything / experienced anything like this before?

Also, on a side note my ferritin is 263 and normal range is 10-154. Is it okay to have it that much higher than the normal range? I am happy because I've had several infusions over the years but didn't know about it being nearly 2xs the normal high end range. Thoughts?

Thanks in advance.

High PTH means that you are leaching calcium from your bones to maintain that normal calcium blood level.  Prescription D is worthless.  It is usually D2 and we can't absorb that.  You have to take dry D3.  You can get it from vitalady and on amazon.  Get the 50K unit dose and take 2 per day.  Optimally you want to have you D level be above 80.  What is it currently?  The PTH is not going to come down until you get your D level up.  I would suggest adding 100,000 units dry D3 per day and retest in 3 months (D, PTH and calcium levels). 

Have you had a DEXA scan to check for osteoporosis?  If you have not had one of these scans yet, I would highly suggest that you get one ASAP! 

Can you post your vitamin regimen?  That can help us help you too!

Thanks for the reply! Yes, the Drs just keep giving me the same old calcium/Vit D regimen which isn't working. My PTH keeps getting higher and higher. My DEXA in Jan of this year was normal; for now anyway. I have linked my labs here. Let me know what you think. Thanks for taking a look. I very much appreciate it and I'll be sure to get the dry D3.

http://awlschronicle.wordpress.com/2012/08/10/august-2012-la bs/ 

I only see your vite regimen in this doc. How about your actual lab values?

 Yup, they are both there. The next line down there is a 2nd file. That one is the labs. Here is a direct link I think. http://awlschronicle.files.wordpress.com/2012/08/labs_updated_aug_20121.pdf

Ok, got it.

Question for you.....how good are you at taking your vites?  Would you say 50%?  75%?  90%?  I just ask to see where you are at.  Your list shows that you are taking 5000mcg of B12 per day....but your B12 is only in the 400's?  Are you sure you are taking it every day?  Your taking enough calcium..but definitely up the dry D3 to 2 per day.

Regarding your labs....have you had your other B vites checked?  B1?  B6?  How about pre-albumin?  Vit K?  Vit E?  Zinc?  You seem to be missing some labs that should be checked.  Your total protein is on the low end of normal and could be better.  Add another shake a day.  How much protein do you get in per day? 

I would keep checking your D, calcium and PTH levels every three months until you get it better.  HTH.

 I take that list of stuff religiously M-F but don't take any but the scripts on Sat & Sun. However, I have been out of the B12 for a few weeks so haven't taken any so perhaps that is why that level is low. Yes, I never noticed that he wasn't including some of my others like K and no he's never tested me for other B's. I will make a note to have all of these included in my next set of labs. I've made an appointment to meet with him again in 90 days. I will double my dry D and you were right. I looked at my script D bottle and it says D2. Why would a Dr. who knows better prescribe me something he knows I can't absorb. It even looks clear in there like it's all gelly? Anyhow, thanks so much for the feedback. It makes perfect sense to me now after talking with you. Oh, and I have 2 protein shakes in the morning with my coffees 7 days/ week but I'll add a 3rd to up that protein # a bit. Thanks again. I'll repost in a few months when hopefully my #'s will be looking better. :))

Are you still being followed by your surgeon, or has your PCP taken over your care?

My surgeon/program has a 5 year follow protocol.  This gives the PCP time to wrap his/her head around all that is required to keep you healthy.  It helps to have a PCP that will *listen* to what you tell him/her. 

That being said, those are more rare than hen's teeth, and you may have to shop a bit, even if you've been going to your doctor for years, if there is a communication problem.

Most doctors don't like to own up to the fact that they don't know everything,  Your health, and your very life is at stake if you can't find a doctor that will allow you to guide him/her through unfamiliar territory.

Not official stats, but I would guess that 95% of MD's know little or nothing about post-bariatric nutrition..much less normie nutrition!

Did you have a parathyroid scan to rule out parathyroid tumors?

Hi Jazzy. Thanks for the response. Yes, I was going to my surgeon all the way up until July 1 this year. Now my PCP has taken over care due to the change to an HMO in insurance. Luckily for me he listens and really cares. He has been my PCP forever. However, as you said, he doesn't know anything about bariatric surgery and so he defers to me which is good and bad. Good because he's not trying to shove anything down my throat but bad because that means I have to really know my stuff to advise him what I need from him but I guess that's not a bad idea anyway. He always says, "you the boss; what you need from me? You tell me what you need; me do." He's Indian and had very broken English so this his how he sounds...LOL. He's really a very kind man. So I have been good about asking specifically what I need. I have not had a scan of my thyroid though. When I saw the endocrinologist she did something with it to see if there was a tumor but it was a blood test. Does this sound right? Perhaps I'll just check it with a scan to be sure. I plan to up the dose of dry D3 and see how that fairs too. I fully plan to stay on top of this and my PCP to stay healthy. I sure didn't go through all that comes with this surgery to end up unhealthy anyway although in a different way than when I was overweight. :)) Thanks again for the feedback.

That was probably a sestamibi test.  Did you have to drink anything or get an injection?  I had one...no, wait...I think that is an actual radiation-type test.  THe blood tests check for thyroid hormone levels.

You want to be careful about bombarding your thyroid with x-rays.