PTH question?

Hi Guys, so got some bloods back and my PTh intact is 34 and my TSH is o.86. Is this a good thing or not? D3 was 41??

Yorkie x

 Your PTH is good - I would die to have a PTH that low!   Although it would be wonderful thing to get your D higher, my endo doc explained to me that we all have a different capacities for how much we can absorb, and with a low PTH like that, your D is acceptable.   What dose are you taking of D?   I'd still try to work on getting that up there, but what some people don't understand around is here is that that might be as good as it gets for you.     For example my D is a 31 (just one point into the lowest of low normal range) but my PTH is 157.    So for me, the high PTH indicates that my D is unacceptable.   

 Hi Julie,

You are right; each person has their own "set-point."
PTH does not increase in every deficient patient. Oral calcium intake defines the PTH reaction - the higher the daily dose of calcium, the lower the vitamin D level required to start the PTH reaction. 
Does your MD ever monitor your Osteocalcin level or other markers of bone resorption?
Are you taking rifampin, an anticonvulsant, diuretic, lithium, or other medication containing phosphate? PTH has a half-life of ~ 4 minutes. 

With this said, it is important to monitor other measures of bone resorption in addition to PTH (osteocalcin, etc). Significant weight loss and inadequate protein intake are also significant factors associated with bone breakdown. Vitamin K def. can also lead to metabolic bone disease. 

As of my last set of labs, which were taken last summer (I am OVERdue for them, but the Vitamin D specialist I saw is 4.5 hours away, so I'm waiting till school is out to see him) shows that my serum phosphorus is high and my bone specific alk phos is high - no osteocalcin listed on this set of labs, unfortunately, and I know it should be.   Also, my 24 hour urine stone profile is terrible, but a CT of the kidney shows no stones...yet!

Have you considered any meds for your osteoporosis? zoledronic acid?

My doctor and I have discussed Reclast.   My DEXA scores, as of last-year, showed ostepenia of the spine and osteoporosis of the femur.   I think I was a -2.3 something for the spine and -2.7 for the femur, so definitely, I am a candidate.    My doc did not want to do anything until my serum calcium was stable, which, last I checked, now finally is.     I am perimenopausal at age 50 and still having regular periods.  

 awesome. :)  It may be costly, but worth it. 

Your PTh and TSH look good to me. 
In the US we more often give vit. D levels in nanograms/mL (I think that's it), while internationally it is more often given in nanomoles per (I forget the second part).  I think either way (if you have Vit. D at 41 in either of those ways of measuring it), it is in what mainstream labs consider to be the normal range, but the ones around here who go by VitaLady's targets want it to be higher than that. 

I don't know what your ranges are measured in, but for PTH you want to be medium low end of the range and the D3 you want to be at the very top if you can.
 
--gina