Labs

PTH level 156

Akaline phosphate 187

Calcium 8.6

Worried

It doesn't sound great. Have you had a dexascan to see if it's been an issue long enough to cause a problem?
What kind of vit dosages are you taking ie calcium/K2/Magnesium?

You've identified a problem so that's half the battle now it's just figuring out how big a problem and how to fix it.

Pete

You are right to be worried. Your PTH is very high, and the reason is that you aren't getting in enough calcium. Now, that may not seem obvious as your calcium level is ok, but blood calcium levels are tightly regulated because too low calcium is dangerous for your heart. So your body steals calcium from your bones to compensate for inadequate intake (or failure to absorb enough) by raising PTH, which takes calcium out of your bones to keep your calcium level within range.

I don't know how much calcium you're taking, I just know it isn't enough, or it isn't the right form of calcium, or both. We need calcium citrate, as calcium carbonate is not well absorbed by us. And most of us take at least 3-4 doses/day, and each dose should be 500 mg. Since the pills are large, a dose equals 2 pills or most brands, not just one pill. Be sure to read the label to make sure it's calcium citrate (some of the names are confusing) and how much is in each pill. If you are like me and just can't swallow those horse pills, either use a pill cutter (cheap at Walmart or any drug store) or get chewable calcium citrate. Costs more, but worth it.

What may happen is that your pcp will think you have an abnormal growth of your parathyroid gland(s) and order a fancy work-up and someone may even recommend surgery. but really, the problem is almost certainly inadequate calcium intake/absorption.

Larra

You may also need up up your D3.  When my PTH was high, I was taking calcium 6x/day.  I was also taking 150k of D3.  That was enough to bring my D up to 120 and my PTH down to 25.

your PTH is high because your serum calcium is low, while you may say that it is "normal" this is due to your PTH, its job it to keep your calcium in a very tightly controlled range, to increase the calcium in your blood.  Because your heart is more imp than your bones, your body will sacrifice everything including your calcium stores in your bones to keep this tight calcium control.  You need to increase your calcium citrate, and most likely increase your Vit D3, your Alk phos (if fractionated should reveal that the bone alk phos is high) are all indicators you are prime candidate for metabolic bone disease....you can turn it around.....