High pth levels and confused

[Calfran]

I am a 26 year old female with no underlying health problems.  My endo checked my pth levels after my vitamin d 1,25 results came back high at 89 a month before.  My obgyn ordered the 1,25 when I asked her to check my vitamin d...not sure why she ordered that lab instead of 25. I am 5'8.5 and 165 lbs.

Results may 15 2012
Pth intact 87
Serum ca 9.3 (9.3 in march 2011)
Ionized ca 1.24
Phosporus 2.9
Vitamin d (25) 40 (22 in march 2011)
Creatinine .6 (.7 in march 2011)
Bun  10 (16 in march 2011)
24 hour urine normal at 303 
Alkaline phosphatase 49 (43 in march 2011)
No stones that I know of
Negative for celiacs


Follow up on 7/30/12
Pth intact 94
Serum ca 9.1
Ionized ca 1.22
Phosphorus 3.1
Creatinine .7
Bun 16
Alkaline phosphatase 55
Still no stones
Vitamin d results not back yet....but I take 2,000 I u daily, fish oil daily and I am in the sun often without sunscreen for at least 15 min.   So I'm thinking it should be fine.

What is this looking like?  I'm concerned about this being the beginning of Kidney disease or failure even though my creatinine and bun are fine.  Oh and I don't drink alcohol and I'm not a recovering alcoholic. 
Is it normal for my ca to fluctuate like that in just 2 months?
What are the possible causes for my high pth. I have researched the heck out of ca homeostasis and I am stumped with my results. I take in enough ca etc in my diet as well.
Should I be concerned?

Thanks!

[Mark Lupo, M.D.]

This is not straightforward.  Your kidney function is normal.  Your calcium is 9.1 and 9.3 both of which are normal.  Your vitamin D status is normal. Your 24-hour urine calcium was high normal.  This may be the most clear evidence that this situation may represent early primary hyperparathyroidism however at this point there is not enough data to move forward with surgical consideration.  The high normal urine calcium indicates that you're taking in adequate calcium.

[Calfran]

Just got vitamin d 25 results - 41 ng/ ml