Could I have a parathyroid problem?

[FerrisWheel]

Hello, My calcium and PTH has been checked various times over the past few years because I have osteoporosis and I am in my early 30's.  Both Calcium/PTH levels go up and down a lot, especially in the last 12 months.  In 2003, it was checked and PTH was 50 with calcium 10.1 with osteopenia. My vit D was around 40 while taking 600mg Ca and 250 Vit D for a few months per doctors orders.  I stopped taking it due to constipation, and had levels checked in 11/07.  Vit D was down to 18 and calcium was 9.6 with ionized Ca (being checked for the first time) at 5.7 which was slightly above range.  My PTH was still around 50.  In the last 12 months, my Ca and PTH have been going up and down.  Ca was 8.8 (never that low before) and then in summer it went up to 10.2 consistently for 3 months while getting a lot of sun and vit D levels around 40.   Now, in fall/winter - vit D is going down (25 now) and PTH was 92 with Ca at 8.8.

Since Ca levels have been in 10's, my Bun/creatinine ratio has been elevated along with liver function tests and alkaline phosphatase which I read is high with parathyroid disease.
Should I look into this with a specialist?  Or, does this seem normal?  Docs want me to take a lot of vitamin D tro get it into the 50-70.  

Is that the best thing to do?  It seems when my vit D levels get into range, Ca levels go into the 10's.  If Vit D was to get optimal, I wonder if Ca would be even higher.

Thanks!

[Mark Lupo, M.D.]

Would consult w/ an endocrinologist - this may be early primary hyperparathyroidism along with some vitamin D deficiency.