PTH

I'm 4 yrs. post TT and have had muscle twitching and cramping on and off since. I had my pth tested last year where it came back at 7/calicum normal with some muscle twitching and cramping. This year my pcp ran another PTH and it came back at 4/calicum normal with even more muscle twitching and cramping. My pcp raised my vitamin D to 4000 IU daily and after 2 days of taking it my back and stomach just aches and wants to go into spasms. My last vitamin D level was 32 taking 2000 IU a day. When not taking it I get severe cramps in my calves and feet.What can I do to make taking vit. D a little easier on the body?
I was told that the PTH really doesn't matter as long as the calcium is normal. What happens when the pth goes to 0? Just wondering. Is there any other conditions related to low pth other than hypoparathyroidsm? Why isn't my calcium low as well. Only thing I can think of is that I am a big milk drinker. (32-40oz.+ daily) Could this be throwing my blood calcium off?
Thank you so much for your reply.

[Mark Lupo, M.D.]

would consider testing ionized calcium and magnesium
with the normal calcium, it is hard to conclude the symptoms are due to low calcium -- so must look at magnesium levels (which can also cause low PTH).
4000IU of vitamin D is reasonable but the vitamin D of 32 is fairly normal.
The high milk intake could cause normal appearing calcium with low PTH, but there is likely more going on.