elevated PTH

[PatD195]

I had gastric bypass surgery 3 years ago. My PTH was 101 in June 09, and now in Aug 09 has elevated to 141. My calcium levels have been normal. (None done since June 09).
My Vit D is also normal at 55 in June 09. I developed osteopenia in 2008, one year past GBS(rou-en-y). in 2009 my numbers had worsened by 5%, even with Boniva, then Fosamax. I have many of the symptoms of hyperparathyroid, most notably new dx of A-Fib in the last year.
What should I do? Should I be concerned?

[Mark Lupo, M.D.]

After gastric bypass, malabsorption is common and the PTH level will increase to help regulate calcium.  Taking vitamin D and calcium can help with this.  Depending on the serum calcium level, there is an outside chance this is a parathyroid benign tumor (ie if Ca is >10 it is more likely) but usually in these cases the Ca is in the 8.5-9.5 range) and taking extra oral calcium and vitamin D is the best bet.

Fosamax may (although this is not definitively proven) increase the risk of atrial fibrillation but parathyroid disease does not.

[PatD195]

Thank you! I will be seeing my Dr soon, just wanted some background info also! I'm a nurse and you know we get technical when it's us or our family!

[PatD195]

I have been on Calcium and VitD for 3 yrs! I see you have MD in your tagline, are you a physician? I understand that calcium is leaching from my bones, and I have been on replacement therapy for that. In fact, I just completed the IV Reclast last month. I need to know what else can be done, or do I just have to live with this. By the way, in researching PTH, arrythmia's were a symptom of hyperPTHism.