dose of calcitriol and calcium in hypoparathyroidism

[sudeshsud]

respected doctor,
my Mother is a case of Hypo-Parathyroidism diagnosed one year back . Calcium levels at the time of diagnosis   5.4, Phospahte -11 and PTH -6.5. She also had Tetanic episode of the feet. She was started on calcium carbonate 4 tablets a day(500 mg each) & tab rocaltrol 0.25mg (2 tablets a day).her symptoms resolved with 5 months of treatment and her calcium levels improved to 8.4,phosphates dropped to 5.5 and PTH 2.5.As the levels improved the dose was reduced on her own.Presently on treatment with Shellcal (Calcium carbonate ) 500mg bd and Rocaltrol 0.25 mg od. Her CEC.T Brain done a week back shows extensive intra cranial calcification in the cerebellum,caudate nucleus & lentiform nucleus however with no involuntary movements. Present calcium level is 8.5, Phosphate -6.5 and 24 hour urine calcium is 60mg/day. No Tetanic episodes now since past 6 months however skeletal changes like mild deformity and eczema/contact dermatitis over theindex and middle  finger have started.Is this related to hypoparathyroidism?Also her cholestrol levels have stayed between 250 - 280 since the past one year ispite of being very careful with the diet.Does this also have somyhing to do with hypoparathyroidism?
Sir  Kindly advice the dose of calcium and calcitrol to be taken nowas the level of calcium has normalised.Also how to bring the cholestrol levels down?what to be done regarding the skin and skeletal changes.

[medicmommy]

The Dr is going to need more info like thypatient says...How old is your Mom? is there a history of Rheumatoid arthritis or alzheimers? Has she been tested for an autoimmune disease?
What's the level of ionized calcium? If the hypoparathyroidism was caused by surgery, the plaques in her brain may have been caused by previous hyperparathyroidism (with hypercalcemia)...If this is the case, these plaques are elsewhere too...Kidneys and blood vessels as well...At this point, it looks like the PTH and calcium levels are much improved (if I'm reading the labs right) and if she has excess, it should be flushed out of the body (urinated)...Hope this helps a little...                               ~MM

[Thypatient]

I agree.  This is a complicated one to know without being a medical professional.

There is a website of the Hypoparathyroidism Association called:

hypoparathyroidism.org

They also have a forum you can join for free and ask questions of members.  If you do go to the Dr's forum here to ask your question, or go there to ask a question, I would include how where your mother's hypoparathyroidism is coming from, i.e., was it surgery induced; did she just present symptoms; etc.

I can throw is a couple of random thoughts/guesses (...and I do mean guesses):

- Her calcium level now looks pretty good (It's better than my 7.5).  She should be able to take the regular amounts of calcium to maintain bone density.  That's usually 1000mg or less of elemental calcium (as in that part of calcium carbonate that is straight calcium).  I think the maintenance level of prescribed vit d is .25mg.

- I think the CEC.T Brain issue you describe is something of a different nature to the hypoparathyroidism, unless the hypo... is a diagnosed secondary issue.

(Oh, this is where it's too complicated so I need to stop...).

Good luck.  I know it's tough; I'm with you.

[ChitChatNine]

Hi .. this is the patient community ... you may want to try Dr. Lupo's board as this may be a bit complex for most here, WELCOME to Our Community!

Cheryl