What does an elevated vitamin D 1,25 mean?

Mine is around 117. Top of the normal range is around 75. My vitamin D 25 was around 48, not too bad I guess. My calcium is normal; in the nines. But my PTH is always high; around 120.

My endo says that my high vitamin D 1,25 is normal for someone who's had gastric bypass, and that as long as my calcium is normal, I don't need to worry about it. 

Just wondering what you all thought about this?

Lynda

You're good. The new top of the range for D3 is closer to 150. Not sure why that PTH won't come down though. How much calcium do you take a day?

--gina

OK, so the vitamin D 1,25 is the "active" form of vitamin D.  It's the form of the vitamin that actually acts to increase calcium absorption in the intestine.  We usually measure the vitamin D 25 OH (inactive form) because that's the one that has been studied to tell us that's what is most indicative of our overall vitamin D status.

The pathway is something like:

Body recognizes that calcium level is low > body tells PTH to increase > PTH tells areas of the body (usually kidney) to activate vitamin D > vitamin D 25 turns to vitamin D 1, 25 > vitamin D 1,25 acts to increase calcium absorption

And yes, theoretically it could be dangerous if the vitamin D 1,25 never goes down because it just keeps telling the body to absorb absorb absorb calcium and that could raise the serum calcium level.  Which, in your case, isn't true.

My question would be -- why is the PTH still so high?  The correct response would be that once the body get its calcium back, the PTH goes down so that signal isn't constantly being sent.  It's certainly not something to worry about TODAY, but what about next year?  PTH also tells the body to take calcium from bone in order to maintain that balance so I really wouldn't want to see it high forever.

So, my next thought would be that maybe it's possible something else besides vitamin D is going on?  Is there enough calcium coming in?  Are other minerals doing OK?  These are just the things that'd be rolling around in my head instead of just writing it off completely.  I can't really give recommendations beyond that, I try to avoid that--I'm not really qualified to do so.  Sorry!

Hope that helped at least somewhat, maybe.

Gina and Kayla,

I see an endo for thyroid nodules and share my labs with him.  He SWEARS that PTH is meaningless if the Calcium is normal.  I have told him that I understood that a high PTH may mean that Calcium is being leeched from the bones and he vehemently argues that that is patently untrue and he is tired of GPs sending him patients with normal calcium and high PTH.

Can you direct me to some literature or studies that discuss the relationship between Calcium, PTH and D?

And also can you find anyting on Calcium supplementation in normies who have osteopenia via dexa scan?  My bf has had two broken bones in 2 years and his dexa scan showed osteopenia.  His GP told him to take "one Calcium a day."  (not even one dose, but one pill) and did not order ANY labs.  He said that too much calcium supplemetation can cause heart problems?  WTF???  I'm waiting for the next broken bone.  He's only 52 years old.

Thanks,

Becky

Hi Becky, you might like to read this:

http://labtestsonline.org/understanding/analytes/pth/tab/tes t

It would seem to agree with your endo's statement.

As far as you bf's GP, I've been hearing a lot of talk about normies getting their Calcium from food more so than supplements.  Maybe this GP is of that school....

Becky, I wonder if your boyfriend has a parathyroid tumor. There is an excellent site that I really think you should look at: www.parathyroid.com

There are pages and pages of information there and it's written in layman's terms. Very easy to understand. 

Yes, too much calcium can cause heart issues, as well as strokes. The body will lay down any excess calcium in the blood vessels. This causes hardening of the vessels. The site I gave you discusses all of this. 

You're right, a 52 year old man shouldn't have osteopenia and broken bones. Something isn't right here. 

Good luck,

Lynda

So sorry it took so long to reply. I'm just not on the computer much anymore. 

I'm taking about 1200 mgs of calcium citrate per day.

For years my calcium level hovered around 8.5, but then it started going up around a year ago. Mostly somewhere around 9.5. Twice in the past year or so it's been in the low 10s. I also have quite a bit of pain in my neck, right around my thyroid area. It's pretty much constant. I had an ultrasound done that showed something on or near my thyroid. The doctor didn't know what it was. We were thinking maybe it was a parathyroid tumor. But then I had two subsequent ultrasounds that showed absolutely nothing unusual in my neck. The pain is still there, however. Don't know why. 

With this new liver diagnosis, I'm wondering if the pain is from esophageal varices. I can't get in to see the actual GI (I initially saw the PA) till July, however, so I won't be able to ask about it until then. 

I don't know why my PTH is always too high. I don't know why my calcium has been going up, why I have neck pain, and why one ultrasound showed...something...yet the other two didn't. 

I don't know. I just know that my body does whatever the hell it wants and I'm so, so afraid that getting a revision will make things worse. Did I mention I'm terrified at the idea of having another surgery? 

Thanks for letting me vent,

Lynda

Here is what *I* would do:  I would make sure that my calcium is not being taken all at once. 1200mgs should be 2 doses. *I* would add another dose of calcium.  That is what *I* would do and my calcium, PTH and D are all good. :)

PS. I am 8 years out from DS surgery. :)