Secondary hyperparathyroidism is a condition where the parathyroid glands produce excessive parathyroid hormone (PTH) to compensate for chronically low calcium levels in the blood. It is caused by vitamin D deficiency, chronic kidney disease, or malabsorption disorders that disrupt calcium metabolism. The Parathyroid Hormone (PTH), Intact test is the most important test for diagnosis because it directly measures elevated PTH levels.
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Secondary hyperparathyroidism is caused by chronic conditions that lower calcium levels in the blood, forcing the parathyroid glands to work overtime. The most common causes include chronic kidney disease, which impairs the kidneys' ability to activate vitamin D and regulate phosphorus, and vitamin D deficiency, which reduces calcium absorption from the intestines. Malabsorption disorders like celiac disease or Crohn's disease can also prevent adequate calcium absorption, triggering excessive PTH production as the body attempts to maintain normal calcium levels.
The Parathyroid Hormone (PTH), Intact test is the most important test for secondary hyperparathyroidism because it directly measures the level of parathyroid hormone in your blood. Elevated PTH levels confirm that your parathyroid glands are overproducing hormone in response to low calcium levels. Your doctor will typically order this test alongside calcium, phosphorus, and vitamin D tests to identify the underlying causeâwhether it's kidney disease, vitamin D deficiency, or another condition affecting calcium metabolism. This comprehensive approach helps determine the most effective treatment strategy.
You should get tested if you have chronic kidney disease, as this condition commonly leads to secondary hyperparathyroidism. Testing is also important if you experience bone pain, muscle weakness, or unexplained fatigue, which can indicate prolonged calcium imbalances. People with known vitamin D deficiency, a history of malabsorption disorders, or those taking medications that affect calcium metabolism should also consider testing to catch this condition early and prevent complications like bone disease.
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What this means
Your PTH level is slightly elevated above the optimal range. This may indicate your parathyroid glands are working harder than normal to regulate calcium levels, which could be due to vitamin D deficiency, early kidney issues, or mild parathyroid overactivity. While this elevation is modest, it's worth investigating the underlying cause to protect your bone health long-term.
Recommended actions
Get your vitamin D levels checked, as deficiency is a common cause of elevated PTH
Ensure adequate calcium intake through dairy, leafy greens, and fortified foods
Include magnesium-rich foods like nuts, seeds, and whole grains to support calcium metabolism
Retest PTH along with calcium and vitamin D levels in 3-6 months to monitor trends
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