Patient Scenario: Hypoparathyroidism, desired phosphate & low or normal calcium
Assessing the Clinical and Laboratory Parameters
Was there a prior parathyroidectomy? Low or undetectable PTH levels are an expected finding. Current calcium and phosphate levels are appropriately managed.
Are parathyroids intact (or partially resected/reimplanted during prior parathyroid surgery)? PTH secretion is suppressed, usually secondary to use of calcium based binders and/or use of vitamin D analogues; Parathyroid gland remains sensitive to ambient ionized calcium, i.e. is not autonomous
- Discontinue or lower dose of vitamin D analogue
- Lower dose of calcimimetic.
Approximately 3% of all patients are in this category.