One more question...Calcium, Vit D & PTH levels
Ok....so last question...all stemming from my 12-month labs & the trending I have seen. My doctor orders levels on my calcium & ionized calcium, which both are looking fantastic...well within range & stable. My Vit D has been trending upwards. In a range of 32-100 ng/ml, I have been at 56, 71, 83, & 92 on my 3, 6, 9, 12 month labs respectively...so nice strong increase....at a dosage of 50k iu/day. My question is, I have never had my PTH checked, should I? I have asked my doctor about this and he claims he keeps his eyes on my calcium levels & Vit D to see if there are any calcium absorption issues & that a PTH test is not needed. I am going to see him in February & need to know....based on your insight...should I be fighting to get the PTH testing done? If so, I wanted to be loaded up with convincing/compelling arguments to get this testing. I have done research on back posts here...but wanted to get your opinion.
DS (Lap) on 12/18/12 w/ Dr. Onopchenko, HW- 242, SW- 231, GW- 130 Height - 5'3"
Yes, PTH is needed and should be done at EVERY lab draw. PTH tells you where the calcium in your blood is coming from. You blood calcium levels will always be fine until your bones are too far gone. Your body will continue to pull calcium from your bones to keep your blood calcium levels in the norm. This is critical for many systems in your body, cardiovascular being one of them. By the time you show low calcium levels, your are in trouble. You can have great calcium and D levels and still have high PTH showing that your body is pulling from your bones. If that is the case, you need more calcium supplementation. This is a very important test!
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OK....then I am going loaded with info to put up a fight. I know it is an important test, but when my doctor said it was not needed due to my other levels being OK....I kinda backed down but the little red flag kept waving in my head,,,,
Thanks for the feedback.
DS (Lap) on 12/18/12 w/ Dr. Onopchenko, HW- 242, SW- 231, GW- 130 Height - 5'3"
PTH shouldn't be too expensive either. My PCP orders that I regularly get my PTH checked whereas she refuses to do my A (I only get that done when I see my surgeon a couple of times a year).
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my DS 
Pre-Ds, my D was 17. My PCP had me take additional D and I increased my D to 38 (which by many people's standards, is still low). The blood test I am referring to here is the Vitamin D, 25-hydroxy. It is what is commonly referred to as the test for D.
Unfortunately, I had another test done called the Vitamin D 1,25 which was 95 (range 18-72). My PCP actually called me to tell me to stop taking the D. Shortly thereafter, I made the decision to have the DS and stopped following up with this issue.
Fast forward to a year ago (because my year labs are just due this week), and I know that I have to get both D tests and my PTH tested in order to draw the conclusion that I am adequately absorbing my D. It is a delicate balance and they all work together.
You calcium level really doesnt mean much, because your blood will still calcium from your bones as it needs. It is my understanding that the Vitamin D 1,25 and your PTH results are the only way to really monitor this.
I have spent a lot of time researching the two different D tests, and it is still, clear to me as mud!
