Secondary hyperparathyroidism in primary osteoporosis and osteopenia: optimizing calcium and vitamin D intakes to levels recommended by expert panels may not be sufficient for correction

Abstract

Large doses of vitamin D are frequently necessary to suppress secondary hyperparathyroidism in patients with primary osteoporosis and osteopenia. This suggests that vitamin D metabolism may be altered in some of these patients.

Safety and Efficacy of Weekly 30,000 IU Vitamin D Supplementation as a Slower Loading Dose Administration Compared to a Daily Maintenance Schedule in Deficient Patients: A Randomized, Controlled Clinical Trial

“…The response of serum 25OHD to cholecalciferol is directly related to the cumulative dose of cholecalciferol, whereas PTH response to vitamin D supplementation is largely independent of the dose given. It is possible that, to some extent, PTH needs a longer period of time to respond to cholecalciferol, even when adequate serum 25OHD levels are reached and that the relationship between PTH decrease and 25OHD increase is not linear, as previously reported [34].…”

Normocalcemic Primary Hyperparathyroidism

“…al. [24] observed that in 1/3 of patients the standard treatment of vitamin D deficiency (1,000 unit of vitamin D 3 daily or 50,000 IU vitamin D 2 once weekly) failed to correct secondary hyperparathyroidism. In our study among those with vitamin D deficiency, PTH level returned to normal only in 7 patients over a period of 3 months to 4 years after the correction of the deficiency.…”

Ophthalmic manifestations of endocrine disorders: approaches and medical management

“…Hyperparathyroidism exists as two subsets, primary hyperparathyroidism (PHP) and secondary hyperparathyroidism (SHP) [57]. PHP arises from overactive parathyroid glands secondary to either tumor or hyperplastic tissue.…”