Should I be taking Vitamin D? I am a 53 year old man. I had parathyroid surgery in 2/2023. Prior to surgery, my calcium levels had been high, 10.1 to 10.9 mg/dl for the previous 3 years. Upon diagnosis I was told to take Vitamin D3 (3000 IU) daily. In 6/2023 I began having neck pain and dizziness. My PTH was measured at 121 pg/ml, with Calcium 10.7 mg/dl. In 10/20/2023 I stopped taking Vitamin D3. In 11/23 I was feeling abnormal. Dysphagia came back, very frequent urination etc. I requested labs as a result and my blood calcium came back as 10.7 and PTH was 53, the lowest in 2 years (since being measured). Yet, I feel worse than ever. Should I resume D3? I just do not know. Thank you.
Thanks for writing in. Typically I recommend taking calcium and Vitamin D after parathyroid surgery, but in your case I would advise against it, since your calcium is still high.
Unfortunately, your lab results indicate that you still have primary hyperparathyroidism (pHPT). The calcium level is high for your age, and the PTH is not suppressed, which is inappropriate for the elevated calcium level. PTH levels will fluctuate, so even though your latest PTH was lower than before, it is still inappropriate for a calcium of 10.7 mg/dl. Your most recent labs are still diagnostic for primary hyperparathyroidism.
Regarding the recommendation to take Vitamin D: Vitamin D helps the body absorb calcium from the intestines. When you have primary hyperparathyroidism, taking Vitamin D is not recommended because it can potentially raise the calcium levels further, which isn’t advisable given your already elevated calcium. Vitamin D deficiency is common in patients with primary hyperparathyroidism, but does not need to be treated until after you are cured.
The only cure for primary hyperparathyroidism is surgical removal of the overactive parathyroid gland(s), not Vitamin D supplementation. If your calcium and PTH levels are still high after surgery, it indicates that you either have another diseased parathyroid gland or not all of your parathyroid tumor was removed during the operation. It is not uncommon to have multiple parathyroid tumors.
Your symptoms could be due to the persistently high calcium levels. Symptoms of primary hyperparathyroidism tend to fluctuate, just like the calcium and PTH levels. They are likely unrelated to your Vitamin D levels.
In summary, based on your current lab results and symptoms, I would not recommend taking Vitamin D. It looks like you are going to need another parathyroid operation in order to achieve a cure.
