Elevated parathyroid hormone?

[Loveballet]

Is there any research, data, or personal experience with having parathyroid levels, but not blood calcium levels, become elevated while taking alendronate? I had been on alendronate very successfully (no side effects and a stabilized DEXA) for about 6 months when my TSH to monitor my decade long hypothyroidism went from a well balanced 1.8 to a .3. My parathyroid went from 66 to 75 and then 88. This had never happened before so wasn’t sure if it might be related to the medication. Oddly after having to go off the alendronate for several months due to investigate the cause of an anxiety issue, the parathyroid level finally dropped into the normal range. Admin? Any info on that topic?

And for those of you still afraid to start alendronate/Fosemax, I had absolutely no trouble with it whatsoever. But it’s super important to follow the directions on how to take it. I’ll go back on it as soon as cleared to do so.

Best to all!

Loveballet

[FearFracture]

My doctor didn't monitor my PTH while I was taking alendronate. Actually, the only time he checked my PTH was after I'd stopped taking the alendronate and approximately 6 weeks after I'd had my 1st zoledronic acid infusion so there was no baseline. Additionally, when I requested that he test my PTH, he agreed and failed to mention that 1. bisphosphonates can skew PTH test results and 2. PTH bloodwork should be done while fasting.

I did find this study pubmed.ncbi.nlm.nih.gov/117... which might be helpful.

Shortly after having my zoledronic acid infustion, I looked up something like "how does the body absorb calcium". My goal was to figure out if there were any tricks to get my body to take in more calcium. That is when I first learned about the parathyroid glands and PTH and that blood calcium levels basically tell you nothing unless they fall outside of the normal range. I also learned that the most calcium the body can absorb at one clip is approximately 500 mg. In the US, calcium supplements are generally 600 mg, which seems to make no sense. After learning this, I changed the supplements I was taking and I altered when I take them as well as how I consume calcium rich foods so that instead of getting large doses of calcium twice a day, I now make sure that I am getting smaller doses throughout the day. I figured that by doing this I could sort of force my parathyroid glands to "stop" sending out PTH to get calcium from my bones--if I always have calcium available in by bloodstream, seems like my bones shouldn't need to be drained. I mentioned this to my endocrinologist and he said "be careful." Who knows what he meant by that because given that he didn't bother to tell me that taking 600 mg calcium supplements was basically a waste of at least 100 mg, I'm not sure he's ever really thought about how to actually get the body to absorb more calcium from natural means.

[Mark_ABH in reply to FearFracture]

You are correct about calcium supplements. There are 1,200 mg pills on the market, which is crazy! Just break the 600 mg pill in half to get 300 mg to cover your shortage for the day.

More about getting the best out of your calcium supplement: americanbonehealth.org/nutr...

Please don't overdo it with calcium supplements. Any excess calcium you take probably won't go to your bones. It might camp out in places you don't want it, like your kidneys or your coronary arteries.

[Mark_ABH]

Hi Loveballet, I found this in an overview of bisphosphonates published in Annals of clinical biochemistry in 2001, when these medicines were still fairly new.

pubmed.ncbi.nlm.nih.gov/117...

Bisphosphonate treatment causes an early reduction in bone resorption followed by a later reduction in bone formation. The early inhibition of bone resorption induces a reduction in serum calcium which leads to increased parathyroid hormone (PTH), and subsequently an increase in 1,25-dihydroxyvitamin D.

Osteoporosis treatments have complicated mechanisms. You should discuss your concerns with your health care provider, and if they don't give a satisfactory answer, see if you can find an endocrinologist who specializes in bone health.

[Loveballet in reply to Mark_ABH]

Thank you Mark. I actually found my endocrinologist through this site. Interestingly, I went off alendronate in May to see if it might be the cause of some other health issues I was having and, for the first time in nearly a year, after four months off, the PSH was back down in the normal range. We haven’t been able to find much in the way of peer reviewed literature to convince him that that was the cause. I wonder how long it takes to get to the later bone formation phase and if the PHS goes back down then? It seems ironic that when you are trying to save and increase bone that there is a phase where as you put the alendronate in, the parathyroid glad sucks the calcium out.

Loveballet