Nice to meet you Dr. Laird. TY for subbing for Dr. Agar. The tag team approach is great! Looking back over my lab reports, it seems my alk. phos began to increase the first month i went to nocturnal txs. That is a yr. ago now. Each month it would climb a little higher.
With nocturnal, my pre-PO4 decreased as I expected it would. It has been on the low side of normal ranging from 3.2 to 3.6 and I take a post phos 2 hrs post tx which has ranged from 2.2- 2.8. Calcium has been a little too elevated at around 9.8 - 10.0.
About 3-4 months ago, I went to 7 hr nocturnal txs having previously been on 8 hr txs. Right around in here was when my alk phos started a steeper increase.
Two months ago my PTH started climbing, going first to 400 and then to 600. I was on just one Vit D analog pill a week for months with PTH in range, but at this juncture my dietitian had me go to 2x/wk… When she saw the PTH continuing to climb, she upped the dose to 4/week. At that point the PTH went back down to 400 and my current dose is 3x/week. I will be getting labs soon so will know if my PTH has come down some more. It did respond to the Vitamin D analog when the dose was increased to 4 as you can see.
I don’t know why my PTH started climbing when I went to 7 hr txs., but overall, I am wondering if the lower PO4 and higher cal. I have had for a year now has anything to do with the elevated alk. phos.? When I went to 4x Vit D, my alk phos dropped a little , but it is still about 93 points elevated over scale.
Would the fact that my PO4 has been on the low side while my cal has been on the high side since starting nocturnal txs, be the likely reason alk. phos has steadily gone up? If I was able to take a supplement to get my PO4 up higher, do you think that would be the way to go?
Also, what is the name of the simple blood test you spoke of Dr. Laird? TY for helping me figure this out so I can bring this info back to my neph. He does not know what my alk phos is doing, but he has always told me that PTH changes show up quarterly when something shifts in the balance.