[QUOTE=Cathy S;12730]I guess I am the strangest patient here with unusual “problems”. For a long time low b/p was my biggest problem, but it is starting finally to stabilize in the low normal range.
Then my PTH skyrocketed it got as high as 2200. I was on 2.5 mcg of calcitriol daily (which wrecked havoc with my calcium), 90 mg of Sensipar daily and it still climbed. It finally started on the way down getting to the 800 - 1000 range, still talk of parathyroidectomy, almost scheduled for January. Two months ago my neph finally agreed to a change to Hectoral, they didn’t want to cover it, I was put on 5 mcg daily. Well, my labs came back and lo and behold my PTH had dropped to 200!!
Has anyone else experienced a huge drop due to taking hectorol?? This is the only change in my medication, it has to be due to this. They also repeated the test just to make sure it wasn’t an mistake and the number stayed low. My alkaline phosphatase also dropped significantly, another indicator that the bone disease is reversing.
All other tests were okay, nothing too out of whack.
home hemo 9/04[/QUOTE]
You aren’t the only one trying to figure out pth- add me to the list! In my case, my pth is currently at 1300. It has been high for a long time, the highest being about 1500. My neph goes by the scantibodies ratio which has been low for many months. I have recieved no vit D analog all this time due to the low ratio. After starting daily txs (finally made it), my alkaline phos. became elevated. Neph said this indicated bone activity. He then put me on Hectorol. Pth came down a little this month, but not much. Ratio came up, but is still not where it should be. Neph’s approach is to increase Hectorol dosage. So, won’t know until next labs what state pth is in. Neph said if Hectorol doesn’t work, although my dose is much less than yours, the next step is to try Sensipar. Reading how your dose had to be increased a good bit before you got results makes me wonder if I simply am not getting a high enough dose???
You say your alk phos dropped significantly. What was it previously and what is it now? In my case, when my alk phos jumped up to 400, my neph said that was good news, as whereas I previously had low bone turnover (adynamic) with a high pth, I now have bone activity again.
Everyone I know says a high pth is serious, but my neph says not to be concerned, because the ratio is what is important (more accurate measurement). Very confusing subject- I still don’t understand it. I’ve read many explanations of it, but none have made sense to me yet. If I had another neph I trusted to go to for a second opinion I would. I understand that even the experts disagree on how the balance works. I may be getting the correct guidance from my neph, or he may have let the ball drop- I have no way of knowing until someone suceeds at clarifying for me what is going on. I find it very interesting that the increased dose of Hectorol has you leveled out again. Does your program use scantiblodies labs? Because I am not certain, but think I may of initially become adynamic yrs. back due to vit D analog not being cut off in time. Back then, the unit I was in did not measure pth using scantibodies, so my pth may of plunged too low.