What is the utility of an oral calcium loading test to differentiate FHH from secondary hyperparathyroidism due to low calcium intake?
The patient has very low urinary calcium despite calcium supplements, vitamin D used to be low now normal. Continues to have elevated PTH with normal calcium and phosphate.
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Do you perform a calcium loading test in your workup to differentiate familial hypocalciuric hypercalcemia from secondary hyperparathyroidism?
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2 Answers
Mednet MemberInvited Expert
Endocrinology · Boston University School of Medicine
Answered on
Both vitamin D deficiency and calcium deficiency can result in secondary hyperparathyroidism. Before entertaining the diagnosis of FHH, I would treat the patient with an adequate calcium intake of 1000 mg a day of elemental calcium preferably from dietary sources like dairy. Supplemental sources are...
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Mednet MemberInvited Expert
Endocrinology · University of Missouri School of Medicine
Answered on
Although dairy products are a preferable source of calcium, all calcium supplements work better if given with food. There is evidence that protein facilitates calcium absorption. Also, calcium supplements generally should also be given with some magnesium because they compete with magnesium for inte...
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