Vitamin D and Parathyroid Disease

This topic discusses the importance of vitamin D and its link with primary parathyroid disease.

Vitamin D is required by the body to allow us to absorb calcium from the foods we eat. It is for this reason that many calcium supplements are made with vitamin D added to them as without it the intestines cannot absorb the calcium in the pill.

Vitamin D is made in the skin when the skin is exposed to sunlight.

There is some evidence that when someone starts developing parathyroid disease and the calcium levels rise the body uses vitamin D as a protective mechanism. The basic concept is that as the calcium starts to go up the body limits the amount of vitamin D made which reduces the amount of calcium the body can absorb from the diet.

The end result is that vitamin D levels go lower than normal.

A large study looking at this in nearly 1600 patients with parathyroid disease found that 67% of all patients with parathyroid disease have low levels of vitamin D. There also appeared to be a trend to vitamin D being lower the higher the level of calcium went.

This is an observational study and we do not know the mechanism for this however it does illustrate that vitamin D levels are likely to be low with parathyroid disease.

Occasionally endocrinologists recommend taking extra vitamin D in this situation. Generally this does nothing but it can have the paradoxical effect of increasing blood calcium levels - presumably as the absorption of calcium from the intestine improves.

So correcting the vitamin D level is not the answer for the calcium levels. Calcium levels are only very rarely high due to low vitamin D. What is usually needed is consideration of parathyroid surgery to cure the problem. Vitamin D levels can be corrected easily after surgery.






www.bucksendocrine.com

www.thyroidsurgeon.org.uk