What tests diagnose primary hyperparathyroidism?

Tests that may be helpful in making the diagnosis of primary hyperparathyroidism include the blood phosphate level, the vitamin D level, urine calcium levels (a urine test of calcium collected over a 24-hour period), and the blood creatinine level (a measure of kidney function). The 24 hour urine calcium level will help determine if the individual has familial hypocalciuric hypercalcemia (a benign condition not requiring surgery). Vitamin D levels should be checked because low vitamin D levels may be causing a problem called secondary hyperparathyroidism and vitamin D levels need to be cautiously replaced before further work up is done. Patients with elevated calcium and/or parathyroid hormone levels should also have their bone density tested. This is done by a special x-ray test called a DEXA-scan. 
Joane Goodroe

Diagnosing primary hyperparathyroidism can be confusing.

  • A person with high blood calcium and a high parathyroid hormone level (PTH) at the same time--must have a bad parathyroid gland.
  • Some people will have hyperparathyroidism but they will have a high calcium and NORMAL PTH levels.

The blood calcium level will constantly change so if it is high one time and normal another time, you need to be evaluated for a parathyroid tumor especially if you have symptoms of the disease.

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