Thanks for sharing this. I had something called secondary, non-renal, normocalcemic hyperparathyroidism, which means that my calcium levels were normal. My endo says that the cause of this was low Vitamin D levels, which is a common problem in people with psoriasis, which I have. I no longer have any skin lesions, which I attribute to more than a decade on a plant-based, low-sugar diet with alcohol intake limited to a glass or two of wine once or twice a month. Supplementing with high doses of Vitamin D still didn't raise my levels enough, so my endo prescribed Calcitriol, which is an activated form of Vitamin that is quite a bit more potent. With the Calcitriol, plus 7,000 mg of Vit D3 daily, my D levels are rising and the parathyroid level has fallen from 138 to 88, edging toward the high end of the normal range, which I think is 64. Apparently, the body works to keep calcium in balance as there is a narrow range that it needs to be in and pth hormone can rise to help achieve this. It's much more complicated than I realized ( I write for medical school magazines, but feel like I'd need a degree in endocrinology to really grasp the nuances of this!) I'm so glad, though, that I have a great endocrinologist at Loyola Medical Center in the Chicago area who patiently explains all of this to me, and that we all have this Mayo discussion forum so that we can compare notes. I agree with your advice, by the way!

I received 3 yrs of Reclast and then my % dropped after zi had a spinsl fx. Also my Ca and PTh rose substancaly
After testing and surgery one parathyroid this resolved but bone % dropped greatly.
I was doing great until Reclast but finally ended up on Evenity which I will never do again as pain was horrible. Wish I had seen this before my mess excerated. Now in pain and on a cane.