Parathyroid Q&A is a community of experts and patients dedicated to understanding and treating Parathyroid Disease.


I’m a 32 year old female. I have extreme fatigue and mood swings that are abnormal. It prompted me to ask my PCP for blood tests to try and determine cause. My vitamin D 25-hydroxy came back low at 12 ng/ml and my calcium at 10.4 mg/dl. My PCP prescribed me 50,000 iu of D3 once a week for 12 weeks and told me my calcium was low and to find a daily supplement with calcium in it. The more I read online about calcium and vitamin D, I feel like the root cause of my issues are related to parathyroid. I’m also concerned about the recommendation to take calcium when my mychart shows my calcium on the higher side of the bar chart.

Deva Boone
Answer authored by Deva Boone
Deva Boone, MD is the founder of the Southwest Parathyroid Center. As one of the most experienced parathyroid surgeons in the U.S., she has treated thousands of patients with parathyroid conditions.

Your concerns are valid and it’s good that you’re being proactive about your health. Your calcium level of 10.4 mg/dl is actually on the high side for your age, not low. In your early 30s, you can have calcium levels in the low 10s, but as you get older the calcium should start to go into the 9s.

A high-normal calcium combined with a very low Vitamin D is concerning for primary hyperparathyroidism. Some of your symptoms are classic for the disease, especially fatigue.

In order to figure out what is going on, we need to have a calcium and PTH level together. If your calcium is still on the high side, with a high or high-normal PTH level, then you could have primary hyperparathyroidism.

I typically don’t recommend taking Vitamin D supplementation when the calcium level is already high, since it can raise your calcium further. Low Vitamin D can be caused by primary hyperparathyroidism, and does not need to be treated until after parathyroid surgery. (With primary hyperparathyroidism, the VItamin D 25-OH form is converted to the active form, Vitamin D 1,25-diOH, which is often elevated - so you may not really have a Vitamin D deficiency.)

Before taking Vitamin D or calcium, I would recommend getting your calcium and PTH levels checked.

Vitamin D Primary HPT Diagnosis Vitamin D deficiency
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