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Thyroid  (Expert Forum)
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Rocaltrol and Parathyroid activity...
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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MedHelp Member's Question

Rocaltrol and Parathyroid activity...

by DMLee, May 27, 2007 12:00AM
TT On October of 2007, with one parathryoid removed, one reattached and two not touched.  And still waiting for my Calcium to at least get into the 8's.  I am on 1.0 Rocaltrol 3x/wk and now 1.5 4x/wk.  Last parathyroid activity showed 33.  I was wondering if you have ever had, or come across in your journels, any patients or studies that show that Rocaltrol slowing parathryoid activity?  As I read about the endocrine system these two things work so closely together with the Calcium levels that I wonder if I am flooding my body with Rocaltrol, am I doing something to slow my Parathryoid return.
Thanks for your thoughts.
Doctor's Answer

by Mark Lupo, M.D., May 28, 2007 12:00AM
It is all based on feedback -- so rocaltrol may suppress PTH secretion.  The PTH of 33 suggests some activity/recovery.  Talk to your doc about lowering the rocaltrol while increasing the calcium to see if you can wean off the rocaltrol -- based on the rocaltrol dose and the fact that surgery was 7 months ago, there may not be a full return -- it's trial and error for the most part.
Member Comments (6)

by hazelhurst, May 27, 2007 12:00AM
To: DMLee
DMLEE--we've exchanged comments in the past (I had TT July '06, low calcium since then). My doctor now has me on calcitriol (same thing as Rocaltrol, I think) twice a day = 1 mcg, 7 days a week. My last PTH measurement was 24. I take 4,000 mg. of calcium a day. I am very interested to hear the answer to your question!  Are you also taking HCTZ? I recently went off that due to a rash reaction with sunlight, and the doctor upped the calcitriol to two times a day when my calcium ended up in the low 8's. How much calcium are you taking daily?

by DMLee, May 28, 2007 12:00AM
To: hazelhurst
Sounds like we are on the same boat ride.  I am taking that much Calcium too.  Do you show Parathyroid activity??  Even though I do, my endo thinks that that is all that is going to happen.  Of course the surgeon thinks that they will really kick in.  With all that I have read, I am just wondering if I am doing something to stop the parathyroids from coming back like they want too.  I have always been the type of person that if you tell me that I can't do something I have to show you different, so this is driving me bananas.  I wish I could GET my numbers in the 8's!!!  Yes, so I am getting people's opinions.  Maybe you and I are the two people in the world who don't react to the Rocaltrol (this is the generic form of calcitriol)

by hazelhurst, May 28, 2007 12:00AM
To: DMLee
My calcium test last week was 9.2--five days after I ditched the HCTZ and doubled the calcitriol. Last October, my PTH was 16, and now it's 24. This is still considered low, but at least there is some activity. I'm concerned that my doctor doesn't really have a plan, or at least not one that he has enunciated to me. Shouldn't we be trying to lower the amount of calcium we take, bit by bit, and testing to see if the PTH or blood calcium will start working to take up the slack? I did read somewhere that if the parathyroids don't start doing their job after 6 months, that's it, they are not coming back to their previous levels. But where is the research on this? According to my surgeon, only one of the parathyroids was damaged, and he "re-attached" it. In your case, DMLee, I can see why your doctor is hesitant to try anything until your calcium levels are stable. Is it possible that you have always had lower calcium levels, and that this is just normal for you? I think they should test calcium for several months before surgery, to get a general idea!

by hazelhurst, May 28, 2007 12:00AM
To: DMLee
In light of your question for the doctor, this sentence from the website Parathyroid.com on parathyroid disease is interesting (though I haven't investigated the site thoroughly, and can't vouch for its veracity):

"...a normal parathyroid will shut down and go to sleep if the calcium level is high."  

This doesn't seem to be your problem, however, since your calcium is chronically low. Another question arises: if the parathyroid can "go to sleep", does this mean it can also "wake up", under the right conditions?

by DMLee, May 28, 2007 12:00AM
To: hazelhurst
OH MY GOD CAN YOU NOT FEEL THE FRUSTRATION WITH IT ALL.?????
I have been saying, "what if" for so long now.  And I have read the stuff about the Calcium and Parathyroid stuff too.  Totally agree with you that most of the endos don't really know, or at least want to take the time to know, so they just keep throwing more drugs at you.  At least my GP is open to letting me try stuff cause I would truly like to see if my body would do this.  
What is the other stuff you were writing about HC.....?  Haven't come across that yet.
I was thinking, my regular email is ***@****, and my name is Debbie if you want to just commiserate over regular email.  Would be a lot faster...
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