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What’s happening here with vit.D levels?
Hi. I saw this online, a lady 39y/o posted it and I wanted to know what’s happening? D3 is low and D1 is high. -
11 Replies
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@KK I encourage you to watch this video HERE on testing calcium balance in the Mineral Balance course. It explains the relationships between calcium, phosphorus, vit D, vit D 1,25, and inflammation.
I’d like to hear what you think is going on with these values after watching the video…. putting you to the test. 😉
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@Bernadette Abraham calcium deficiency! But can’t assume and can’t ask since it was a random question online. I am so eager to ask her to do CRP and ionised calcium to see. Her D 1.25 already above the normal range.
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@KK yes correct. You can see her calcium is at the low end of the clinical reference range. But as you mentioned, CRP and ionised calcium would give a clearer picture. Well done!
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@Bernadette Abraham Hi B. The lady posted something and I thought to add it here. Her latest tests PTH is high 82 (15-68)
Ionised calcium 1.24 (1.10-1.35)
CRP 1.25Also I saw she mentioned she’s suffering from low BP and dizziness.
Those results now doesn’t look convincing or don’t make sense when I look at the chart in your video since ionised calcium is normal and CRP is normal too. While she has low vitamin D and elevated D 1.25
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@KK I’d encourage you to watch this video to better understand how PTH works to regulate calcium balance with other hormones in the body.
It’s a feedback mechanism that regulates calcium and phosphorus levels in the body together with the kidneys, and activates vitamin D (calcidiol) to its final form (calcitriol).
With that in mind, the pattern of elevated parathyroid hormone (PTH), normal ionized calcium, low calcidiol (25-hydroxyvitamin D), and high calcitriol (1,25-dihydroxyvitamin D) suggests a condition known as secondary hyperparathyroidism, often associated with vitamin D deficiency.
Here’s how:
High PTH (82 pg/mL): this means the parathyroid glands are working harder to maintain normal calcium levels.
Normal Ionized Calcium (1.24 mmol/L): this suggests that the body is effectively mobilizing calcium from bone and increasing kidney reabsorption to maintain normal blood calcium levels, despite the higher PTH.
Low Calcidiol (25-hydroxyvitamin D): Low levels suggest a deficiency in vitamin D, which is crucial for calcium absorption in the intestines. Vitamin D deficiency is a common cause of secondary hyperparathyroidism.
High Calcitriol (1,25-dihydroxyvitamin D): This final active form of vitamin D is synthesized in the kidneys and is usually elevated in response to low calcidiol levels. The increase in calcitriol is an attempt to enhance intestinal absorption of calcium.
So in summary, this pattern shows that there’s an imbalance of calcium, with low vitamin D levels leading to secondary hyperparathyroidism. So the parathyroid glands are working harder to maintain normal calcium levels, resulting in elevated PTH. The high calcitriol suggests that the body is trying to compensate by increasing the active form of vitamin D.
Now of course, we know nothing about this person, and there can be other reasons for high PTH such as tumors/hyperplasia, kidney disease, genetic factors, and certain medications like lithium and thiazide diuretics (i.e. for high blood pressure and water retention), but most likely it’s vitamin D deficiency.
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@Bernadette Abraham you killed it B! I love the breakdown thank you for taking time and writing it so comparing to the chart I saw from first video it was suggesting either calcium deficiency or inflammation (CRP).
Also, the low BP confused me as well because usually those with hyper parathyroid (primary) experience high BP. -
@KK yes correct about blood pressure. The table I shared is also still correct but it serves as an initial view of what the labs could mean when trying to assess calcium balance. This is the perfect example where labs alone without context would lead to misleading interpretation, and why we always ask for a full health history including food and medications to tie is all together.
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@Bernadette Abraham great and make sense. Her dizziness then could be from low iron
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@KK are you helping this person by any chance?
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@Bernadette Abraham no. It caught me the vitamin D one high and one low and I was very curious to know what could be the reason as I’ve never check mine like this. I only do the regular D 25 hydroxy
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@Bernadette Abraham even doctors only request the D 25.
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