1,25 OH (2) D response to PTH 1-84 - Osteoporosis Message Board

osteoblast · 05-15-2008, 04:07 PM

I read a research article re variable response to PTH 1-84. If you want to look at this article the title is
Hetereogenity in skeletal response to full length parathyroid hormone in the treatment of osteoporosis --one of the authors is Bilezikian
In fact, if you search the research articles of Bilezikian you will find some fascinating info.
First, I know forteo is not full length but rather short chain pth. so relevancy of this research is a question. But, having said that--the conculsion was that the change in1,25OH (2) D explained 16% of the variation in the Bmd response to PTH 1-84. Those with more elevated 1,25 had more bmd response.This is how I read the article-hope I have conveyed it correctly.
I just put this in here because some of us have previously discussed our High 1,25 while on forteo(DB are ya out there?), and some of us worried and of course didn't know what to make of it. Probably we still won't know what to make of it. But--just thought I would throw this article out there for anyone who may be interested.Would be very interested to hear any feedback on this article.

DesertBloom · 05-15-2008, 04:55 PM

Hi Osteo: I don't think I've read this particular article from Bilezikian, but I will in the morning. I just went to the Endo today and my Ca, 1,25 is high and my D 25 low and this was the results after stopping all D for 2 weeks. Originally he felt that the 2000 IU's of D3 was elevating my Ca, but it's still increased some but not as high as the last reading. For the first time he has decided to do a sestimibi scan of my parathyroid, since niether him or the Min Met Dr can figure it out. I've been having tetany, bone pain (only when I apply pressure) and heart probs.

We'll see what happens from the scan. He agreed to order it from an article I have that explains that 10% of people with hypercalcemia, normal or low PTH, normal PTHrP, and low/high D can present with parathyroid adenomas.

I don't think I have this prob with my parathyroid, but it's the only thing that hasn't been checked that could explain these lab scores.

How are you doing? I hope the walking is paying off and you've come to some conclusion on your thyroid issues. I notice your question about the weighted vest, and I was told not to use it because of my degenerative discs, spondy and other probs. I don't know what the current thinking is on this, but I do know that adding weights to susceptible spines can cause damage. My PT, wasn't to thrilled about the idea and said if you *have* to add weights, why not carry them or put them on your ankles to avoid spinal compression. So I don't have a clear answer on this since they were relating it to my situation, and not anyone elses.

I'll let you know what I think about the article after I read it. MIL is visiting so things are kind of hectic, trying to entertain.

osteoblast · 05-15-2008, 06:22 PM

DB-Great to hear from you!

I hope you are doing well.Maybe you could do a thread with your updates soon. I am wishing the best for you.Probably a bit of a strain being entertaining now with your MIL, but I hope that her visit is pleasant. I will look forward to your take on the Bilezikian article.
You must have stopped forteo by now and started evista?? If so, I would bet your body is doing alot of recalibrating, wonder how that might be affecting what is going on for you. What is the title/author of the article you took to the endo? I hope the sestimibi shows what is going on. I do hope your parathyroids are ok. I know someone who is going to have parathyroid surgery soon, her numbers clearly showed hyperpara but her sest.scan did not. She then had an ultrasound where it was possible to identify the problematic parathyroid. I will talk to her to get more info but, there is a big difference with her pth way out of range and calcium too.
My new bone doc is not enthralled with the vest . She has ordered the mri to check size of hemangiomas , to try to understand my L-4 and spine bmd. I am taking it easy with the vest. At 5 pounds in, it really doesn't seem like much , and I don't wear it all the time. The doc was pretty interested in me gaining some weight though-5 pounds. And, she is interested in HRT for me. I saw my wonderful pcp today, she wrote a script for HRT based on what the bone specialist is proposing. My mind is totally confused about HRT,esp HRT and forteo combo, and it HURTS! So when I go back to the bone specialist in 2wks.to learn of the mri results, we are going to talk about whether I stop forteo trtmt now, continue, start hrt or whatever. I cannot believe I am considering HRT-but I am going to hear the expert out.I've got the script for the patch etc. if I decide to go forward.
About the thyroid, I may be having a thyroidectomy. I have the go ahead from the Endo, a more emphatic go ahead from my pcp, and will see the ENT next week. I am surprised it has come to this, but this past 12 months the thyroid levels have not been controllable with thyroid replacement and have fluctuated wildly. My TPO Antibodies are at 1100-which I have read is in the extremely elevated range. I have 7 nodules 2-8mm. , a reactive lymph node and I do not want to ride this roller coaster any longer. Improvement with the present course of treatment looks unlikely.
Please take good care of yourself-keep yourself in the colors you love and enjoy your aromatherapy