Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2014) 34 P19 | DOI: 10.1530/endoabs.34.P19

SFEBES2014 Poster Presentations Bone (30 abstracts)

Treatment of vitamin D deficiency in primary hyperparathyroidism (PHPT) with different vitamin D preparations.

Sarah Goellner , Zana Ameen , Alice Blackwell , Abd Tahrani , Andrew Bates & Asad Rahim


Heart of England NHS Foundation Trust, Birmingham, UK.


Introduction: Eighty percent of patients with PHPT have co-existing vitamin D deficiency. Few large studies have assessed the impact/safety of different vitamin D preparations on calcium, PTH and vitamin D in such patients. We report the use of three different preparations.

Methods: In a retrospective study of 125 patients with confirmed PHPT, 77% were vitamin D deficient (<30 nmol/l)/insufficient (30–50 nmol/l). We assessed the impact and safety of treatment with vitamin D3 or D2 (50 000 IU) after 48 weeks (n=35), calcium and vitamin D (e.g. Adcal-D3) twice daily for 3 months (n=16) and over the counter (OTC) vitamin D 1000 IU/day (n=41) for 3 months on calcium, PTH and vitamin D levels. In four patients, the Vitamin D preparations were unspecified.

Results: See Table. Mean (±S.D.) serum calcium remained stable after treatment for whole group (2.75 (±0.22) vs 2.74 (±0.24) mmol/l; P=0.699).

Table 1
Vit D prepCorrected calcium (mmol/l)Vitamin D (nmol/l)PTH (pmol/l)
Pre-treat mean (±S.D.)Post-treat mean (±S.D.)P valuePre-treat mean (±S.D.)Post-treat mean (±S.D.)P valuePre-treat mean (±S.D.)Post-treat Mean (±S.D.)P value
50000IU2.78 (±0.23)2.76 (±0.24)0.5026.8 (±20.4)72.5 (±35.5)<0.0121.2 (±11.9)17.2 (±8.4)0.02
1000IU2.75 (±0.24)2.76 (±0.27)0.8929.2 (±15.0)70.0 (±28.5)<0.0120.3 (±11.0)21.8 (±27.2)0.73
Ca/Vit D2.63 (±0.13)2.65 (±0.20)0.8132.6 (±27.4)63.5 (±30.6)<0.0117.5 (±8.2)12.0 (±6.3)0.01

Conclusion: Vitamin D repletion, regardless of regimen, in patients with PHPT and Co-existing vitamin D deficiency is safe and does not significantly exacerbate hypercalcaemia for the majority of patients. Patients treated with combined calcium and vitamin D preparations had lower baseline calcium, but calcium levels still did not rise significantly with treatment.

Finally, despite the increased metabolism of vitamin D in PHPT, most patients were replete within 3–6 months regardless of vitamin D preparation.

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