Correction of secondary hyperparathyroidism after distal gastric bypass using oral high dose vitamin D, calcitriol and calcium replacement

Abstract

Purpose: Gastric bypass patients, especially those with malabsorptive procedures, often have profound 25-hydroxy vitamin D (Vit D) deficiency with secondary elevation of parathyroid hormone (PTH) levels causing accelerated bone loss. Hypocalcaemia has developed in such patients receiving antiresorptive therapy (e.g. bisphosphonates). Vit D supplementation decreases PTH gene transcription via the Vit D receptor, similar effects are seen via the calcium receptor with high dose calcium replacement. We hypothesized that treating these patients with high dose Vit D and calcium could reverse secondary hyperparathyroidism (SecHPT).