Hyperparathyroidism and Vitamin D: Relationship Difficulties

Abstract

Hyperparathyroidism is a clinical and laboratory syndrome characterized by hyperproduction of parathyroid hormone (PTH) by cells of the parathyroid glands (PTG) and is subdivided, depending on the cause of its occurrence, into primary (PHPT), secondary (SHPT) and tertiary hyperparathyroidism (THPT). To date, only a few scientific papers have been published on the features of the relationship between vitamin D and various forms of hyperparathyroidism, there may be several reasons for this. First, this is due to the fact that the true prevalence of vitamin D deficiency in hyperparathyroidism is unknown. Secondly, difficulties in the differential diagnosis of hyperparathyroidism sometimes entail not always justified surgical intervention with the potential development of complications, which, of course, is a rather narrow area of interest, both in endocrinology in particular and in medicine in general. Thirdly, the asymptomatic, often hidden, latent nature of the variety of multiple organ clinical manifestations of hyperparathyroidism, in combination with low levels of 25(OH)D, as the disease progresses, can lead to a significant decrease in the quality and life expectancy of patients. The combination of these arguments prompted us to summarize all the data available to date on the complexity of the relationship between vitamin D and various forms of hyperparathyroidism.