Simplified Calcium/Phosphate interpretation.
Low Vitamin D action, low calcium and we have
low phosphate, unless renal failure.
I’ve emphasized that so many times now.
Whenever you have calcium imbalance, you’re
always going to look for renal status, always.
It changes the entire complexity or complexion
of the pathology.
If it’s high Vitamin D action, the opposite
would be true.
If it’s low PTH action, why?
Well, maybe the hyperparathyr-... the parathyroids
have been lost resulting in low PTH action.
You would expect there would be low calcium
and high phosphate.
If there’s high PTH or PTHrp and with this,
we’ve talked about with primary hyperparathyroidism
or secondary hyperparathyroidism, once again,
the big exception here, we expect your calcium
to be high, your phosphate will be low because
PTH gets rid of your phosphate, unless renal
failure where the phosphate will be elevated.
Bottom line, calcium and phosphate tend to
deviate together, both up or down, in Vitamin
D derangements whereas the deviation or the
changes between calcium and phosphate will
be the opposite when it comes to parathyroid
Exception, chronic… a big exception, chronic