Normocalcemic hyperparathyroidism presents a diagnostic challenge

A study introduced a preoperative calcium challenge for patients with elevated parathyroid hormone and normal calcium levels. Of 29 patients, 55% normalized parathyroid hormone with persistent normocalcemia, confirming secondary hyperparathyroidism. In 19%, classic primary hyperparathyroidism was diagnosed. Short-interval calcium supplementation revealed ∼50% resolved secondary hyperparathyroidism due to low calcium intake, avoiding unnecessary surgery. This approach, with 92% compliance, enhances diagnostic accuracy, prevents unwarranted procedures, and ensures timely intervention for primary hyperparathyroidism.