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Summarized in the table below the drugs that were listed in my professor's lecture slides for the treatment of Hyperparathyroidism (first column) and hypoparathyroidism (second column)

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  • Are treatments for (hyper/hypo)parathyroidism mutually exclusive from treatmeants to (hyper/hypo)calcemia?
    • That is, I have to decide whether I am willing to treat the calcium disorder or the parathyroid disorder, but I can't target both at the same time, is this correct?
    • While studying, I thought that if, for example, we were to treat hyperparathyroidism by giving cincalcet (which lowers PTH), and then we decide to give Furosemide (which lowers calcium).
    • Wouldn’t that be arbitrary and pointless? especially that if we lower calcium by furosemide then we are inducing hypocalcemia which would stimulate PTH release all over again.
      • My point is, we can’t use Furosemide to treat hyperparathyroidism, but we can use it to treat hypercalcemia provided that no PTH-lowering drugs were used.
    • In the same vein, using teriparatide (↑PTH) and thiazide diuretics (↑Ca) simultaneously would counteract the efforts towards treating hypoparathyroidism and culminate in lowering PTH all over again. Am I right?

Attached below are the original lecture slides, for your reference enter image description here enter image description here

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The 1 dislike on the Q seems to be right as no research effort has been put but still assuming being a student having doubts and and is still in theory stage (inexperienced) i would try to answer.

Your questions seems to be flawed as you are not taking into account what is the cause of hyper/hypo states

  1. e.g.in hypo-parathyroidism if the cause is surgical excision of glands then shouldnt, we treat the both the cause and effect i.e. treat the hypoparathyroid state with teriparatide (rPTH) and effect of hypoparathyroidism specifically hypocalcemia using calcium supplements, thiazides conserving calcium by decreasing excretion, and using Vit D which has effects at mutiple levels
  2. similary in hyperparathyroid state if the cause of hypercalcemia is an adenoma then shouldn't we treat the functional adenoma and its effects - that is treat the hyperparathyroidism by giving cinalcet and treat the effect hypercalemia by causing excretion using furosemide.

Hope this clarifies. This answer is targetted at UG level because beyond that guidelines based on severity of states would be better to answer. what to use in which situation.

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  • While I agree that this is essentially correct, you should support the answer with a source or two, otherwise why trust it? Also, the wording - which might be a language issue - is a bit odd. Might you have used AI to help answer the question? Apologies if I offend. Commented May 20, 2023 at 1:16
  • Your answered clarified it so much, especially the part where you say that we have to treat the disorder and its effects. This addressed my doubts directly. So thank you so much and many apologies if my question sounded naive compared to the questions on this website.
    – Doe Pull
    Commented May 20, 2023 at 2:41
  • @anongoodnurse you very right, something anybody said or writes as answer should be verified; but as it is sort of discussion group, hence i posted without any specific reference. but on other level the nature of question was similar to what i went and pondered over during me UG course so i could resonate quickly.
    – Sage
    Commented May 20, 2023 at 5:06
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    @Sage - This isn't a discussion board; it's a Q&A site with the goal of authoritative answers for (researched) questions. I would not be surprised if it gets a post notice for lack of sources, even if it is accurate. Also, which textbooks don't have a list of supporting sources at the end of each chapter? Which journal articles don't support their statements? You are in error; even Cochrane papers have links. Commented May 20, 2023 at 12:41
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    Nobody here is expecting a full systematic review, but we do expect that you support your answer with at least one authoritative reference. You said above, "open williams endocrinology textbook find the chapter of parathyroid disorders - In 16E it would be Chapter 28 titled 'Hormones & Disorders of Mineral Metabolism'". That would suffice if you actually edit your question and add it, but things you say in comments don't matter. So your choice. Your answer may be deleted if you leave it as is.
    – Carey Gregory
    Commented May 21, 2023 at 3:01

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