Kidney function influences PTH, therefore it is not of use in identifying vitamin D deficiency. See attached paper.
Jeff
Jeffrey Barron
Auckland
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Webster Craig
Sent: Monday, 22 August 2011 8:02 PM
To: [log in to unmask]
Subject: Re: BBC News - Vitamin D mum test 'could protect babies from rickets'
Hi,
This is what we found at Nottingham and here at Heartlands, the only reliable marker of vitamin D status is 25-OH Vitamin D.
Best Wishes
Craig
On 21 Aug 2011, at 14:42, Mascall, Gary (Biochemistry) wrote:
>
> Interesting, and something which has been taxing me for some time.
> Classically it used to be taught that Rickets/Vitamin D deficiency resulted in low serum Calcium, raised Phosphate and Alkaline Phosphates.
> Having reviewed several hundred Vitamin D requests, there appears to be no correlation between Vitamin D levels and these other "markers". The only good indicator appears to be PTH done at same time, which will be high, showing increased bone resorption, and falls with adequate replacement, although it appears to take quite some time to do so, and for the calcium level to increase.
> So should we abandon the old cheaper tests, and move across to Vitamin D and PTH instead?
>
> Looking at another parameter in pregancy, I frequently see very low
> Ferritin levels, usually with normal serum iron status. So for both,
> are we saying that irrespective of what the blood results are telling
> us, we should give
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