How is workup labs of primary hyperPTH?

-Total serum Ca, albumin levels or ionized Ca levels should be measured -HyperCa should be documented on more than one occasion -Intact PTH level = core of the diagnosis -An elevated intact PTH level with an elevated ionized serum Ca level is diagnostic of primary hyperparathyroidism -A 24-hour urine Ca measurement is necessary to rule out FHH -Mild hyperchloremic acidosis, hypophosphatemia, and mild to moderate increase in urinary Ca excretion rate -Vitamin D levels should be measured in the evaluation of PH -Vitamin D deficiency can cause secondary hyperparathyroidism and repletion of vitamin D deficiency can help to reduce PTH