Peer-reviewed, evidence-based analysis of vitamin D and primary hyperparathyroidism

Background: Research into the actions of vitamin D on the human body has been increasing at an exponential rate, as has understanding of the impact of vitamin D on various aspects of the endocrine system. Primary hyperparathyroidism (PHPT) is a disease of the endocrine system that can result in debility if not diagnosed. New understanding about the effect of vitamin D on parathyroid hormone regulation may provide an opportunity to better understand the coexistence of PHPT and vitamin D deficiency. Methods: An evidence-based literature review was based on a PubMed search for research involving vitamin D and primary hyperparathyroidism, and evaluating existing research on vitamin D. The PubMed search included English-language articles published between 1977 and 2008, with a focus on research and analysis completed between 2005 and the present. This study examined recent developments in understanding the relationship between vitamin D and PHPT. This review of existing literature examined the impact of vitamin D insufficiency and deficiency, including the impact on diagnosis of vitamin D insufficiency/deficiency, diagnosis and management of PHPT, and the impact on overall health. The level of evidence was determined according to criteria proposed by Sackett et al. and the grade of recommendation according to the criteria proposed by Heinrich et al. Results: Level III and level IV evidence predominates the vitamin D/PHPT based literature, with several notable Heinrich grade A, B, and C studies available. Additional evaluation of studies' review is provided by reference and by section. Conclusions: Vitamin D metabolism plays an important role in PHPT etiology, diagnosis, and management. Care of both conditions may have an important impact on overall health in humans.