Clinician handoff
Hyperparathyroidism
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I've been experiencing brain fog - difficulty with concentration, word-finding, and memory - along with fatigue that's worse in the afternoon. I've read that primary hyperparathyroidism can cause these symptoms and is often missed. Could we check my serum calcium and intact PTH together? I'd also like to know my vitamin D level and phosphorus.
What would weaken it
- -Completely normal calcium AND PTH on repeat testing
- -Symptoms that clearly correlate with another identified cause (thyroid, menopause, B12 deficiency)
- -No afternoon crash pattern, no bone/joint pain, no kidney stones, no GI symptoms
Tests and measurements to discuss
Serum calcium (total) + albumin for corrected calcium
Ionized calcium (catches 24% of cases total calcium misses)
Intact PTH (parathyroid hormone)
25-hydroxyvitamin D
What this helps clarify: This cluster is mainly there to rule out common medical overlaps that can mimic or amplify cognitive fog before settling on a single explanation.
Phosphorus
24-hour urine calcium + creatinine (to rule out FHH if calcium is high)
Basic metabolic panel + creatinine (kidney function)
Peer-reviewed references