23rd May 2025

A 40-year-old female has been reviewed for ongoing fatigue, muscle weakness and constipation.

A 40-year-old female has been reviewed for ongoing fatigue, muscle weakness and constipation. A set of blood tests shows a slightly raised calcium 2.65 mmol/L (normal 2.20 – 2.60mmol/L) and raised intact PTH with a creatinine clearance of 70mL/min.  Repeat blood tests show similar results. She has no significant past medical history and a DXA scan is negative. 24-hour urinary calcium is 300mg/day.  

What is the best long-term management for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.