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I have also been on Calcitriol 0.5 mcg x 2 twice daily in addition to 5400 mg (total) calcium and 756 mg magnesium (total) daily. Still experiencing sever symptoms of hypocalcemia - tingling, chills, muscle spasm, light headedness, etc. Also, had papillary cancer with all thyroid removed - surgeon likely removed all parathyroids as 2 were found in pathology and no parathyroid hormone detected in subsequent lab tests.

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Magnesium is an important co-factor in the production and release of PTH from the parathyroid gland.

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The first endocrine gland dysfunction to occur in APS1 is usually hypoparathyroidism (under functioning of the parathyroid glands).

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The so-called hungry bone disease that occurs after removal of Parathyroids in patients with hyper parathyroid bone disease can cause severe, serious hypocalcemia and is resistant to treatment.

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But that has nothing to do with how much calcium or calcitriol she may need.

As the effects of PTH raise the blood level of calcium, the calcium sensors back in the parathyroid gland take note.

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