TG and hyperthyroidism: Some studies have explored the mechanisms by which thyroid hormone alters calcium metabolism.[2,9] Increased serum ALP level was found in approximately 50% of the patients with hyperthyroidism complicated with hypercalcemia.[2,8,11] Whereas in our case, in spite of the normal ALP level, the bone formation markers (BALP and PINP), and bone resorption marker were all increased.