She remains in the long term on high-dose medical therapy with normal serum calcium levels and PTH levels around 100 pg/mL.<h4>Discussion</h4>Our patient's protracted hypocalcemia originates from a combination of 3.5 gland parathyroidectomy, altered intestinal anatomy post-RYGBP, and potentially her pancreas transplant causing additional metabolic derangement. Here, PTH is linked to Hypocalcemia.