Even asymptomatic individuals can present alterations in bone histology, such as osteitis fibrosa (characterized by high bone turnover due to hyperparathyroidism), adynamic bone disease (characterized by very low or lack of bone turnover frequently seen in patients with low PTH and low tissue-specific alkaline phosphatase activity) and osteomalacia (related to insufficient bone formation and mineralization) [6,10,11,12]. Here, PTH is linked to osteitis fibrosa.