PTH and osteomalacia: In addition to osteoporosis, the patient presented with abnormal bone metabolism characteristic of osteomalacia: covert hypophosphatemia, a low serum concentration of Ca (8.1 mg/dL, reference of 8.8–10.1 mg/dL), elevated serum bone-specific alkaline phosphatase (48.4 μg/L, reference of 3.8–22.6 IU/L), elevated serum whole-PTH (204 pg/mL, reference of 8.3–38.7 pg/mL), and elevated urinary NTx (90.1 nmol/mmol cr., reference of >55 nmol/mmol cr).