I'm having trouble wrapping my head around the lab findings in osteomalacia.
Why would you have increased alkaline phosphatase levels (indicating osteoblast activity) in osteomalacia, when you have increased PTH levels in response to the low calcium levels? Couldn't the increased PTH cause the osteoblasts to activate the osteoclasts instead, therefore leading to more clast activity and DECREASED ALP? A mechanism besides 'compensatory osteoblast activity' would help because I'm becoming OCD about this.
Why would you have increased alkaline phosphatase levels (indicating osteoblast activity) in osteomalacia, when you have increased PTH levels in response to the low calcium levels? Couldn't the increased PTH cause the osteoblasts to activate the osteoclasts instead, therefore leading to more clast activity and DECREASED ALP? A mechanism besides 'compensatory osteoblast activity' would help because I'm becoming OCD about this.