Hyper and Hypoparathyroid disease states are often latent with a multiplicity of manifestations ranging from asymptomatic state to obvious symptoms and complications such as fatigue, depression, kidney stones, bone fractures and intracranial calcifications.  Both conditions are associated with significant morbidity related to cardiac and vascular calcifications, hypertension, and seizure disorders.  As Dr. Rao picks up the normality enigma, the altered parathyroid state and its importance will be addressed diagnostically as it applies to the choices made in the course of clinical management.