How do i better understand my pth level of 210 and calcium at 5.9 ?

Hmm: Pth is high, which most commonly means hyperparathyroidism. You should have high calcium for which i suspect your level is an ionized calcium and is high also. You should see an experienced head and neck surgeon who performs minimally invasive surgery and can further evaluate if you are a candidate.

Calcium low PTH high: There is an inverse relationship between calcium and PTH. Assuming your calcium is on a scale where the low cut off is 8.4, your parathyroids are producing more hormone to raise your calcium. Vitamin D deficiency and kidney disease can also cause the PTH to be elevated.