Hand x-ray mentioned demineralization. worried about hyperparathyroidism. calcium is 9.5. alkaline phosphatase is 38. hyperparathyrodism possible?

Possible: Hyperparathyroidism possible, should have level checked, but alk phos normal, so other causes should be ruled out. Thyroid function, vitamin d, kidney function, magnesium level, should also have formal bone mineral density checked (dexa scan).

Not likely: Bone demineralization at age of 65 is not that abnormal.You know you have osteoporosis.You need to have 25 hydroxyl level and Ionised Calcium done. And if you have any other symptoms like kidney stones or symptoms related to high calcium have Parathyroid level done to make sure Consult your Doctor or an Endocrinologist

Unlikely: If calcium and alk phos is normal, it's unlikely you have hyperparathyroidsm but the only way to know is to check a parathyroid level as well.