When one pth is in the 300 range, is surgery necessary?

Check calcium, Vit D: Parathyroid hormone (PTH) is a hormone used by the body to regulate calcium balance. Very high PTH levels can be seen with extremely low levels of both calcium and vitamin d. If those are normal, you should have an ultrasound and PTH scan. They may help determine if surgery is needed. But generally, if the PTH is that high, you should have the surgery. Severe elevations an cause a lot of problems.

Maybe: Agree can be elevated with vitamin d deficiency, calcium deficiency, kidney failure. Typically causes high blood calcium. If cause is from parathyroids, need to check if it is from an adenoma (generally benign tumor) of a single or 2 parathyroid glands, or if all four are overproducing hormone-different surgical rx. Sometimes there can be medical rx. If due to other cause, treat underlying.

Reason?: Pth levels can be elevated for different reasons. Some require surgery and others don't. More information is necessary to comment further. Please provide more details. Thanks.