What is the cause of calcium 10.3, tsh 4.780 , vitamin d 18 and parathyroid is normal?

Hyperparathyroidism?: If serum calcium is persistently above 10 mg/dl and parathyroid hormone is not below normal the most likely diagnosis is mild primary hyperparathyroidism. There is also mild vitamin d defieicency if 18 is the serum 25ohd level.

Hyperparathyroidism: The question is... Is the PTH too high for this level of blood calcium. You may have very mild hpt. Just follow the blood levels for now. Tsh is on the high side.