Objective. Coeliac disease (CD) may present in its clas sical form with diarrhoea and weight loss, but also with atypical symptoms th at are both related and unrelated to malabsorption. Osteomalacia or osteopenia f ollowing malabsorption of calcium and vitamin D is known to occur in patients wi th CD, and in such cases secondary hyperparathyroidism(SHP) caused by low serum calcium levels is frequently found. However, the prevalence of CD in subjects wi th SHP has not been reported. Material and methods. In the Troms study 2001, ser um parathyroid hormone (PTH) and calcium were measured in 7954 subjects of whom 6061 were eligible for follow- up. From this group, 97 subjects with SHP (serum PTH ≥ 6.5 pmol/l and serum calcium < 2.40 mmol/l) and 104 matched control subj ects were re- examined with serological tests for CD (antitissue transglutamina se, anti- gluten IgA and IgG). Results. CD was diagnosed in 4 subjects, all fro m the original SHP group. At the re- examination, only 29 of the 97 subjects wi th SHP still had elevated serum PTH levels. Among these were 3 of the subjects w ith CD. When grouping the serological test results as negative, borderline or po sitive, there was a significant difference between the SHP group and the control s for anti- tissue transglutaminase and anti- gluten IgA (p < 0.05). Conclusio ns. Subjects with SHP, at least when SHP is persistent, should be tested for CD. Objectives. Coeliac disease (CD) may present in its clas sical form with diarrhea and weight loss, but also with atypical symptoms th at are both related and unrelated to malabsorption. Osteomalacia or osteopenia f ollowing malabsorption of calcium and vitamin D is known to occur in patients wi th CD, and in such cases secondary hyperparathyroidism (SHP) caused by low serum calcium levels are frequently found. However, the prevalence of CD in subjects wi th SHP has not been reported. Material and methods. In the Troms study 2001 , from subjects in whom 6061 were eligible for follow-up. From this group, 97 subjects with SHP (serum PTH ≧ 6.5 pmol / l and serum calcium <2.40 mmol / l), serumal parathyroid hormone (PTH) and calcium were measured in 7954 subjects of whom 6061 were eligible for follow- and 104 matched control subj ects were re- examined with serological tests for CD (antitissue transglutamina se, anti-gluten IgA and IgG). Results. CD was diagnosed in 4 subjects, all fro m the original SHP group. At the re- examination , only 29 of the group of the serological test results as negative, borderline or po sitive, there was a significant difference between the SHP group and the control s for anti-tissue transglutaminase and anti-gluten IgA (p <0.05) Conclusio ns. Subjects with SHP, at least when SHP is persistent, should be tested for CD.