Hello, Welcome to Healthcare Magic. I have read your question fully and understand your concerns. Pseudo hypoparathyroidism is a condition where there is resistance to the Parathyroid hormone. Patients who are not treated will have low levels of calcium, high phosphate levels and high serum Parathyroid hormone levels You daughter is being treated with 1-Alpha 1 mcg every day. It is a Vitamin D analogue which helps to absorb calcium and maintain adequate calcium levels. Vitamin-D is not found much in food. A precursor of Vitamin-D is found in skin, and upon action of sun rays this precursor changes into active Vitamin-D. But in places which does not see sun much, or in people who are predominantly indoors this activation of precursor Vitamin-D to active Vitamin-D may not be possible leading to low Vitamin-D levels and this affects the body calcium levels. If your daughter stops her 1- Alpha tablet, her body calcium levels will fall leading to symptoms ranging from mild to severe. Patients with low calcium levels may experience problems with their nerves (tingling, burning), muscle cramps, voice changes, dry skin, irritability, seizures etc. Hence, to prevent low calcium levels your daughter needs to take the 1-Alpha tablet every day for the rest of her life. She may even need calcium supplements if her serum calcium is still low. I hope this answer has helped you. Thank you Regards Dr Sunita Sayammagaru