Parathyroid Hormone (PTH)

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Pseudohypoparathyroidism

Caused by PTH hyposecretion and tisssue resistance to PTH (PTH-dependent Hypocalcemia.

Primary hyperparathyroidism

Caused by tumor or hyperplasia.

Labs of primary hyperparathyroidism

Increased PTH, increased calcium, normal or decreased phosphorous

Secondary hyperparathyroidism labs

Increased PTH, low calcium,, high phosphorous

Secondary hyperparathyroidism

Occures when the body attempts to compensate for low calcium by putting out more PTH. Usually problem in kidneys (letting go too much calcium)

Effect on calcium

PTH increases serum calcium by increasing bone resorption of calcium into blood (this requires vitamin D). Increases renal reabsorption of calcium.

Symptom of hypercalcemia

Polyuria, polydipsia, hypertension, acid-base disorders, kidney stones, etc. Can be asymptomatic.

Hypercalcemia

can be caused by malignancy or bone disease

Idiopathic hypoparathyroidism

cause unknown, rare, thought to be hereditary.

Primary hypoparathyroidism

caused by surgical removal of parathyroid gland, surgical trauma, or radiation.

PTH-Independent Hypocalcemia

caused by vitamin D deficiency

Effect on serum phosphate

decreases blood phosphate via inhibition of renal reabsorption of phosphate

Release and Regulation

ionized calcium regulates PTH release. Magnesium and vitamin D can also slightly regulate it.

pseudohypoparathyroidism

lack of renal and tissue responsiveness to PTH. Not a decrease in PTH, Kidneys do not respond to PTH, so calcium is not reabsorbed.

Lab results of primary hypoparathyroidism

low calcium and high phosphorous

Function

metabolism of calcium and phosphorous in kidney and bone.

Multiple Endocrine Neoplasia (MEN)

new tissue growth of several endocrine glands (including parathyroid).

Calcitonin

synthesized in thyroid and regulated by calcium. It decreases serum calcium by inhibiting bone resorption of Ca and decreasing kidney reabsorption of Ca, Ph, K, and Mg.

Symptoms of hypocalcemia

tetany (muscle twitching), dry skin, and hypotension

Labs of Idiopathic hypoparathyroidism

very low calcium, very high phosphorous


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