If parathyroid hormone in the blood is elevated, how can it be reduced? Parathyroid hormone in the blood is elevated: what does this mean?

Small structures called parathyroid glands produce important substance- parathyroid hormone.

Existence is impossible without it human body. This hormone is responsible for the metabolism of such minerals, like calcium and phosphorus.

Parathyroid hormone, despite the growth of research medicine, is little known to physicians.

Intact parathyroid hormone is a chain of more than 80 protein molecules, molecular mass which is more than 9 kilodaltons.

Each of the intact or active PTH lives in the human bloodstream for no more than 5 minutes, during which time it needs to correctly perform its functions to ensure metabolism.

It is possible to indicate with great precision what this substance affects:

• on the exchange of calcium and phosphorus;
• on lipid metabolism;
• on the processes of glucose metabolism in the blood;
• on the reactivity of the nervous system.

PTH penetrates almost all systems internal organs that a person has.
First of all, these are the following bodies:

• human skeleton;
• genitourinary system;
• subcutaneous fat layer;
• liver tissue;
• nerve fibers.

More parathyroid hormone is produced if there is less calcium in the blood than needed. And vice versa, if in large quantities, then the PTH concentration decreases.

Calcitonin and parathyroid hormone are antagonists that are produced by different glands.

Unlike calcitonin, PTH works with greater activity, and if its synthesis fails, a complication in the form of osteoarthritis can occur.

Hormone functions

The main work of the PTG is based on the following functions:

1. Regulation of calcium leaching by the kidneys towards a decrease.
2. Regulation of phosphorus leaching by the kidneys towards an increase.
3. Release of minerals from skeletal bones.
4. Increased mineralization bone tissue when there is an excess of them in the bloodstream.

Parathyroid hormone has a daily cycle. Its quantity constantly fluctuates depending on the time of day.

For reference!

The peak activity of parathyroid hormone production occurs at 15:00, and its decline occurs at 7:00 am.

Types of hormone secretion

There are two types of synthesis of this substance:

• constant production;
• pulse production.

At the same time, it is the second type of release that responds to fluctuations in calcium in the blood. When the concentration of the mineral in the blood decreases, pulse emissions increase, and vice versa.

Thus, it is clear that the concentration of PTH in the bloodstream is directly affected by mineral composition main body fluid.

How to properly prepare for the analysis?

The following specialists can prescribe a parathyroid hormone test:

• endocrinologist;
• orthopedist;
• oncologist;
• rheumatologist;
• therapist.

Before taking the test, you need to properly prepare and eliminate risk factors that could lead to an incorrect result:

1. Do not drink alcohol during the day before the examination.
2. No smoking within three hours before the test.
3. Do not carry out heavy physical activity on the body.
4. Do screening in the morning, preferably at 8 am.
5. Don't eat or drink water before testing.

If the patient takes medications, especially hormonal ones, then after consultation with a specialist the day before taking venous blood for parathyroid hormone, you should refrain from taking them.

The test must be taken at 8 a.m. after good sleep, on an empty stomach. This will ensure maximum correct result steam condition indicators thyroid gland.

Indications for testing

A parathyroid hormone test may be prescribed for the following disorders:

1. Inadequate levels of calcium and phosphorus.
2. A state of bone destruction.
3. When pseudofractures of large bones occur.
4. Development of osteosclerosis of the spinal column.
5. The occurrence of stones in the kidneys.

Pathologies such as neurofibromatosis and endocrine neoplasia are especially concerning. The occurrence also becomes a provoking factor for increasing the synthesis of PTH.

PTH screening in young children

To do a blood test for parathyroid hormone small child, it is necessary to correctly collect the material.

To do this, it is not necessary to find a vein; it is enough to make a small prick on the finger. A small amount of blood is taken from it onto a special medical glass or strip.

After the procedure, disinfection of the area and a sterile bandage on the cut site are indicated.

If there is a suspicion that the wound has become suppurated, it should be treated with special antiseptic and healing agents for a week.

Decoding PTG norm

The reference (long-term indicator) PTH value in the blood can correspond to 14-64 pg/ml.
There are some features of the norm in groups of people:

1. The PTH value in children should be within the normal range of 11.9-94.9 pg/ml.
2. In men, normal values ​​between the ages of 22 and 69 years are 9.4-74.9 pg/ml.
3. Among women childbearing age normal amount PTH varies between 9.4-74pg/ml.
4. In pregnant women, the PTH level can vary from 9.4 to 74.9 pg/ml.

Parathyroid hormone must be taken in conjunction with mineral tests. If hormone levels are normal, but calcium levels are elevated, this may indicate deficiency.

If both indicators are elevated, then we can talk about hyperparathyroidism.

Factors for elevated PTH

There are some reasons that influence the increase in the level of indicators:

1. Enlargement of the gland or the appearance of tumors of a benign nature.
2. Malignant neoplasms.
3. Renal failure in chronic form.
4. Insufficiency of vitamins D and PP.
5. Rickety changes.
6. Manifestations of nonspecific colitis.

The general significance of such diseases relates to hyperfunction of the parathyroid gland.
Hyperparathyroidism can manifest itself in the following forms:

1. Primary due to changes in the gland itself.
2. Secondary to changes in the pituitary gland.
3. Tertiary with independently functioning adenoma near the thyroid gland and disorders in the pituitary gland.
4. False if a genetic disorder occurs.

Hyperthyroidism can be diagnosed when tissues are not responsive to PTH.

The disease most often affects women of childbearing age; among the total number of patients with hyperparathyroidism, there are three times more of them than men.

Causes of deviations in hyperfunction

If the synthesis of this hormone is disrupted, the patient experiences changes in calcium-phosphorus metabolism.
This is manifested by the following non-compliance with the norm:

• constant loss of calcium in the urine;
• decreased absorption of minerals in the intestines;
• severe loss of calcium in the bones.

Hyperparathyroidism provokes the appearance of osteoporosis and urolithiasis. Ulceration of the intestinal tissue begins.

Primary hyperfunction of the gland

Manifested by increased calcium and normal indicators phosphorus. Appears most often in connection with the formation of benign or malignant tumors on iron.

Secondary hyperfunction

Manifested by a decrease in calcium and calcitonin levels. It is caused by kidney disease with decreased excretory function and malabsorption syndrome.

False decrease in gland function

Manifested by tissue immunity to parathyroid hormone. It can lead to various states, including final stages cancer or pregnancy.

Symptoms of decreased hormone secretion

A decrease in parathyroid hormone is manifested by the following symptoms:

• bone pain;
• deformation of bone tissue;
• improper walking;
• disruption of the pancreas;
• gastrointestinal disorders;
• the appearance of nausea, vomiting.

Beyond the symptoms initial stage Symptoms of complications, such as kidney failure, may occur.

Decreased PTH

Reduced PTH levels indicate a hypofunction of the parathyroid gland or the occurrence of severe bone destruction.

By their nature, they distinguish between primary and. In this case, the first form is characterized by changes in the parenchyma of the gland, and the second by external factors.

In this case, the following violations may be the reasons:

• autoimmune process in the glands;
• after surgical intervention in the thyroid area;
• excess vitamin D;
• low magnesium content or its inability to be absorbed;
• sarcoidosis

Being involved in an accident that results in severe injuries can also have a negative impact on your job. endocrine system and lead to decreased hormone synthesis.

To decrease function parathyroid glands Hypothyroidism may also affect it.

Symptoms of hypoparathyroidism

Hypoparathyroidism is manifested by the following symptoms:

• convulsive syndrome;
• tachycardia and pain in the heart muscle;
• decreased skin hydration;
• decreased intellectual abilities;
• the appearance of nervous disorders.

With such symptoms, an examination of the endocrine system is indicated, including a study of the parathyroid gland and its functioning.

What can affect the test results?

Besides painful conditions The results of the analysis can also be influenced by factors not related to the functioning of the endocrine system:

1. Drinking milk the day before will reduce your readings.
2. Pregnancy and lactation affect the increase in concentration.
3. reduces concentration.
4. Previous studies using radioisotopes will affect the result.

The following medications improve performance:

• diuretic;
• lithium-based drugs;
• use of Rifampicin, Furosemide;
• taking steroids or anticonvulsants.

The concentration will decrease if you take Cimetidine or Propanodol.

It has been proven that women taking COCs (combined oral contraceptives) can lead to disruption of the endocrine system, including a decrease in parathyroid function.

Consequences of deviations

The negative consequences of impaired hormone synthesis are expressed in the appearance of the following deviations:

• muscle atrophy, difficulty moving;
• increased urination;
• constant feeling of thirst.

Acute hyperparathyroid intoxication develops, which is manifested by the following symptoms:

• epigastric pain;
• headaches;
• fever.

This condition requires correction, otherwise changes in blood circulation will begin.

Treatment of increased gland function

For hyperparathyroidism, the following treatment tactics are used:

• surgery to remove tumors;
• reception medicines with phosphorus salts;
• powerful diuretics;
• special diet.

Other diseases require use conservative methods treatment to correct metabolism.

It is assumed that the glands are completely removed during a malignant process, while hormone replacement therapy is carried out for the rest of life.

Diet

When performing resection of the parathyroid gland and maintenance therapy for diseases of this gland, diet No. 11 is used.
It has the following features:

1. Increased amount of minerals and proteins.
2. Increased energy value, which is about 3700 kcal per day.
3. Drink plenty of water, up to 2 liters of water per day.
4. There are no restrictions on food processing.
5. Small meals up to 6 times a day.

This diet can increase the body's resistance to infectious diseases and will increase overall tone.

The following products are used:

• bakery products without restrictions;
• any meat and liver;
• sausages;
• various varieties of fish;
• egg dishes;
• lactic acid products;
• cereal and vegetable dishes.

The exception is canned food and spices. There are also no restrictions on drinks, but preference is given natural juices and herbal decoctions.

Therapy for decreased hormone synthesis

Hypofunction requires the use of the following medications:

• calcium preparations;
• vitamin D preparations;
• use synthetic analogue hormone - Parathyroidin.

Replacement therapy is carried out intravenous infusions from 1 to 12 ml of medicines per day.

Folk remedies against parathyroid disorders

Often, in the first stages of gland dysfunction, methods are used that smooth out the symptoms of diseases and gently eliminate hormonal imbalances.
The following folk remedies are used in therapeutic practice:

1. Hemlock tincture, prepared at the rate of 1 tbsp. l of collection per 1 bottle of vodka, after 15 days of infusion, used to wipe the thyroid area.
2. Oatmeal decoction helps restore calcium levels. For this, use 1 tbsp. l of unrefined cereal, which is brought to a boil in 1 liter of water, and simmered for three hours. Then pour in a liter of milk, bring to a boil again and leave until the morning. The entire broth is drunk during the day.
3. Tincture from partitions increases the amount of hormone walnuts, which is prepared in proportions 3:5 with vodka and infused for 1.5 weeks. Reception this tool carried out in courses of 3 weeks, 2 times a day before meals.
4. Root decoction horse sorrel, which is brewed with boiling water at a ratio of 1:6 and simmered slowly for three hours. Used before meals, for breakfast, lunch and dinner.
5. Brewed in a glass of milk 1 tbsp. l flaxseeds filtered and applied to the neck for 30 minutes a day.
6. Tincture lotion horse chestnut and lilac, used to increase hormone synthesis. A solution is prepared in vodka in proportions 1:1:5. Use in weekly courses with a seven-day break.
7. You can prepare a decoction from the roots of one adult sunflower and 2 liters of water, which is boiled for 10 minutes. The cooled solution is drunk within 24 hours.

Such remedies usually help restore balance hormonal system, responsible for the bones of the skeleton.

They have a mild effect on the body, but must be used under the guidance of a doctor.

Parathyroid hormone was deciphered in the 80s of the 20th century by the American scientist Rosalyn Yalow, for which she was awarded Nobel Prize. This hormone ensures that the body absorbs calcium in sufficient quantities for health. If parathyroid hormone is elevated, this indicates various pathologies, as well as a reduced volume of substance.

Functions and production of PTH

The hormone is produced by the parathyroid glands, which can be located in the thickness of the thyroid gland or on it. back surface. As a rule, a person has 4 parathyroid glands, although there are cases where more are detected.

The main function of PTH is the production of calcium, which plays a role in the health of a person and his organs (intestines, heart, muscle tissue). Calcium, with the help of parathyroid hormone, is taken from skeletal system. If the body senses a lack of calcium, the receptors of the parathyroid glands react to this, and the secretion of a hormone begins, increasing the content of the element in the blood.

If a person’s calcium level is too high, this indicates excessive leaching of the element from the bones and its entry into the patient’s blood, and means an increase in parathyroid hormone. All problems with calcium and dysfunction of the parathyroid glands are associated with the generation of parathyroid hormone.

PTG performs the following functions:

• Inhibits the removal of calcium from the body in the urine;
• Promotes the removal of phosphorus;
• Regulates vitamin D levels;
• Promotes kidney and adrenal health;
• Positively affects the health of endocrine organs;
• When calcium production is excessive, it stimulates its deposition in the bones;
• Blocks the disease rickets;
• Prevents diabetes mellitus;
• Protects against thyrotoxicosis (a disease in which there is an increase in the production of thyroid hormones, which disrupts the functioning of body organs and metabolism).

The volume of parathyroid hormone can vary throughout the day according to various reasons. These fluctuations are taken into account when testing for hormones.

Signs of increased PTH

What does it mean when parathyroid hormone is elevated? An excess of the substance can affect many systems and organs of the human body:

• Skeletal system and muscles:
  • Constant pain in joints and bones;
  • Frequent fractures due to bone fragility;
  • Leg deformity in the shape of the letter X;
  • Diagnosis of osteoporosis;
  • Weakening of teeth;
  • Skeletal deformities;
  • Growth retardation in a child;
  • Jaw cysts.

• Kidneys and urinary organs, genitals:
  • Pain in the lumbar region;
  • Stones in the kidneys or bladder;
  • Colic;
  • Other kidney diseases (pyelonephritis, etc.);
  • Decreased potency in men and decreased libido in women.

• Effect on the gastrointestinal tract:
  • Nausea and vomiting;
  • Dry mouth;
  • Constant thirst;
  • Pain in the stomach area;
  • Frequent constipation;
  • Loss of appetite;
  • Rapid weight loss;
  • Diagnosis of gastritis, stomach ulcers or 12 duodenum, pancreatitis.

• Disturbance of the central nervous system:
  • Weakness and fatigue;
  • Sullen mood;
  • Memory impairment;
  • Psychoses.

• Effect on the heart and blood vessels:
  • Increased blood pressure;
  • Bradycardia (slow heartbeat);
  • Irregular heart rhythm (arrhythmia);
  • Negative effect on blood lipids.

When a patient develops symptoms such as muscle cramps, dry mouth, bronchial or stomach spasms, high fever or chills, heart pain, insomnia, memory impairment, special attention should be paid to this.

If several symptoms are observed different systems and body organs, you need to conduct a test for parathyroid hormone. An endocrinologist can prescribe an analysis. The same doctor will decide whether to treat the patient or redirect him to a specialist of another profile.

When calcium levels in the body are elevated for many years, there is a possibility of a hypercalcemic crisis, which threatens coma. Increased hormone dangerous. The state must not be started under any circumstances. A sign of an approaching crisis is a sudden deterioration in health, vomiting, fever up to 40 degrees, pain in the abdomen, pain with any movement. In this case, you should urgently call an ambulance.

Causes of elevated PTH levels

High levels of the hormone may indicate a serious illness:

• Carcinoma - malignant tumor, affecting epithelial cells;
• Adenoma is a benign tumor of the glandular epithelium;
• Blastoma is a malignant uncontrolled growth of deformed cells;
• Kidney failure due to high levels of phosphorus and lack of calcium;
• Benign tumor of the parathyroid glands;
• Pseudohyperparathyroidism - occurs when tumor diseases, when PTH is produced not by the corresponding glands, but by neoplasms.

For tumor diseases detected on early stage, surgery may not be required. Treatment is prescribed with medication. But if the doctor believes that surgery is needed, the sooner it is done, the greater the patient’s chances of a full recovery.

The listed diseases belong to primary hyperparathyroidism. The causes of secondary hyperparathyroidism are as follows:

• Lack of calcium in the body;
• Vitamin D deficiency;
• Tendency to rickets;
• Kidney pathology;
• DM of the first and second types;
• Malfunctions of the gastrointestinal tract;
• Malabsorption is the loss of any nutrient digestive tract as a result low level its absorption by the small intestine;

There is also tertiary hyperparathyroidism, which means oncological diseases lungs, kidneys or liver. At this stage of the disease, endocrine neoplasia may occur, in which the production of PTH is carried out by inactive tissues endocrine glands. The stage of the disease can be determined by the level of PTH in the blood. If the hormone level is 2 to 4 times higher than normal, this is a primary increase in PTH, from 4 to 10 times is secondary, and more than 10 times is tertiary.

An excess of PTH in the blood can be caused by taking certain medications. For example, if a patient has tuberculosis and takes Cyclosporine or Isoniazid for treatment, this increases parathyroid hormone. It is increased by reception hormonal drugs group of estrogens.

Normal parathyroid hormone

PTH norm table:

PTH test

The doctor will refer you for analysis if a deficiency or excess of calcium is detected, if urolithiasis is diagnosed, if osteoporosis is suspected, if there are signs of endocrine neoplasia, if there are sclerotic changes in the vertebrae, or if there are tumor diseases.

For analysis, blood is taken from a vein in the morning on an empty stomach. The day before is worth sticking to proper nutrition(do not use spicy and fatty dishes, canned food, smoked meats, sweets, pickles). Not to accept medical supplies, do not drink alcohol. The day before the analysis should be excluded physical exercise, avoid mental stress. On the morning of the study, not only drinking and eating, but also tobacco use (smoking) is prohibited.

How to reduce PTH volume

If a patient is diagnosed with secondary hyperparateriosis, it is necessary to treat the underlying disease that caused an excess of PTH. That is, to reduce parathyroid hormone, you need to take vitamins with calcium in case of calcium deficiency, take vitamin D, treat kidney disease, treat gastrointestinal diseases, etc. Thus, the question “how to reduce the hormone” can be answered: “get rid of the lack of calcium and vitamin D, and treat hormone-increasing diseases.”

If primary hyperparateriosis is detected, it is necessary surgical intervention. With its help, the patient has a tumor or part of the parathyroid gland removed, if it is enlarged. After surgery, hormone replacement therapy may be prescribed if any hormone is too low.

If parathyroid hormone is slightly elevated, the doctor will recommend a diet as treatment. It involves reducing the consumption of foods containing phosphates. The amount of salt consumed is also greatly reduced. It is recommended to include vegetables and vegetable oils, and meat foods, smoked, salted, pickled dishes should be kept to a minimum.

What to do if you have signs of increased parathyroid hormone, how to lower it? You need to contact an endocrinologist. If there is a decrease in the hormone relative to the norm, this is also a reason to consult a specialist.

Parathyroid hormone in a blood test is not one of the mandatory measurements, but its importance for the body is high. It is also called parathyroid hormone. What it is? This is a product parathyroid glands – endocrine glands small in size, located behind the thyroid gland.

The importance of parathyroid hormone is confirmed rare cases accidental removal of the parathyroid glands during surgery surgical removal thyroid gland. After removal, the person soon experienced hypocalcemic crisis, expressed in multiples muscle cramps followed by death.

It turns out that leg cramps at night are a problem with phosphorus-calcium metabolism. Parathyroid hormone is one of the main regulators of this metabolism. Low calcium in the blood means you have seizures.

However, if parathyroid hormone is elevated, then problems cannot be avoided in this case. The main sites of application of parathyroid hormone are bones and kidneys. Too much high speed the entry of parathyroid hormone into the blood can lead to a disease called hyperparathyroidism with unpleasant consequences(hypercalcemia or Recklinghausen's disease).

At various diseases parathyroid glands, parathyroid hormone (PTH) is produced in excess or insufficient quantities. An increase in the level of parathyroid hormone (hyperparathyroidism) is accompanied by leaching of calcium from bone tissue and bone resorption (destruction). The calcium ions released in this process enter the blood and lead to hypercalcemia. This condition promotes the development of kidney stones, stomach and duodenal ulcers, pancreatitis, etc.

A decrease in the production of parathyroid hormone by the parathyroid glands (hypoparathyroidism) leads to the fact that as a result of hypocalcemia, convulsions (up to lethal tetany), pain in the abdomen and muscles, a feeling of “pins and needles” and tingling in the extremities appear.

Functions in the body

Complete secretion of parathyroid hormone ensures:

• regulation of Ca and P metabolism;
• balance of the level of calcium and phosphorus ions in the extracellular fluid;
• education active form vitamin D3;
• complete mineralization of bones;
• stimulation of bone tissue regeneration during fractures;
• increased processes of lipolysis in adipose tissue and gluconeogenesis in the liver;
• increased Ca reabsorption by distal renal tubules;
• complete absorption of calcium ions in the small intestine;
• increased release of phosphates.

Parathyroid hormone and calcium

For reference. Parathyroid hormone has a significant effect on the process of regulating phosphorus and calcium metabolism. Parathyroid hormone is able to maintain stable concentrations of Ca and phosphates in the extracellular fluid, necessary for the full functioning of cells.

Calcium ions:

• are structural component bone tissue;
• play a leading role in the process of muscle contraction;
• help increase permeability cell membrane for potassium;
• influence sodium metabolism;
• normalize the operation of ion pumps;
• participate in hormonal secretion;
• support normal blood clotting;
• participate in the transfer nerve impulses.

If the level of parathyroid hormone is disturbed, the concentration of calcium in the extracellular and, consequently, in the intracellular fluid changes. This leads to disruption of cellular excitability and transmission of nerve impulses, hormonal imbalance, disorders in the hemostasis system, etc.

Also, changes in the levels of calcium and phosphorus ions in the extracellular fluid lead to impaired mineralization of bone tissue.

Mechanisms of regulation of parathyroid hormone levels

For reference. The production of parathyroid hormone is associated with the level of Ca, Mg (magnesium), K (potassium), P and the amount of vitamin D3 in the body. Regulation of the release of parathyroid hormone into the blood is ensured by the feedback principle.

A decrease in the amount of Ca in the blood (hypocalcemia) stimulates the production and release of the hormone into the blood. Accordingly, hypercalcemia (increased calcium concentration in the blood) inhibits the production of parathyroid hormone.

This labile regulatory mechanism is aimed at maintaining the normal balance of electrolytes in the extracellular and intracellular fluid.

Why is a change in parathyroid hormone levels dangerous?

With increased secretion of parathyroid hormone, osteoclast activity is activated and bone resorption increases. This leads to softening of the bones and osteopenia. The leaching of calcium from bones as a result of hyperparathyroidism is called parathyroid osteodystrophy. Clinically, this process is manifested by severe bone pain and frequent fractures.

Increased secretion of parathyroid hormone also enhances the absorption of Ca in the intestine and the accumulation of calcium washed out of the bones in the blood.

Emerging hypercalcemia manifests itself:

• arrhythmias;
• mental disorders, lethargy, severe fatigue;
• muscle hypotonia;
• impaired blood clotting and increased risk of thrombosis (increased platelet aggregation),
• the appearance of kidney stones and gallbladder Bile ducts (biliary ducts);
• pancreatitis;
• constipation;
• peptic ulcers of the stomach and duodenum.

Important. A decrease in the secretion of parathyroid hormone leads to a significant increase in the amount of phosphate in the blood and progressive hypocalcemia. The degree of calcium absorption in the intestine is impaired, as well as renal reabsorption (re-absorption) of calcium.

Hypocalcemia, clinically manifested by impaired tissue trophism, early appearance of gray hair, hair loss and brittle nails, dental problems, early cataracts, mental disorders(depression, frequent mood swings, emotional instability), insomnia, headaches, muscle and abdominal pain, vomiting, arrhythmias.

Main specific symptoms hypoparathyroidism will cause seizures, muscle tetany (painful muscle contractions), and autonomic disorders(tingling sensation, crawling sensations, heat, etc.).

In severe hypoparathyroidism, muscle tetany (laryngospasm, cardiac arrest, etc.) can be fatal.

Indications for analysis

In addition to diagnosing the causes of hypocalcemia and hypercalcemia, a blood test for parathyroid hormone is performed in patients with:

• osteoporosis (especially at a young age);
• frequent fractures;
• urine - and cholelithiasis;
• multiple endocrine neoplasia;
• arrhythmias of unknown origin;
• muscle hypotonia;
• neurofibromatosis;
• neoplasms in thyroid gland and parathyroid glands;
• chronic kidney diseases.

Parathyroid hormone. Norm

For reference. The level of PTH does not depend on gender, so the parathyroid hormone level is the same in women and men.

Test results can be recorded in pg/milliliter or pmol/liter.

The norm of parathyroid hormone in pg/milliliter ranges from fifteen to 65.

When using pmol/liter:

• in children under seventeen years of age, the parathyroid hormone level is from 1.3 to 10;
• after seventeen – from 1.3 to 6.8.

The data obtained in different laboratories may vary somewhat, so it is necessary to focus on the standards indicated in the form.

In pregnant women, the level of parathyroid hormone does not change normally or approaches upper limit norms. A marked increase in parathyroid hormone levels may be associated with hypocalcemia (a compensatory increase in hormone secretion in response to a decrease in the level of calcium ions in the blood). In this case, it is necessary to examine the level of Ca and blood phosphates.

Very important! Hypocalcemia in pregnant women can lead to:

• miscarriage,
• intrauterine growth retardation,
• arrhythmias in the mother,
• gestosis,
• bleeding during childbirth.

Features of the analysis

The analysis should be taken in the morning (optimally at eight in the morning, at this time it is observed basal value hormone in the blood). Blood should be donated on an empty stomach. Avoid drinking alcohol 48 hours before and smoking one hour before the test.

It is also necessary to take into account that treatment with cyclosporine, cortisol, nifedipine, verapamil, ketoconazole, and estrogens leads to an increase in PTH.

PTH levels at the upper limit of normal can be observed in pregnant and breastfeeding women.

The following can lead to underestimated analysis results:

• taking milk before donating blood,
• treatment:
  • cimetidine,
  • combined oral contraceptives,
  • thiazide diuretics,
  • vitamin D,
  • famotidine,
  • diltiazem.

After the administration of radioisotope media, the PTH analysis must be postponed for at least 7 days, due to distortion of the results.

Parathyroid hormone is elevated - what does this mean?

A compensatory increase in the secretion of parathyroid hormone is possible in response to a decrease in calcium levels in the blood. In this case, increased PTH promotes increased absorption of Ca and its mobilization from the depot. The tests show hypocalcemia against the background of elevated PTH.

At primary hyperparathyroidism Both PTH and Ca levels increase. The amount of phosphate (normal or reduced) depends on the severity of hyperparathyroidism.

Primary hyperparathyroidism is observed with hyperplasia of the tissues of the parathyroid glands, their damage to cancer or adenoma. Also, primary hyperproduction of PTH may be associated with multiple endocrine neoplasia.

At secondary hyperparathyroidism, parathyroid hormone is elevated against the background of normal or slightly reduced Ca levels. At the same time, there is a decrease in calcitonin levels.

Secondary hypersecretion is observed in patients with:

• chronic kidney failure;
• rickets and vitamin D hypovitaminosis;
• UC (nonspecific ulcerative colitis);
• Crohn's disease;
• spinal cord injury;
• familial forms of thyroid cancer;
• malabsorption syndrome.

Tertiary hyperproduction of PTH is caused by autonomous hormone-secreting tumors in the parathyroid glands, kidneys, lungs, etc.

A rare cause of an increase in PTH may be peripheral tissue resistance in Zollinger-Ellison syndrome, Albright syndrome, hereditary osteodystrophies, etc.

Parathyroid hormone is also increased when metastatic lesion bone tissue.

Parathyroid hormone is low. Causes

Primary hypoparathyroidism (reduced PTH and Ca) results from dysfunction of the parathyroid glands.

The development of secondary hypothyroidism can be caused by;

• complications after surgical treatment pathologies of the thyroid gland or after resection of the parathyroid glands;
• decreased level of magnesium in the blood;
• hypervitaminosis of vitamin D or A;
• idiopathic hypercalcemia;
• severe thyrotoxicosis;
• hyperchromatosis;
• Konovalov-Wilson disease;
• sarcoidosis and myeloma;
• some autoimmune diseases;
• active destruction of bone tissue.

Normalization of PTH levels

Important! Violation of the level of parathyroid hormone in the blood is a life-threatening condition and requires mandatory specialized treatment.

An endocrinologist should prescribe therapy after full examination and identifying the cause of deviations in analyzes.

Attempts self-treatment may cause irreparable damage to health. Correction of hormone levels and electrolyte balance should be carried out strictly under laboratory control of the parameters being adjusted (parathyroid hormone, calcium, phosphates, etc.).

Parathyroid hormone (PTH) is a hormonal substance that is biologically active. It is produced by the parathyroid glands. Chemical structure The hormone is complex; it consists of several dozen amino acids. Approximately a third of them are responsible for the biological activity of PTH, and the rest ensure the binding of the substance to receptors and its stability.

The purpose of parathyroid hormone is to regulate the level of calcium and phosphorus in the blood. Depending on their content, PTH secretion is stimulated or suspended.

Calcium and PTH

The amount of PTH directly depends on the level of calcium ions in the bloodstream. If it decreases, then the activity of the parathyroid glands that produce parathyroid hormone immediately increases.

The main mission that PTH must perform is maintaining the required amount of calcium cations in the blood. Its implementation includes several actions.

• Under the influence of PTH, vitamin D is intensely activated in the kidneys. It is converted to calcitriol (a hormone-like substance). It stimulates the absorption of calcium by the intestines and its active entry from food into the blood.

  To successfully carry out this action, the body must have a sufficient amount of vitamin D.

• Parathyroid hormone enhances the reabsorption of calcium cations from primary urine (glomerular ultrafiltrate). This happens at the level of the renal tubules. This reduces the loss of the substance in the urine, while increasing the excretion of phosphorus.
• In conditions of calcium deficiency, PTH promotes its extraction from bone tissue and movement into the blood. The hormone increases the activity of osteoclasts - giant multinucleated cells that destroy bone tissue. They remove it by dissolving the mineral component and destroying collagen. Osteoclasts actively break bone beams and release calcium into the blood, which is formed during such actions. Its concentration in the life-giving liquid increases.

But there is also Negative consequences: the strength of bone tissue decreases, which means the likelihood of fractures increases.

It should be noted that this becomes possible only if the hormone exceeds the norm for a long time. With periodic and short-term entry of PTH into the blood, positive impact on bone tissue: it strengthens. Parathyroid hormone promotes the deposition of calcium in the bones if there is too much of it in the blood.

Parathyroid hormone is normal in women

IN female blood The normative level of parathyroid hormone changes rarely. It fluctuates depending on how old the fair sex is.

Until the age of twenty, the PTH content should be within the following limits (pg/ml):

• minimum – 12.0;
• maximum – 95.0.

All subsequent years, up to 70 years, the norm decreases, and its boundaries are as follows (pg/ml):

• minimum – 9.5;
• maximum – 75.0.

After 70 years, the lower value of the norm is fixed at 4.7, which is half the previous level. Upper permissible level PTH increases significantly and amounts to 117.0.

For women during pregnancy, the permissible level of parathyroid hormone should be in the following range (pg/ml):

• minimum – 9.5;
• maximum – 75.0.

Parathyroid hormone is normal in men

The optimal level of parathyroid hormone ranges from 12.0 to 65.0 (pg/ml). Normal PTH for men is no different from women's indicators.

• minimum – 12.0;
• maximum – 95.0.

From 23 to 70:

• minimum – 9.5;
• maximum – 75.0.

Over 70:

• minimum – 4.7;
• maximum – 117.0.

Although the range normal values is the same, it has been established that the production of the hormone increases with age to a greater extent in the fair sex.

Normal parathyroid hormone levels in children

The permissible amount of parathyroid hormone in children remains unchanged from the day of birth until adulthood (up to 22 years). Its interval is as follows (pg/ml):

• minimum – 12.0;
• maximum – 95.0.

Just like in adults, the amount of parathyroid hormone fluctuates throughout the day. This is due to the metabolism in the body and its biorhythms.

Diagnosis of PTH

Testing for parathyroid hormone is prescribed:

• orthopedist;
• endocrinologist;
• therapist.

The need for research appears in the following cases:

• Osteoporosis.
• Urolithiasis with calculi (stones), which are predominantly composed of calcium and phosphorus.
• Spinal sclerosis.
• Possible neoplasm in the parathyroid gland.
• Increased incidence of bone injuries and fractures in seemingly safe situations.
• Reduced or higher level calcium in the body.
• Changes in bone tissue.

The test is carried out in the morning. Before the procedure, you should follow the standard rules:

• after dinner and before the test, do not eat anything;
• do not touch alcohol the day before testing;
• do not smoke at least one hour before diagnosis;
• sports or intense physical exercise suspend for three days.

Why does PTH decrease or increase?

Exceeding the level of parathyroid hormone most often indicates damage to the parathyroid glands. The disease is quite common; it is diagnosed three times more often in women.

Reasons for a persistent increase in parathyroid hormone:

• Neoplasms in the thyroid and parathyroid glands, metastases to these organs from a tumor of a different location.
• Rickets (vitamin D deficiency).
• Crohn's disease.
• Tumor in the pancreas.
• Kidney failure.
• Colitis.

Why is the level of parathyroid hormone reduced? Possible reasons decreases in the amount of parathyroid hormone are as follows:

• The development of sarcoidosis is a systemic pathology affecting the lungs.
• Magnesium deficiency.
• Surgical intervention on the thyroid gland.
• Osteoliosis is the complete resorption of bone tissue and all its elements.

The level of parathyroid hormone is affected by drugs such as lithium, isoniazid, cyclosporine, hormonal agents, the basis of which is estrogen. They are able to temporarily increase the level of PTH in the blood.

It is possible to reduce the amount of parathyroid hormone in women oral contraceptives, drugs with vitamin D, prednisolone, magnesium sulfate, famotidine.

Consequences of PTH deviation from normal

When the level of parathyroid hormone deviates from the norm in one direction or another, a disturbance in the metabolism of calcium and phosphorus occurs. This adversely affects the functioning of all internal human organs. He has:

• muscle weakness;
• difficulties in walking;
• constant feeling of thirst;
• dysuria – frequent urination.

There is a high probability of developing a hyperparathyroid crisis - serious condition, which progresses rapidly against the background sharp jump calcium level. It is characterized by:

• significant increase in body temperature;
• confusion;
• painful sensations in the abdominal area.

Long-term excess calcium in the blood slows down the formation bone cells. And the old bone beams continue to dissolve. There is an imbalance between tissue formation and destruction. This is fraught with osteoporosis and pathological softening of bones.

Negative processes reach the kidneys and urinary system: the threat of stone formation increases.

Deviations in PTH levels from normal also affect the vascular system. Calcification develops, that is, calcium salts are deposited in those tissues and organs where they should not be. They also affect blood vessels, increasing the risk of ulcers forming in the stomach and causing general disorder blood circulation

If during the examination of the patient there are suspicions about the presence of pathology of the parathyroid glands or other ailments that violate the proportion between calcium and phosphorus, this serves as a reason to conduct a test for the level of parathyroid hormone in the blood.

Photo: Emw - own work, CC BY-SA 3.0