Let's learn about Parathyroid Hormone, which controls calcium in your body.

We all have little messengers working invisibly inside our bodies, we call them hormones. And they are the ones who do a great service for our body's health. Parathyroid hormone , or (PTH) for short. Simply put, this hormone controls the amount of calcium in our blood. This is very important because our nerves, muscles, and heart all need to have the right amount of calcium in their blood to function properly.

You know, calcium is a very common mineral that our body needs. It's not just for keeping our bones and teeth strong, it's for many other things too. Also, this parathyroid hormone `(PTH)` helps control the levels of phosphorus (another mineral) and vitamin D (a type of hormone) in our blood and bones. So, this friend `(PTH)` is like the calcium manager in our body.

What is the role of parathyroid hormone (PTH)?

Okay, now let's see what this `(PTH)` actually does. In your neck, right behind your thyroid gland, there are four small parathyroid glands. They're about the size of four grains of rice. When your body senses that your blood calcium level is low, these parathyroid glands release `(PTH)`. Then this `(PTH)` goes to several parts of our body and brings the blood calcium level back to the right level. Do you know how it does that?

Here's how it happens:

• Bones: Our bones are like a storehouse of calcium. So, when the calcium in the blood is low, `(PTH)` helps to release a small amount of calcium from our bones into the bloodstream. This is like taking some out of the bank when we are low on money. However, if this happens regularly, it can also weaken the bones.

• Kidneys: The kidneys are also a very important organ for this job. `(PTH)` signals our kidneys to make the active form of vitamin D, that is, `(Calcitriol)`. This active vitamin D helps the body absorb calcium from the food we eat. Also, this `(PTH)` tells the kidneys to keep the calcium in the blood inside the body instead of letting it go out with the urine. Simply put, it does not let valuable calcium go to waste.

• Small Intestine: The small intestine is also told to absorb more calcium from the food we eat, but it does so through the previously mentioned active vitamin D. So, these three work together to maintain the correct level of calcium in the blood.

How does our body control the level of parathyroid hormone (PTH)?

This is a very simple, yet very amazing process. Our bodies are very good at controlling things like this. The level of `(PTH)` is determined by how much calcium is in the blood. We call this a `(feedback loop)` .

Think about it this way.

• The calcium level in your blood is decreasing.
• This is felt by the parathyroid glands .
• At the same time, the glands release `( PTH )` into the blood.
• As mentioned earlier, PTH adds calcium to the blood through the bones, kidneys, and small intestine.
• The calcium level in the blood returns to normal.
• When calcium levels return to normal, the parathyroid glands reduce or stop releasing parathyroid hormone (PTH).

This is just like the motor automatically ``turning off`` when the water tank is full, or the ``compressor`` of the ``AC`` automatically ``turning off`` when the room gets cold.

However, sometimes, if there is some problem or disease in these parathyroid glands, they can release more or less PTH than necessary, without taking that ``feedback loop'' into account. That's when problems arise.

What conditions are caused by parathyroid hormone (PTH) imbalances?

Now you probably understand how important a hormone `(PTH)` is for the calcium balance in our body. So if this `(PTH)` level fluctuates, whether it increases or decreases, various health problems can occur. Let's see what they are.

Increased PTH levels (Hyperparathyroidism)

If the level of `(PTH)` is higher than necessary, we call it `(Hyperparathyroidism)` . This is when the parathyroid glands produce more `(PTH)` than necessary. Then the following things can happen:

• The level of calcium in the blood increases. Doctors call this ``Hypercalcemia'' . Because there is too much ``(PTH)'', more calcium comes from the bones into the blood, the excretion of calcium from the kidneys decreases, and the amount of calcium absorbed from food increases.
• Phosphorus levels in the blood decrease. This is called hypophosphatemia . When PTH increases, it increases the excretion of phosphorus from the kidneys.

There can be several main causes for this ``Hyperparathyroidism``.

• Most often, the cause is a benign tumor (parathyroid adenoma) that develops in the parathyroid gland. This is called a parathyroid adenoma . This is not cancer.
• Rarely, all four parathyroid glands may become enlarged and produce too much hormone.
• Very rarely, it can be caused by parathyroid cancer .
• This condition can also occur in people with certain kidney diseases , especially those with long-term kidney failure. This is because when the kidneys are not working properly, vitamin D production decreases, phosphorus levels increase, and parathyroid hormone (PTH) increases in response.

Decreased PTH levels (Hypoparathyroidism)

When the level of `(PTH)` is lower than the required amount, we call it `(Hypoparathyroidism)` . This is not as common as `(Hyperparathyroidism)`, but a little rarer. What happens in this is that the parathyroid glands do not produce enough `(PTH)`. Then this happens:

• The level of calcium in the blood decreases. This is called `(Hypocalcemia)` . Due to low `(PTH)`, less calcium is released from the bones into the blood, less calcium is reabsorbed by the kidneys, and the production of active vitamin D, which helps absorb calcium from food, is also reduced.
• Phosphorus levels in the blood increase. This is called hyperphosphatemia . Low PTH reduces the excretion of phosphorus from the kidneys.

The main cause of hypoparathyroidism is accidental damage or removal of the parathyroid glands during neck surgery, especially thyroid surgery. Roughly speaking, this is the cause of about 75% of cases.

In addition,

• Some genetic conditions can cause the parathyroid glands to not develop properly from birth.
• This can also happen due to autoimmune conditions , which means the body's own immune system attacks the parathyroid glands.
• Rarely, even when magnesium levels are very low, PTH activity may be reduced.

What are the symptoms of abnormal PTH levels?

Now, `(PTH)` mainly controls the calcium level in the blood. So whether the `(PTH)` level is low or high, the symptoms we experience are actually due to the low or high calcium level in the blood. Therefore, it is very important to be aware of these symptoms.

Symptoms of low blood calcium levels (Hypocalcemia)

When calcium in the blood is low (as in hypoparathyroidism), you may experience the following symptoms:

• You may feel like your brain is slowing down , it's hard to focus (brain fog) or you may feel confused.
• The skin becomes dry, the nails break easily , and the hair falls out.
• Muscle cramps are a feeling of tightening or twitching in the muscles. This can occur especially in the muscles of the arms, legs, and face.
• Tingling is a feeling of numbness in the lips, fingertips, and toes. Sometimes it can also feel like a burning sensation.
• Mental symptoms such as upset, anxiety, and depression may occur.
• Rarely, if calcium levels drop too low , seizures can occur.

Symptoms of high blood calcium levels (Hypercalcemia)

When calcium in the blood increases (as in hyperparathyroidism), the following symptoms may occur:

• Feeling tired all the time (Fatigue). Feeling like you don't want to do anything.
• Headache.
• Joint pain, bone pain. Because `(PTH)` takes more calcium from the bones.
• You need to urinate frequently, and you feel thirsty all the time. This happens because your kidneys are trying to get rid of excess calcium.
• Digestive system problems such as stomach upset, nausea, vomiting, and constipation may occur.
• Kidney stones can form.
• Memory weakens, concentration becomes difficult, and mental confusion may occur.
• Severely elevated calcium levels can cause heart rhythm irregularities.

If you have one or more of these symptoms of low or high calcium in your blood, you should definitely see a doctor for advice . Because it is very important to find the cause and treat it. It is better not to go and get medicine on your own, right?

How are parathyroid hormone (PTH) levels tested?

This is very easy to do. Your doctor can check your PTH level with a simple blood test . Usually, when you check your PTH level, they also check your blood calcium, phosphorus, and vitamin D levels. That way, you can get a complete picture.

Doctors and laboratories call this test ``PTH, intact.'' This measures the amount of active ``(PTH)'' in the body.

What is the normal level of parathyroid hormone (PTH)?

A normal level of PTH in a blood test is considered to be between 15 and 65 picograms per milliliter (15 to 65 pg/mL) . A picogram is one trillionth of a gram (that's 12 drops). Imagine how small that is!

But the most important thing to remember is that these normal ranges can vary slightly from one laboratory to another. These values ​​can fluctuate slightly depending on the equipment and methods they use. Therefore, always check the normal range (Normal Range / Reference Range) of the relevant laboratory on your blood test report.

If you have a test to check your PTH level, your doctor will evaluate the result and tell you exactly whether it is normal, high, or low, what the cause might be, and whether further testing is needed.

Take-Home Message:

Okay, so let's review the important points we've talked about about the parathyroid hormone. It's worth keeping these in mind.

• "`(PTH)` is a very important hormone produced by the parathyroid glands in our neck that controls the level of calcium in the blood . It is related not only to calcium, but also to phosphorus and vitamin D."
• "If this doesn't work properly, that is, if the level of `(PTH)` is increased `(Hyperparathyroidism)` or decreased `(Hypoparathyroidism)`, the level of calcium in the blood can become abnormal and cause various health problems. There are also changes in phosphorus levels."
• "If you have symptoms such as muscle problems (numbness, muscle twitching), changes in mental function (confusion, memory loss), frequent fatigue, bone pain, frequent urination and thirst, and stomach upset , these may be symptoms of `(Hypercalcemia)` (increased calcium) or `(Hypocalcemia)` (decreased calcium). If you feel this way, please seek medical advice immediately. "
• "Don't worry, a simple blood test can tell you things like `(PTH)` levels and calcium levels. So it's not difficult to diagnose."
• "Remember, these conditions can be largely controlled if identified early and treated properly. So don't ignore the symptoms."

So, parathyroid hormone is like a little hero working silently in our bodies. If it does its job properly, we stay healthy. So it's good to know a little about it, right?

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