We all have little chemical messengers working inside our bodies, unseen, to keep us healthy. One such messenger is the parathyroid hormone. Simply put, this hormone controls the amount of calcium in our blood. Why is it so important? Because calcium is essential for our nerves, muscles, and heart to function properly.
This parathyroid hormone (Parathyroid Hormone - PTH) is made by our parathyroid glands. These are located in our neck, behind the thyroid gland. They are four very small glands. Their main job is to control the amount of calcium in our blood . Remember, it is not the calcium in the bones, but the calcium in the blood. In addition, this PTH also helps to control the mineral phosphorus and the hormone vitamin D in the blood and bones.
How does parathyroid hormone (PTH) work?
Okay, now let's look at how this parathyroid hormone (PTH) works. When your blood calcium levels drop, the parathyroid glands release PTH. It's like a sensor. This PTH then goes and affects several parts of our body to bring the calcium levels back up.
- Bones: First, our bones are given a little signal, saying, 'Release some calcium into the blood.' Then a small amount of calcium from the bones is added to the blood. This does not weaken the bones, because this is a controlled process.
- Kidneys: Secondly, it affects our kidneys. One is that the kidneys help make active vitamin D, which is called calcitriol. This calcitriol helps the body absorb calcium from the food we eat. The other thing is that it tells the kidneys to 'keep the calcium in the body, don't excrete it in the urine'. Then the calcium won't be wasted.
- Small Intestine: Thirdly, as mentioned earlier, vitamin D (Calcitriol) sends a signal to our small intestine to absorb more calcium from the foods we eat.
That's how PTH works to keep the calcium level in the blood at the right level by influencing different parts of the body. Isn't this an amazing mechanism?
How does our body control PTH levels?
How does our body control this PTH level? It also happens in a very strange way. It's called a feedback loop . Simply put, when the calcium in the blood decreases, the parathyroid glands are stimulated and release PTH. When the calcium in the blood increases, it signals the glands to 'stop making PTH now, enough'. So that's how it's controlled. It's like a motor in a house that turns on when the water in the water tank is low and turns off when the tank is full.
However, sometimes if there is a problem with our parathyroid glands, this feedback loop may not work properly, causing either too much or too little PTH to be produced. That's when the problems begin.
What diseases can occur if PTH levels are disturbed?
Now let's see what health conditions can occur if parathyroid hormone (PTH) levels are disrupted.
What happens if PTH levels increase? (Hyperparathyroidism)
If PTH levels are too high, we call it hyperparathyroidism . Then two main things happen:
- The level of calcium in the blood increases . This is called hypercalcemia.
- The level of phosphorus in the blood decreases . This is called hypophosphatemia.
Imagine, PTH keeps releasing calcium from the bones into the blood, stops the kidneys from releasing calcium, and absorbs more from food... and then the blood becomes full of calcium, right? This is like a pipe getting clogged and water overflowing.
There can be several causes for this condition, such as:
- Parathyroid Adenoma: This is not cancer, but this tumor causes the gland to produce too much PTH. This is the most common cause.
- Parathyroid Hyperplasia: All four glands become enlarged and produce more hormones.
- Kidney Disease: This condition can occur especially in people with long-term kidney disease. Because when the kidneys are not working properly, the production of vitamin D decreases and the excretion of phosphorus decreases. This stimulates the parathyroid glands to produce more PTH.
- Parathyroid Cancer: This is very rare, but it can happen.
What happens if PTH levels decrease? (Hypoparathyroidism)
If PTH levels are low, it is called hypoparathyroidism . Then the opposite happens:
- Low blood calcium levels. This is called hypocalcemia.
- The level of phosphorus in the blood increases . This is called hyperphosphatemia.
Hypoparathyroidism is a rare condition. The majority of cases (about 75%) are caused by accidental damage to or removal of the parathyroid glands during neck surgery, especially thyroid surgery. It can also be caused by certain genetic conditions and autoimmune conditions – diseases in which the body's immune system attacks its own cells.
How do you know if your PTH level is abnormal? What are the symptoms?
As we've discussed before, PTH primarily controls the amount of calcium in the blood. So the symptoms that occur when PTH levels are low or high are actually symptoms of low or high calcium levels in the blood. Let's see what they are.
Symptoms of low blood calcium (Hypocalcemia):
You may feel things like this:
- Brain fog or confusion. It can feel like your head is covered in fog.
- The skin becomes dry, the nails break easily, and the hair falls out.
- Muscle cramps, especially in the legs and arms.
- Tingling in your lips, fingers or feet.
- Things like anxiety and depression may also occur.
- In severe cases, seizures may occur.
Imagine, Niluka suddenly felt numbness in her fingers, tingling around her mouth, and the flesh on her legs started to turn red. She felt very uncomfortable. It was only when she went to see a doctor that she learned that her blood calcium level had decreased, and the cause was hypoparathyroidism.
Symptoms of high blood calcium (Hypercalcemia):
Symptoms like these may indicate high blood calcium:
- I feel very tired, like I have no energy (Fatigue). No matter how much I sleep, the fatigue doesn't seem to go away.
- Headache.
- Joint pain and bone pain.
- Needing to urinate more frequently and being thirsty.
- Things like stomach upset, nausea, vomiting, and diarrhea.
- It's hard to concentrate, memory lapses, and mental confusion.
- In severe cases, kidney stones and heart rhythm irregularities can occur.
For example, Uncle Saman had been feeling very tired for a few days, and his joints were hurting. He was always thirsty and needed to go to the bathroom. When the doctor checked him, he was told that his blood calcium was a little high. He had hyperparathyroidism.
If you have these symptoms, meaning that you feel like your blood calcium levels are low or high, you should definitely see a doctor . Don't forget that. These are not good symptoms to ignore.
How to check PTH level?
Your doctor can check your parathyroid hormone levels with a simple blood test . Doctors and labs call this test “PTH, intact.” They also usually check your blood levels of calcium, phosphorus, and vitamin D to get a complete picture.
What are the normal values for PTH levels?
In a typical PTH blood test, a healthy level is between 15 and 65 picograms per milliliter (pg/mL) . A picogram is one trillionth of a gram. That means a very small amount does this important job in our bodies.
But one thing to keep in mind is that these normal values can vary slightly from lab to lab. Therefore, you should always look at the normal range for that lab on your blood test report.
If you have a PTH test, your doctor will be the one who will interpret the results accurately. He/she will compare it with your calcium level and tell you whether further testing is needed.
So, what are the things we need to remember from all of this?
Parathyroid Hormone (PTH) is a very important hormone that precisely controls the level of calcium in our blood. This calcium level is essential for the healthy functioning of our nervous system, muscles, and heart.
If you have symptoms of hypercalcemia (high blood calcium) or hypocalcemia (low blood calcium), such as muscle problems, changes in mental function, excessive fatigue, and bone pain, it is important to seek medical advice without delay. If these conditions persist, they can cause damage to the kidneys, heart, and bones.
Your doctor can run a few simple tests to determine if your parathyroid hormone levels are the cause. If so, they can start treatment right away. Sometimes these problems can be treated with medication, sometimes with minor surgery. So, taking care of your body, understanding the signals it gives, and acting on them is the best way to stay healthy.
` Parathyroid hormone, PTH, calcium, hyperparathyroidism, hypoparathyroidism, hypercalcemia, hypocalcemia
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