Parathyroid hormone (PTH) is produced by four small glands sitting behind the thyroid in your neck. Despite the similar name, the parathyroid glands are entirely separate from the thyroid and serve a different function. Their job is to regulate calcium levels in the blood. When calcium drops, the parathyroid glands release more PTH, which pulls calcium from bones, increases calcium absorption from food, and reduces calcium lost through the kidneys. When calcium rises, PTH production slows down.
This feedback loop normally keeps calcium within a tight range. When it malfunctions, the consequences can be significant. Overproduction of PTH (hyperparathyroidism) leads to elevated blood calcium, which over time can cause bone thinning, kidney stones, fatigue, and muscle weakness. Underproduction (hypoparathyroidism) results in low calcium, which can trigger muscle cramps, tingling, and in severe cases, seizures.
Primary hyperparathyroidism, where one or more parathyroid glands become overactive on their own, is one of the most common endocrine disorders. Secondary hyperparathyroidism occurs when the glands ramp up PTH in response to low calcium caused by vitamin D deficiency or kidney disease. The distinction between these matters for treatment, and PTH tested alongside calcium and vitamin D is what allows your practitioner to tell them apart.
This test is most commonly ordered when a calcium abnormality has been found on a routine blood test, when investigating bone density concerns, or when kidney stones are recurring. A fasting morning sample is recommended for the most stable and comparable result, as PTH levels fluctuate throughout the day.
This test helps assess whether your parathyroid glands are producing too much or too little PTH. Overproduction (hyperparathyroidism) can cause elevated calcium, bone thinning, and kidney stones. Underproduction (hypoparathyroidism) leads to low calcium levels that can cause muscle cramps and neurological symptoms. PTH is most useful when interpreted alongside calcium and Vitamin D levels.