Parathyroid hormone analysis. Physiological role of the hormone

Research methods: enzyme immunoassay, chemiluminescent immunoassay and radioimmunological method.

Blood is donated on an empty stomach, no earlier than 12 hours after the last meal. Should be excluded nervous tension and heavy physical work on the eve of the test. If the patient constantly takes medications, you should consult your doctor - some medications affect parathyroid hormone levels. Therefore, if possible, you should stop taking it 24 hours before the test. medicines. You should not drink alcohol the night before the test.

Material for research: venous blood. Serum is obtained from the blood by centrifugation, in which the level of the hormone is determined.

The concentration of PTH is directly related to the concentration of calcium in the blood, and a change in the concentration of the hormone indicates a change in the metabolism of this mineral. Therefore, the level of parathyroid hormone must be correlated with the level of blood calcium.

With increased calcium concentration:

With hypocalcemia - hypofunction of the parathyroid gland.

An increase in parathyroid hormone levels is observed in the following cases:

Simultaneously with hypercalcemia:

Simultaneously with hypocalcemia:

Medicines that affect parathyroid hormone levels

Increase PTH levels: cortisol, anti-tuberculosis drugs (isoniazid), nifedipine, estrogens, verapamil.

Reduce PTH levels: oral contraceptives, famotidine, gentamicin, prednisolone, vitamin D and its analogues.

Literature:

Parathyroid hormone is a hormone produced by the parathyroid glands.(it would be more correct to say “ parathyroid glands”, but many patients are already very accustomed to the term “parathyroid glands”, although it is not entirely correct from the point of view of word formation).

Parathyroid hormone production produced by parathyroid cells in response to a decrease in the level of ionized calcium in the blood. On the surface of the cells of the parathyroid glands there are special receptors that are able to assess the concentration of ionized calcium in the blood and, in accordance with its level, produce parathyroid hormone in larger or smaller quantities.

Very often the term " parathyroid hormone"(parathyroid hormone - from parathyroid hormone) is written incorrectly, since it can be difficult for a non-specialist to hear all the features of the correct spelling. Often on the Internet you can come across terms such as “ parath hormone», « parade hormone" and even " parade of hormones". The correct term, of course, is one - parathyroid hormone (written together and without a hyphen).

Parathyroid hormone is a polypeptide hormone(i.e. consisting of amino acids). There are 84 amino acid residues in the parathyroid hormone molecule. Currently, the structure of parathyroid hormone has been completely deciphered by scientists. It was found that in the parathyroid hormone molecule biological activity The first 34 amino acid residues are responsible, and the rest are responsible for the binding of the hormone to receptors and the stability of the molecule as a whole.

Basics the action of parathyroid hormone is aimed at increasing the level of ionized calcium in blood. This action is realized through three different effects.

Firstly, parathyroid hormone enhances the activation of vitamin D in the kidneys, which leads to the formation of an important hormone-like substance, calcitriol, from vitamin D. Calcitriol stimulates the absorption of calcium in the intestine, which leads to an increased flow of calcium from food into the blood. Required condition for implementation this effect parathyroid hormone is the presence sufficient quantity vitamin D in the body. Without sufficient supply of vitamin D in the blood, parathyroid hormone is not able to enhance the absorption of calcium in the intestines.

Secondly, parathyroid hormone enhances the reabsorption of calcium ions from primary urine. This effect is realized at the level of the renal tubules.

Third, parathyroid hormone enhances osteoclast activity– cells that destroy bone tissue. Osteoclasts, like bulldozers or excavators, begin to actively destroy bone beams and release the resulting calcium into the blood. As a result, the concentration of calcium in the blood increases, but the strength of bone tissue decreases, which increases the likelihood of fractures.

Parathyroid hormone is very interesting hormone, because the The effect of parathyroid hormone on the bone directly depends on the mode of its production. Everything we said above about negative impact parathyroid hormone on bone tissue is true only for cases when parathyroid hormone is elevated constantly and continuously. At the same time, periodic and short-term release of parathyroid hormone into the blood has an effect on bone tissue positive effect, leading to increased formation of bone beams and strengthening of the bone. Now this effect is used in the treatment of osteoporosis - it has even been synthesized medicinal analogue parathyroid hormone (teriparatide), periodic administration of which into the body can increase the strength of bone tissue and reduce the likelihood of fractures.

Parathyroid hormone production

The production of parathyroid hormone is regulated by the level of ionized calcium in blood. If calcium in the blood decreases, parathyroid hormone begins to be released more actively.

On the surface of the cells of the parathyroid glands there is a calcium-binding receptor, which is directly able to “sense” the concentration of calcium in the blood and regulate the rate at which parathyroid hormone is produced. This is the only one on this moment a receptor known to science, which is “controlled” not by peptides or hormones, but by the substance itself - or rather, by its ions. Be that as it may, parathyroid hormone is normally produced by the parathyroid glands only when the concentration of calcium in the blood decreases.

Parathyroid hormone and calcium

There are two “friends” in the body, two substances that are inextricably linked - parathyroid hormone, calcium. At the same time, there is a relationship between them, which in endocrinology is described as “double feedback”. They sort of regulate each other. When the level of calcium in the blood decreases, parathyroid hormone begins to be released more strongly, as a result of which calcium in the blood increases and acts on the cells of the parathyroid glands through the receptor, causing them to stop releasing parathyroid hormone. After the release of parathyroid hormone ceases, calcium begins to gradually decrease until it reaches a level at which the cells of the parathyroid glands are activated with the release of parathyroid hormone - and the cycle repeats. Calcium is the main thing that parathyroid hormone influences, and at the same time parathyroid hormone is one of the most important substances that calcium influences.

Parathyroid hormone and calcitonin

Unlike a substance such as calcium, parathyroid hormone and calcitonin are “enemies”, antagonists. Parathyroid hormone aims to increase the level of calcium in the blood, and calcitonin aims to reduce it. Parathyroid hormone stimulates the destruction of bone beams with a prolonged increase, and calcitonin, on the contrary, causes the formation of new bone tissue and thereby strengthens the bone. The relationships between hormones, if you dig deep, are even deeper - for example, in some hereditary syndromes(multiple endocrine neoplasia syndrome, MEN) simultaneously develop tumors that produce both hormones - parathyroid hormone and calcitonin. That's why When examined for elevated parathyroid hormone, calcitonin is required.

Vitamin D and parathyroid hormone

Vitamin D and parathyroid hormone are substances whose effects are similar and largely depend on each other. Both substances both vitamin D and parathyroid hormone – their main effect is to increase blood calcium levels. As is the case with calcium, parathyroid hormone and vitamin D can influence each other. This effect is very interesting and is realized in general outline So. When the level of calcium in the blood decreases, the cells of the parathyroid glands begin to actively produce parathyroid hormone, which enhances the hydroxylation of vitamin D in the kidneys and the formation of calcitriol, the active form of vitamin D, which, due to the strength of its action, can be confidently recognized as a hormone. Calcitriol, on the one hand, enhances the release of a special transport protein in the intestinal wall - calmodulin, which “drags” calcium from the intestinal lumen into the blood, and on the other hand, it directly acts on a special receptor on the surface of the cells of the parathyroid glands (it is called the vitamin receptor D or VDR, vitamin D receptor). Activation of the vitamin D receptor leads to suppression of the proliferation of parathyroid gland cells, i.e. indirectly acts to reduce parathyroid hormone levels.

It is important to understand that a decrease in the intake of vitamin D into the human body leads to a “disinhibition” of the division of cells of the parathyroid glands and at the same time to stimulation of the production of parathyroid hormone by these cells. This happens when there is a small amount sun rays that come into contact with the skin, since vitamin D is produced in human skin. The second cause of vitamin D deficiency is insufficient intake of vitamin D from food. Low vitamin D in the blood leads to a low intake of calcium into the blood, which activates the production of parathyroid hormone by the cells of the parathyroid glands.

Vitamin D deficiency has been proven to increase the incidence of benign tumors– adenomas of the parathyroid glands (probably due to the elimination of the inhibitory effect of vitamin D on the division of cells of the parathyroid glands due to its deficiency).

The second common situation with which patients come to the Northwestern Endocrinology Center is the so-called secondary hyperparathyroidism, i.e. a condition in which parathyroid hormone is elevated in the blood, but calcium is normal. The detection of normal or reduced calcium simultaneously with an increase in parathyroid hormone levels usually indicates a low level of vitamin D in the blood. You can, of course, conduct a blood test for vitamin D, but you can do it differently - prescribe vitamin D and calcium supplements to the patient, and after 1-2 months, repeat the blood test for parathyroid hormone and ionized calcium. If a repeated analysis reveals a decrease or normalization of parathyroid hormone, and the calcium level is normal, this will indicate with a high degree of certainty that the patient simply needs to take calcium and vitamin D supplements longer. If a repeated blood test shows that parathyroid hormone is is still high, and calcium has increased above normal - this will indicate that the patient has primary hyperparathyroidism, a tumor of the parathyroid gland.

Blood test for parathyroid hormone

Analysis for parathyroid hormone is one of the most important in the list of examinations prescribed for suspected calcium metabolism disorders, including the development of osteoporosis. Blood for parathyroid hormone is usually donated simultaneously with an analysis for ionized calcium, phosphorus, calcitonin, since such a block of studies allows the endocrinologist to most fully assess the metabolic state. It is also highly advisable to immediately perform densitometry - a study of bone tissue density, which shows the likelihood of developing bone fractures.

Parathyroid hormone - analysis, the quality of which varies greatly between different laboratories. Currently, the most common methods of performing a blood test for parathyroid hormone are enzyme immunoassay (the so-called 2nd generation method) and immunochemiluminescence (3rd generation method).

Most laboratories conduct parathyroid hormone analysis using the 2nd generation method, since equipment and reagents for enzyme immunoassay(ELISA) are inexpensive - you can even use domestically produced reagents. At the same time, the use of the ELISA method leads to a decrease in the accuracy of the analysis of parathyroid hormone in the blood and an increase in error.

The specialized laboratory of the North-Western Endocrinology Center uses an automatic immunochemiluminescent analyzer of the 3rd generation DiaSorin Liaison XL (Italy) to perform analysis for parathyroid hormone - a device with exclusively high accuracy analysis. In the work of endocrinologists at our center, the accuracy of a test such as a blood test for parathyroid hormone is the main diagnostic component, so we take issues of research quality very seriously. The specialized laboratory of the center NEVER performs parathyroid hormone analysis using the 2nd generation method and NEVER uses either domestic or Chinese reagents - only reagents made in Italy by the DiaSorin company.

If you decide where to test parathyroid hormone, and are not sure what tests should be taken additionally - do the following blood test: parathyroid hormone and calcium (ionized is very desirable), phosphorus, calcitonin. If you also donate your daily urine test for calcium, that will be simply wonderful; any endocrinologist will appreciate your erudition in matters of taking tests.

In the laboratory of the Endocrinology Center, the analysis for ionized calcium is carried out using an automatic biochemical analyzer Olympus AU-680 (Japan) - a high-performance, high-precision automatic machine capable of conducting up to 680 biochemical tests per hour! Combined with high accuracy tests for parathyroid hormone and calcitonin, accurate analysis for calcium will provide optimal diagnostic results.

Where to get parathyroid hormone

The specialized laboratory of the North-Western Endocrinology Center is receiving tests for parathyroid hormone and calcium, phosphorus and calcitonin, as well as receiving other analyzes (more than 1000 studies) at the following addresses in St. Petersburg and Vyborg:

- Petrograd branch of the endocrinology center– center of St. Petersburg, 200 meters to the left on foot from the Gorkovskaya metro station, Kronverksky Prospekt, building 31. Branch opening hours: 7.30-20.00, seven days a week. Phone: 498-10-30. There is parking for cars.

- Primorsky branch of the endocrinology center– Primorsky district of St. Petersburg, 250 meters to the right from the Begovaya metro station. Branch address: st. Savushkina, house 124, building 1. Branch opening hours: 7.00-20.00, seven days a week. Phone: 344-0-344. There is parking for cars.

- Vyborg branch of the Endocrinology Center– Vyborg, Leningrad region, Pobedy Avenue, 27A. Branch opening hours: 7.30-20.00, seven days a week. Phone: 36-306. There is parking for cars.

The branches of the Endocrinology Center provide everything for the comfort of patients who came to take parathyroid hormone, calcium and other tests– no queues, comfortable treatment rooms with comfortable chairs and cartoons for positive attitude, air conditioning and deep air purification systems, modern vacuum systems taking blood.

You can get the results of a blood test for parathyroid hormone and other indicators at e-mail immediately after they are completed. In the vast majority of cases, tests are performed within 1 day (often the test for parathyroid hormone and calcium is ready in the evening of the day the patient came for the test).

WITH full list branches of the laboratory in the Leningrad region (the cities of Luga, Gatchina, Kingisepp, Svetogorsk) you can familiarize yourself with.

If you're not sure yet, where to take parathyroid hormone in St. Petersburg or Leningrad region– contact the Northwestern Endocrinology Center. You will be confident in the quality of the research and conduct it with comfort. It is important that in the same center you can get a consultation with an endocrinologist who has significant experience in treating disorders of parathyroid hormone production.

How to take parathyroid hormone

The main thing is to take parathyroid hormone on an empty stomach. The duration of fasting should be about 10-12 hours. If you are taking any medications (especially those containing calcium and vitamin D), stop them 1-2 days before the test.

Parathyroid hormone is normal

When you donate blood in a specialized modern laboratory, and you get test result for parathyroid hormone, the norm is indicated on the laboratory form immediately after your individual result.

Parathyroid hormone levels can be expressed in two different units of measurement - pg/ml and pmol/l. Recalculation between them is possible using the following formula:

parathyroid hormone level in pmol/l x 9.8 = parathyroid hormone level in pg/ml

Parathyroid hormone is normal, when it fits within the boundaries specified as reference limits (standards). This indicator is not dependent on gender - if you test parathyroid hormone, the norm for women will not differ from the norm for men.

Parathyroid hormone is elevated

Increased parathyroid hormone is one of the most common reasons for patients to visit an endocrinologist - and rightly so, since high parathyroid hormone in the blood always means the presence of a disease that needs to be treated.

An increase in parathyroid hormone is referred to as “hyperparathyroidism”. High parahormone is the main symptom of hyperparathyroidism. There are two main variants of this condition: primary hyperparathyroidism and secondary hyperparathyroidism. Also distinguished tertiary hyperparathyroidism occurring in patients with chronic renal failure receiving hemodialysis - but we will not consider it within the scope of this article.

Primary hyperparathyroidism is a condition where both in the blood parathyroid hormone is increased, calcium is increased. Additional symptoms of primary hyperparathyroidism are a decrease in blood phosphorus (not found in all cases) and an increase in the level of calcium in daily urine (also not in all cases). High parathyroid hormone in the blood in primary hyperparathyroidism is associated with the formation of parathyroid adenoma - usually benign tumor, which produces parathyroid hormone uncontrollably. The increase in parathyroid hormone in the blood directly depends on the size of the adenoma - the larger it is, the higher the parathyroid hormone is detected. If a patient has primary hyperparathyroidism and parathyroid hormone is elevated - treatment is always surgical - removal of the adenoma gives excellent results, returning all components of phosphorus-calcium metabolism to normal limits.

When a patient has high parathyroid hormone, the causes of this condition may be associated with vitamin D deficiency (we talked about this earlier). If in the blood parathyroid hormone is increased, and calcium is normal or decreased- Most likely, we're talking about O secondary hyperparathyroidism, associated with a low amount of vitamin D entering the body. Treatment of such an increase in parathyroid hormone is always carried out in a conservative way, taking vitamin D and calcium supplements.

It is very important, when understanding the reasons why parathyroid hormone is elevated, not to confuse secondary hyperparathyroidism with primary hyperparathyroidism - otherwise the patient will undergo an absolutely unnecessary surgical intervention, the results of which, of course, will not please either the doctor or the patient.

Elevated parathyroid hormone - how to cure, where to cure?

In our center, we annually consult several thousand patients whom doctors (!) refer for surgery to remove a parathyroid adenoma, but in fact the patients only have a deficiency or insufficiency of vitamin D, which is easily eliminated by taking pills. True, there are also opposite situations when patients with large parathyroid adenomas come to us for surgery, in whom the diagnosis has not been established for several years, which leads to simply catastrophic consequences for the body. Every year, several patients with elevated parathyroid hormone due to adenoma require resuscitation measures due to the threat of coma development. There are situations when patients undergo surgery on the very first day, the adenoma is removed, and then a two to three month course of resuscitation and restorative treatment is required - that is how far the pathological process goes.

In the vast majority of cases, patients from other regions of Russia undergo surgical treatment free of charge, under the federal quota system or simply under a compulsory health insurance policy. Outpatient examinations are carried out for a fee, but their cost is rarely high.

So, if you have elevated parathyroid hormone, it is wiser to come for examination and treatment to a specialized endocrinology center, where you will receive qualified assistance.

Parathyroid hormone is low

The situation when parathyroid hormone is low, occurs rarely in life. The main reason for a decrease in parathyroid hormone in the blood is a previous operation on thyroid gland, in which nearby small and not always clearly visible parathyroid glands were accidentally removed or deprived of blood supply.

Usually when parathyroid hormone is low, symptoms include numbness of the fingers and toes, the appearance unpleasant feeling“goosebumps” on the skin, the appearance of convulsive muscle contractions. The severity of these symptoms depends on the level of calcium in the blood - the lower they are, the worse the patient feels. In severe cases, generalized seizures may develop. If left untreated, the patient may die.

For a condition where parathyroid hormone is low, there is a special term - “hypoparathyroidism”. Many patients with similar problem trying to figure out how to increase parathyroid hormone, however, whether an increase in parathyroid hormone will occur in the future or not after surgery usually depends only on how much injury was caused to the parathyroid glands. If restoration of the function of the parathyroid glands is possible, then it will certainly occur. However, during the entire time that parathyroid hormone is low, patients need to take vitamin D and calcium supplements - sometimes in quite large doses.

• Parathyroid glands

  general information about the parathyroid glands (location, number, function, history of discovery, underlying diseases, operations)

According to statistics, parathyroid hormone is elevated in every thousandth inhabitant of the planet, which means it is not so rare. The reason for this lies in the many prerequisites for the occurrence of such a condition.

The analysis shows an increase in parathyroid hormone levels, what does this mean?

Parathyroid hormone - biologically active substance produced by the parathyroid glands. The importance of this hormone for our body cannot be overestimated, since it has a regulating effect on mineral metabolism.

PTH together with calcitonin (a hormone produced thyroid gland) and vitamin D represent the highest level of regulation of calcium and phosphorus metabolism. The balance of these microelements primarily determines the strength of bone tissue and teeth. Calcium, in addition, affects the contractile activity of all muscles of the body, including the work of the myocardium. Deviation of its concentration from the norm can negatively affect the heart muscle, namely lead to a violation heart rate and even sudden stop hearts. In addition to this, calcium ions are directly involved in the transmission of signals along the fibers of the nervous system, and also activate coagulation factors and some enzymes.

Parathyroid hormone and calcium ion metabolism are closely related to each other. Similar phenomena V medical literature are called binary feedback. It manifests itself in the fact that a decrease in calcium levels causes an increase in the secretion of the hormone. After this, the calcium concentration returns to normal, and the parathyroid glands reduce the production of the hormone.

Therefore, the level of parathyroid hormone in the blood should not be subject to significant fluctuations, since even the slightest deviations in the processes it regulates can provoke many serious consequences, including death.

How does parathyroid hormone work?

Parathyroid hormone regulates calcium metabolism in three ways.

• The main mechanism of action is the effect of the hormone on tissue skeletal system. It contains chemical receptors that are sensitive to changes in calcium levels. Parathyroid hormone activates osteoclasts - cells that cause the destruction of bone beams, and calcium released from the physiological depot enters the blood.
• Next option biological action parathyroid hormone is the synthesis of physiologically active vitamin D in the kidneys. Calcitriol is then formed from it, which increases the intensity of calcium absorption from the lumen of the small intestine.
• The third mechanism of action is realized at the level of renal tubular function and consists in enhancing the reabsorption (reabsorption) of calcium ions into their lumen. How to detect an increase in parathyroid hormone

How to detect an increase in parathyroid hormone

Patients undergoing treatment for diseases of the musculoskeletal system are often tested to determine the level of parathyroid hormone. To monitor PTH levels, a test is performed venous blood enzyme immunoassay method.

The hormone produced by the parathyroid glands enters the bloodstream continuously, but its level fluctuates throughout the day. Physiologically high levels of the hormone are observed from 3 to 4 o'clock in the afternoon, while it is lowered at approximately 7-8 o'clock in the morning; this indicator has no gender differences (the same for both men and women).

Age norm for the amount of PGT in the blood

In addition, the female body produces different amounts of the hormone depending on the trimester of pregnancy.

Calcium is normally determined in the blood at a level of 2.15 - 2.50 mmol/l.

Reasons why parathyroid hormone is higher than normal

Hyperparathyroidism - that's what it's called endocrine disruption when the level of parathyroid hormone in the blood is elevated. This violation comes in several types.

Primary hyperparathyroidism

This is a pathology of the parathyroid glands themselves with increased secretion parathyroid hormone. There are many known causes for this condition, the most common of which are:

• hyperplasia, adenoma or carcinoma of the parathyroid glands;
• idiopathic hypercalcemia in children;
• plasmacytoma;
• Burnett's syndrome;
• multiple endocrine neoplasia type I (causes tumors of the endocrine glands and pituitary gland in combination with hyperparathyroidism)

Secondary hyperparathyroidism

It is caused by abnormalities not in the parathyroid glands themselves, but in other organs, accompanied by a long-term decrease in the content of calcium ions in the blood. Pathology occurs due to various reasons, the main ones of which are:

• oncological neoplasms of the thyroid and parathyroid glands, metastases to them;
• chronic renal failure;
• reduced concentration of vitamin D as a result of impaired synthesis of its biologically active form in the kidneys or rickets;
• decrease in the intensity of absorption of calcium by the walls of the small intestine, resulting from atrophic gastritis, nonspecific ulcerative colitis, Crohn's disease, Zollinger-Ellison syndrome ( tumor disease pancreas) and other conditions accompanied by persistent dysfunction of the pancreas;

Tertiary hyperparathyroidism

It occurs as a consequence of a long-term decrease in calcium content in the intercellular space during secondary hyperparathyroidism. In this case, complete autonomy of the parathyroid glands occurs, which lose the ability to respond to changes in content minerals.

Separately, it is worth mentioning such a condition as pseudohyperparathyroidism - an excessive amount of parathyroid hormone is produced not by the thyroid gland, but by the glands endocrine system, and a hormonally active tumor ( malignant neoplasm kidneys or lungs).

How to recognize elevated levels of parathyroid hormone

The primary symptoms of this condition are nonspecific:

• deterioration and even lack of appetite, nausea, constipation;
• muscle weakness, osteo-articular pain, even difficulty walking, patients often stumble “out of the blue,” fall, find it difficult to get up from a sitting position (lean on their hands), the gait takes on the appearance of a so-called duck due to looseness in the joints;
• thirst, which subsequently causes increased urination (for this reason, at the onset of hyperparathyroidism, it is often confused with diabetes insipidus);
• the skin takes on an earthy tint and becomes dry;
• apathy and lethargy;
• Fever and anemia are possible.

What is dangerous about long-term elevated levels of parathyroid hormone?

As a result of this pathological condition, the calcium content decreases in bone tissue, while increasing in the blood serum. Subsequently develop negative consequences for almost all organs and systems of the body for which patients need treatment. The most commonly observed changes are:

from the musculoskeletal system

• osteoporosis develops - reduced level calcium in the bones causes their fragility, there is a risk of fracture at the slightest injury, in severe cases, fractures can occur spontaneously (especially typical for radiation and humerus, femoral neck and collarbone);
• the vertebrae flatten, which externally manifests itself as a decrease in adult height and deformation of the chest;
• valgus (X-shaped) deformity of the lower leg in children;
• cysts in the bone tissue of the jaws, their softening and tooth loss.

from the urinary system:

• due to deposition mineral salts in the renal glomeruli provokes the development urolithiasis, its symptoms are lower back pain up to attacks of renal colic;
• pyelonephritis;
• chronic renal failure.

from the gastrointestinal tract:

• anorexia;
• calcifying pancreatitis, which causes disruption of the digestive system and metabolism;
• ulceration in the stomach and duodenum;
• cholelithiasis.

from the nervous system:

• fast fatiguability;
• memory impairment;
• psychoses.

from the circulatory system:

• calcification blood vessels, which leads to deterioration of elasticity vascular wall what could cause it to increase? arterial pressure, gradually leading to the development of hypertension;
• arrhythmia and bradycardia.

In addition, the reproductive system of women may suffer, especially during pregnancy. At increased content calcium in the blood may interfere with implantation ovum into the endometrium, since its vessels are already compacted due to calcification.

The most dangerous of possible consequences excess parathyroid hormone - development of hyperparathyroid crisis - a life-threatening condition. It occurs due to a concentration of calcium in the blood that is many times higher than normal and is characterized by sharp increase temperature, severe pain in the abdomen and impaired consciousness, treatment is required immediately.

Is the pill capable of reducing parathyroid hormones to normal?

Any drug or folk method is powerless if the increase in parathyroid hormone levels occurs as a result of hyperfunction of the parathyroid glands. In this case, treatment that can reduce parathyroid hormone is only timely and delicate surgical intervention (there is always a risk of developing postoperative hypoparathyroidism if an excessive amount of glandular tissue). Conservative therapy involves the use of medicine to force diuresis, which will allow short period time to enhance the kidneys' excretion of excess calcium in the blood.

For the treatment of osteoporosis, the drug of choice is calcium-containing drugs; they can reduce the softening of bone tissue. In addition, recommendation reviews have therapeutic diet, which includes eating foods rich in calcium.

Correct symptomatic treatment is required to relieve other manifestations of the disease.

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 minerals such as 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, the molecular weight of 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 of bone tissue when there is an excess of bone tissue 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 is taking medications, especially hormonal ones, then after consultation with a specialist the day before taking venous blood for parathyroid hormone, it is necessary to refrain from taking them.

The test must be taken at 8 a.m. after good sleep, on an empty stomach. This will ensure the most accurate result of the parathyroid gland indicators.

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 this place is indicated and sterile dressing to the place of the cut.

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 at the age of 22 to 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 PTH norm 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 intestine;
• 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.

In addition to the symptoms of the initial stage, symptoms of complications may occur, for example, kidney failure.

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

Getting into an accident, which is accompanied by severe injuries, can also negatively affect the functioning of the endocrine system and lead to decreased hormone synthesis.

Hypothyroidism can also affect decreased function of the parathyroid glands.

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?

Apart from 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;
• taking medications with phosphorus salts;
• powerful diuretics;
• special diet.

Other diseases require the use of conservative treatment methods to correct metabolism.

Supposed complete removal glands during a malignant process, while hormone replacement therapy is carried out until the end 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;
• the use of a synthetic analogue of the hormone - Parathyroidin.

Replacement therapy is carried out with intravenous infusions of 1 to 12 ml of drugs 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.