Parathyroid disorders

Key Information

Appropriate Tests

Hypoparathyroidism

Total Calcium, and Albumin, or Ionised Calcium, Phosphate, Intact Parthyroid hormone (PTH) and Magnesium.

In hypoparathyroidism, a low serum calcium, hyperphosphataemia and a low or inappropriately normal PTH are found. The commonest cause of hypoparathyroidism is iatrogenic in the setting of anterior neck surgery. Hypoparathyroidism may also be due to congenital disorders / genetic abnormalities, autoimmune diseases, infiltrative disorders of the parathyroids. Impaired secretion of PTH may be seen with hypomagnesemia

Al-Azem H. Best Pract Res Clin Endocrinol Metab. 2012;26(4):517-22 

Hyperparathyroidism

Total Calcium, and Albumin, or Ionised Calcium, Phosphate, Intact Parthyroid horrmone, Vitamin D, Alkaline phosphatase; fasting spot urine: Calcium and Creatinine

In primary hyperparathyroidism, a high serum calcium is found together with an increased or inappropriately high-normal PTH. Similar findings are seen in tertiary hyperparathyroidism, but following long term secondary hyperparathyroidism, usually as a consequence of chronic renal failure.

Secondary hyperparathyroidism is characterised by a raised PTH in association with a low or low-normal serum calcium, usually due to renal failure or vitamin D deficiency.

Reference: Eastel R et al J Clin Endocrinol Metab. 2014;99(10):3570-9

See also Multiple endocrine neoplasia