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Parathyroid hormone secretion and action

Ghada El-Hajj Fuleihan, MD, MPH
Edward M Brown, MD
Section Editor
Clifford J Rosen, MD
Deputy Editor
Jean E Mulder, MD


Parathyroid hormone (PTH) is one of three key hormones modulating calcium and phosphate homeostasis; the other two are calcitriol (1,25-dihydroxyvitamin D) and fibroblast growth factor 23 (FGF23) [1]. The minute-to-minute control of serum ionized calcium concentration is exclusively mediated by PTH, maintaining the concentration of this divalent cation within a narrow range through stimulation of renal tubular calcium reabsorption and bone resorption [2,3].

On a more chronic basis, PTH also stimulates the conversion of calcidiol (25-hydroxyvitamin D) to calcitriol in renal tubular cells, thereby stimulating intestinal calcium absorption as well as bone turnover. Calcitriol feeds back to inhibit PTH secretion indirectly through its calcemic action, as well as by exerting a direct inhibitory action on PTH biosynthesis and parathyroid cell proliferation [4].

This topic will review PTH secretion and action. Clinical disorders related to PTH excess or insufficiency, as well as the use of PTH for the treatment of osteoporosis, are reviewed separately.

(See "Primary hyperparathyroidism: Clinical manifestations".)

(See "Primary hyperparathyroidism: Diagnosis, differential diagnosis, and evaluation".)

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Literature review current through: Nov 2017. | This topic last updated: Jul 20, 2017.
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