PARATHYROID GLAND

PARATHYROID HORMONE [PTH]

Normal level: 1 ngm / ml

ESSENTIAL FOR LIFE
Two types of cells
• Chief cells- secrets PTH
• OXYPHIL CELLS

ROLE
1. MAINTAIN normal levels of C a+ in blood
2. Acts on bone and kidney

ACTIONS

1. Increases plasma calcium and decrease plasma phosphate

2. Causes bone resorption and pumps calcium into ECF
3. Decrease Reabsorption of phosphate from kidneys
4. Promotes conversion of 25 HCC to 1,25 DHCC in kidneys that leads
to reabsorption of Ca from intestine
5. Decrease excretion of NH+ and H+

REGULATORY MECHANISMS
1. Decreased S. Calcium level
Low levels of serum C a+
↓
Stimulates Parathyroid gland
↓
Increase PTH production
↓
CA+ mobilization from bones to ECF
↓
Normal Calcium level in blood
 2. Increased S. Phosphate level

High levels of serum phosphate → stimulates PTH

APPLIED HYPOPARATHYROIDISM

Cause
Destruction of parathyroid gland
Respiratory alkalosis- decreased Ionised calcium level
S.Calcium level decrease to 4-8 mg% and S.Phosphate increase to 6-15
mg%

Characteristic features
Decrease in S.Ca+ levels and increase in Phosphate levels

1. Tetany
Increased excitability of nerves, numbness, tingling sensations.
 Chvosteks sign : Increased excitability of facial nerves to
stimulation
Carpopedal spasm : Flexion at the wrist and thumb with
hyperextension of fingers
Trousseau's sign : Inflation of sphygmomanometer cuff occuldes
the blood supply to a limb and causes
carpopedal spasm.

HYPERPARATHYROIDISM

Increase in serum calcium levels above 12 mg%

Decrease in Phosphate- < 2.5 mg%
Increase in alkaline phosphatase

Cause
Malignancy
Hyperplasia

Characteristic features
1. Weakness, thirst, polyuria, nausea, vomiting, anorexia
2. Kidney stones
3. Demineralization of bones.

CALCITONIN

Lowers the plasma level of serum calcium.

ACTIONS
 z Inhibitory effect on osteoclastic activity of bones.
z Decrease calcium permeability of Osteoclasts and osteoblasts
z Increase in alkaline phosphate synthesis
z Decrease formation of 1,25 DHCC from kidneys, therefore decreasing
serum calcium level
z Inhibits intestinal absorption of calcium and Phosphate..

VITAMIN D

Converted in body to physiological active hormone 1,25 DHCC

1, 25 DHCC acts on GIT, kidney and bones and increase serum calcium and
phosphate level

ACTION
 z GIT- Increases calcium and phosphate absorption in the intestine.
z Kidney- Increases calcium reabsorption from DCT
z BONES- Increases calcium mobilisation from bones to ECF

REGULATION OF 1,25 DHCC

Low S. Calcium
↓
Stimulates PTH ←
Decreased S. Phosphate
↓
Increase formation of 1, 25 DHCC