Parathyroid hormone (PTH) is a hormone produced by four small parathyroid glands in the neck. This hormone maintains the balance of calcium and phosphorus in the body. It acts on bones, kidneys, and intestines to regulate these minerals, essential for various bodily functions. Elevated PTH levels often signal an underlying imbalance requiring medical attention.
Understanding Elevated PTH
Elevated parathyroid hormone levels can disrupt mineral regulation, leading to health effects. Prolonged high PTH can contribute to bone weakening, as it draws too much calcium from bones. It can also cause kidney stones due to increased calcium excretion, and symptoms like fatigue or muscle weakness.
The most common reason for elevated PTH is primary hyperparathyroidism, when one or more parathyroid glands become overactive. This is usually caused by a benign growth (adenoma) on one gland, though multiple glands can be involved. This leads to high blood calcium, as excess PTH signals calcium release from bones and reabsorption in the kidneys.
Another frequent cause is secondary hyperparathyroidism, which arises from other health conditions causing persistently low calcium. Chronic kidney disease is common, as impaired kidneys struggle to convert vitamin D and excrete phosphorus, both lowering blood calcium. Severe vitamin D deficiency (reducing calcium absorption) and prolonged low dietary calcium can also trigger PTH overproduction to normalize calcium.
Dietary and Lifestyle Approaches
Dietary and lifestyle adjustments can support healthy PTH levels, especially for secondary hyperparathyroidism. Adequate, but not excessive, calcium intake is important, as low calcium can stimulate PTH production. Most adults need 1,000 to 1,200 milligrams daily, from sources like dairy, fortified plant-based milks, or leafy green vegetables.
Sufficient vitamin D is also important, as it is necessary for calcium absorption. Increase vitamin D through safe sun exposure, vitamin D-rich foods (like fatty fish), or supplementation under medical guidance. Consult a healthcare provider for appropriate dosage to avoid harmful excessive intake.
Managing phosphorus intake is particularly relevant for individuals with kidney concerns, as kidneys play a role in phosphorus excretion. Limiting high-phosphorus foods like processed meats, certain sodas, and some dairy products can help prevent phosphorus buildup, which can otherwise contribute to PTH elevation. Staying well-hydrated by drinking enough water throughout the day aids kidney function, supporting the body’s natural processes for mineral balance. Regular physical activity, such as walking or cycling, also contributes to bone health and overall well-being, which indirectly supports the body’s ability to maintain balanced mineral levels. These dietary and lifestyle strategies are often beneficial, and any significant changes should always be discussed with a healthcare professional.
Medical Treatments and Procedures
When dietary and lifestyle adjustments are not sufficient to manage elevated parathyroid hormone levels, medical interventions become necessary, particularly for primary hyperparathyroidism. Medications known as calcimimetics, such as cinacalcet, are often prescribed to reduce PTH secretion by making the parathyroid glands less sensitive to calcium levels in the blood. This action helps to lower PTH and calcium concentrations, addressing the underlying imbalance.
Specific forms of vitamin D supplements, such as calcitriol or paricalcitol, are frequently used, especially for individuals with chronic kidney disease. These active forms of vitamin D can help to suppress PTH production and improve calcium and phosphorus balance, which is often disrupted in kidney impairment. For patients with kidney issues who also have high phosphorus levels, phosphate binders are administered with meals to reduce the absorption of phosphorus from the digestive tract. These binders prevent excess phosphorus from accumulating in the blood, which can otherwise stimulate PTH release.
For primary hyperparathyroidism, surgical removal of the overactive parathyroid gland or glands, a procedure called parathyroidectomy, is frequently the definitive treatment. This surgery directly addresses the source of excess PTH production, often leading to a rapid and sustained normalization of PTH and calcium levels. Following any medical or surgical intervention, ongoing monitoring of PTH levels, along with calcium and phosphorus, is a standard part of management to ensure treatment effectiveness and to make any necessary adjustments.