Physiology of Parathyroid Hormone

Goltzman D1.

Endocrinol Metab Clin North Am. 2018 Dec;47(4):743-758. doi: 10.1016/j.ecl.2018.07.003. Epub 2018 Oct 11.

Abstract
Parathyroid hormone (PTH) is the major secretory product of the parathyroid glands, and in hypocalcemic conditions, can enhance renal calcium reabsorption, increase active vitamin D production to increase intestinal calcium absorption, and mobilize calcium from bone by increasing turnover, mainly but not exclusively in cortical bone. PTH has therefore found clinical use as replacement therapy in hypoparathyroidism. PTH also may have a physiologic role in augmenting bone formation, particularly in trabecular and to some extent in cortical bone. This action has been applied to the clinic to provide anabolic therapy for osteoporosis.

KEY POINTS

_ Parathyroid hormone (PTH) is essential in the regulation of extracellular calcium and phosphate metabolism.

_ PTH enhances calcium reabsorption and inhibits phosphate reabsorption in the renal

tubule.

_ PTH augments the renal synthesis of 1,25-dihydroxyvitamin D, which then increases intestina calcium absorption.

_ PTH can increase bone remodeling to exert a catabolic effect on cortical and to some

extent trabecular bone.

_ PTH can have an anabolic effect on bone mainly in trabecular bone but to some extent in cortical bone.

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