PARATHYROID PANEL (PTH, TOTAL PROTEIN, MAGNESIUM, ALKALINE PHOSPHATASE, CREATININE, CALCIUM TOTAL & IONISED, 24 HRS URINE CALCIUM)

Parathyroid Panel is a comprehensive laboratory assessment designed to evaluate parathyroid gland function, calcium regulation, bone metabolism, mineral balance, and kidney function. The panel includes Parathyroid Hormone (PTH), Total Protein, Magnesium, Alkaline Phosphatase, Creatinine, Total Calcium, Ionised Calcium, and 24-Hour Urine Calcium.

The parathyroid glands are small glands located in the neck behind the thyroid gland. They produce PTH, a hormone that maintains calcium balance by acting on the bones, kidneys, and intestines. Evaluating PTH together with calcium, magnesium, kidney function, bone-related markers, and urinary calcium provides a more complete clinical picture than testing PTH alone.

Tests Included in the Panel

• Parathyroid Hormone (PTH): Measures the hormone responsible for regulating calcium and phosphate balance.
• Total Protein: Measures the combined amount of albumin and globulins and supports interpretation of total calcium.
• Magnesium: Evaluates a mineral necessary for normal PTH secretion and calcium regulation.
• Alkaline Phosphatase (ALP): Supports assessment of bone turnover and hepatobiliary conditions.
• Creatinine: Helps evaluate kidney function, which can significantly affect PTH and mineral balance.
• Total Calcium: Measures calcium that is both protein-bound and unbound in the blood.
• Ionised Calcium: Measures the biologically active form of calcium available to body tissues.
• 24-Hour Urine Calcium: Measures the total amount of calcium excreted in urine over a complete 24-hour period.

Benefits of the Test

• Provides a comprehensive assessment of parathyroid function.
• Supports investigation of abnormal blood calcium levels.
• Helps evaluate primary and secondary hyperparathyroidism.
• Assists in assessing hypoparathyroidism and low calcium levels.
• Evaluates calcium loss through urine and kidney-stone risk.
• Supports assessment of bone and mineral metabolism.
• Examines kidney function in relation to PTH elevation.
• Provides both total and biologically active calcium measurements.

Why Doctors Recommend This Test

Doctors may recommend this panel for individuals with high or low blood calcium, kidney stones, osteoporosis, repeated fractures, bone pain, muscle weakness, tingling, muscle cramps, excessive thirst, frequent urination, unexplained fatigue, chronic kidney disease, or suspected parathyroid gland dysfunction. It may also be used to monitor patients with a known parathyroid disorder or following parathyroid treatment.

Preparation Before Test

• Fasting requirements depend on the laboratory method and accompanying investigations; follow the instructions provided by your doctor or laboratory.
• Blood collection may be scheduled at a particular time because PTH levels can vary during the day.
• Inform your doctor about calcium, vitamin D, magnesium, biotin, diuretics, lithium, antacids, and all other medicines or supplements.
• Do not stop medicines or supplements unless specifically instructed by your doctor.
• A separate container is required for the complete 24-hour urine collection.
• Do not collect only a random urine sample when a 24-hour collection has been prescribed.
• Follow all storage and transportation instructions provided with the urine container.

How to Collect 24-Hour Urine

• Select a day when the entire collection can be completed without interruption.
• On starting the collection, pass the first morning urine into the toilet and note the exact time.
• After that, collect every urine sample passed during the day and night in the provided container.
• At the same time the following morning, collect the final urine sample and add it to the container.
• Keep the container refrigerated or stored exactly as instructed by the laboratory.
• If any urine is missed or spilled, contact the laboratory because the collection may need to be restarted.
• Return the complete collection promptly with the start time, end time, and requested patient details.

Normal Reporting Time

The reporting time for the Parathyroid Panel depends on completion of the 24-hour urine collection, receipt of all required samples, PTH and ionised-calcium processing, analytical schedules, and quality review. Results are generally completed within several working days after all samples have been received. Please confirm the expected turnaround time with Focus Diagnostics.

Who Should Take This Test?

This panel may be recommended for:

• Patients with high or low serum calcium levels.
• Individuals with suspected hyperparathyroidism or hypoparathyroidism.
• People with recurrent calcium-containing kidney stones.
• Patients with osteoporosis, bone pain, or unexplained fractures.
• Individuals with chronic kidney disease and elevated PTH.
• Patients with muscle cramps, tingling, weakness, or abnormal heart rhythm associated with calcium imbalance.
• People with excessive thirst, frequent urination, or unexplained fatigue.
• Patients being monitored following treatment for a parathyroid disorder.

Detailed Information

PTH plays a central role in maintaining calcium levels within a narrow range. When blood calcium falls, the parathyroid glands release PTH. This hormone increases calcium release from bones, promotes calcium conservation by the kidneys, and supports activation of vitamin D, which helps the intestines absorb calcium.

When calcium levels return to an appropriate range, PTH secretion normally decreases. Measuring PTH together with calcium is essential because a PTH value that falls within the laboratory reference interval may still be inappropriate when the calcium level is elevated.

High PTH combined with high calcium may support primary hyperparathyroidism. This can occur because of a benign parathyroid adenoma, enlargement of multiple parathyroid glands, inherited conditions, or, rarely, parathyroid cancer. High PTH with low or normal calcium may be associated with secondary hyperparathyroidism due to vitamin D deficiency, chronic kidney disease, inadequate calcium intake, or malabsorption.

Low PTH with low calcium may indicate hypoparathyroidism, which can occur after neck surgery, autoimmune damage, genetic conditions, severe magnesium imbalance, or other disorders affecting the parathyroid glands.

Total calcium includes both protein-bound calcium and free calcium. Because changes in blood proteins can influence total calcium, this panel also includes total protein and ionised calcium. Ionised calcium represents the biologically active portion and can provide important information when protein levels or acid-base balance may affect total-calcium interpretation.

Magnesium is necessary for normal PTH secretion and action. Severe magnesium deficiency can reduce PTH release and contribute to low calcium. Alkaline phosphatase may provide information about increased bone formation or turnover, while creatinine helps evaluate whether reduced kidney function is affecting PTH and mineral metabolism.

The 24-hour urine calcium test measures calcium excretion across a complete day. It may help evaluate kidney-stone risk, distinguish between certain causes of high blood calcium, investigate parathyroid function, and monitor calcium or vitamin D treatment. An incomplete urine collection can produce misleading results.

No individual result in this panel should be interpreted separately. Doctors assess the relationship among PTH, calcium, magnesium, creatinine, urinary calcium, symptoms, medicines, kidney function, vitamin D status, and clinical history. Additional tests or imaging may be recommended based on the results.

At Focus Diagnostics, the Parathyroid Panel is processed using validated biochemistry and hormone-assay methodologies with established quality-control procedures to provide reliable and clinically meaningful results.