Calcitonin
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Calcitonin is a hormone secreted by C-cells (parafollicular cells) in the thyroid gland
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🧪 Calcitonin Test
Parameter | Details |
|---|---|
Full Name | Calcitonin (Thyroid C-cell hormone) |
Sample Type | Blood (serum) |
Fasting Required | ✅ Yes – 8 to 12 hours recommended |
Organ Involved | Thyroid gland – parafollicular (C) cells |
Primary Use | Detecting and monitoring medullary thyroid carcinoma (MTC) |
🔬 What is Calcitonin?
Calcitonin is a hormone secreted by C-cells (parafollicular cells) in the thyroid gland. It helps regulate calcium and phosphate levels in the blood, though its physiologic role in humans is minor.
Its clinical importance lies in its role as a tumor marker for:
- Medullary Thyroid Carcinoma (MTC)
- C-cell hyperplasia
- Rarely, neuroendocrine tumors or other cancers
📈 Normal & Elevated Levels
Population | Normal Range (pg/mL) |
|---|---|
Men | 0–8.4 |
Women | 0–5.0 |
Children | Higher levels possible due to bone growth |
>100 pg/mL | Highly suggestive of medullary thyroid cancer |
>500 pg/mL | Strong evidence of metastasis or advanced disease |
Stimulation tests (e.g., with pentagastrin or calcium) may be used if baseline is borderline.
🧫 Why is Calcitonin Measured?
Clinical Indication | Purpose |
|---|---|
🧪 Detect MTC early | Even before imaging shows nodules |
🔁 Monitor post-surgery recurrence | Rising levels post-thyroidectomy may indicate relapse |
👪 Screen at-risk family members | In familial MEN2 (Multiple Endocrine Neoplasia type 2) |
❗ Investigate thyroid nodules | Especially when ultrasound findings are suspicious |
🔗 Associated Tests
Test | Why it’s Done |
|---|---|
Carcinoembryonic Antigen (CEA) | Also elevated in MTC; used with calcitonin for monitoring |
Thyroid Function Tests (T3, T4, TSH) | Rule out other thyroid disorders |
RET gene mutation analysis | In hereditary MTC (MEN2 syndromes) |
Neck Ultrasound / FNAC | Detect structural thyroid abnormalities |
⚠️ Causes of Elevated Calcitonin (Non-Cancerous)
Cause | Remarks |
|---|---|
C-cell hyperplasia | Often a precursor to medullary cancer |
Chronic kidney disease | May increase calcitonin levels |
Proton pump inhibitors | Can mildly elevate levels |
Smoking | Associated with slight increases |
Lung or pancreatic neuroendocrine tumors | Rare causes |
📋 Summary Table
Test | Calcitonin (Thyroid C-cell hormone) |
|---|---|
Sample Type | Blood (serum) |
Fasting Required | Yes (8–12 hours) |
Normal Range | Men: 0–8.4 pg/mL; Women: 0–5.0 pg/mL |
Use | Diagnose and monitor medullary thyroid carcinoma |
Other Markers | CEA, RET mutation, TSH, T3, T4 |
Limitations | Mild increases can occur in CKD, gastrinoma, smoking |
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