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Also known as:  Thyrocalcitonin, CT, human Calcitonin, hCT

What is the calcitonin test? 

A calcitonin test is performed to diagnose the level of calcitonin hormone in the blood. Calcitonin is a hormone produced by the thyroid gland's parafollicular cells (commonly known as C-cells). It's a tiny, butterfly-like gland found adjacent to the front of your lower neck above the collar bones. In addition to Calcitonin, the thyroid produces other hormones, i.e., thyroxine (T4) and triiodothyronine (T3), which help control the metabolism rate. 

Calcitonin helps control the breakdown and rebuilding of bones because it regulates the utilization of body calcium by limiting the amount of calcium released from bones. It also aids as a type of tumor marker. Body cells synthesize tumor markers in response to specific cancers. It plays a crucial role in lowering blood phosphorus levels when it increases above normal. Calcitonin hormone is also instrumental in opposition to parathyroid hormone (PTH) and 1,25-dihydroxy vitamin D. 

What is the test used for?

Calcitonin prevents bone resorption; it also acts as a medication to treat several bone diseases and calcium anomalies such as osteoporosis, Paget's disease, and hypercalcemia.
Calcitonin test is frequently used to:

  • Identify C-cell hyperplasia and medullary thyroid cancer
  • Helps to identify the functionality of medullary thyroid cancer treatment
  • To detect the reoccurrence of medullary thyroid cancer after treatment
  • To find out individuals with a family background of multiple endocrine neoplasia type 2 (MEN 2). A family history of this disease has a greater chance of acquiring medullary thyroid cancer.

A stimulation test is more sensitive compared to a single calcitonin analysis. This examination consists of taking an initial blood specimen (baseline), then injecting intravenous calcium or pentagastrin, elements that facilitate the thyroid to release Calcitonin. Various other blood samples are drawn over several additional minutes to identify the influence of the stimulation.

Why and when do you need the calcitonin test?

The health care provider recommends this test when a person suspects medullary thyroid cancer. In specific tumors, including insulinomas (tumor in the pancreas that produces too much insulin), VIPomas (cancer that usually grows from islet cells in the pancreas), and lung cancer, calcitonin levels become higher. 

You need this test in either of the following cases:

  • Under the treatment of medullary thyroid cancer to check the authenticity of the treatment.
  • After the completion of the treatment to monitor the reoccurrence of cancer.
  • Having a family trail of MEN 2.

If someone has symptoms of thyroid disease but has not been diagnosed with cancer, then the need for a calcitonin test kept great importance. It consists of:

  • A lump in the front of the neck
  • Swollen lymph nodes of the neck
  • Pain at the throat or in the neck
  • Difficulty engulfing
  • voice changes, such as hoarseness

Screening tells more about the risk of acquiring cancer. It suggests whether you should take additional precautions. The earlier detection of cancer provides better chances of survival.

What kind of sample is required for the test?

Clean the skin with antiseptic before inserting the needle for blood collection, blood is drawn from the inside vein of the elbow or backside of the hand, and this blood is taken in an air-tight vial or a syringe. After the blood is drawn, the puncture site is covered to stop any bleeding.

For an infant or young child, the skin area is disinfected with antiseptic and punctured with a sharp needle or a lancet, and blood may be drawn in a small pipette, on a glass slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site to prevent bleeding.

Do you need to prepare for the test?

Before the test, overnight fasting may be suggested (not eat or drink) for several hours, or your physician/ laboratory will advise if you need to fast and if there are any special instructions to follow. Discuss all your medicines, herbs, vitamins, and supplements with your physicians. These include all medications, including prescription and non-prescription drugs. 

Are there any risks to this test?

From person to person size of veins and arteries can vary, and it also differs from one side of the body to the other hence in some people, it might cause some difficulty in drawing a blood sample. Besides all these, there is too little risk related to blood tests. These include a slight pain or sting or bruising at the site where the needle was pricked. Afterward, the site may be sore, but most symptoms resolve rapidly.

Other minor risks linked with having blood drawn include:

  • Excessive bleeding
  • Lightheadedness
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

What do the test results mean?

Calcitonin is measured in picograms per milliliter (pg/mL). The normal range is <10 pg/ml (picograms per milliliter). Male and females have different normal values, with males exhibiting higher values.

  • 8.4 pg/mL or less for men
  • 5.0 pg/mL or less for women

Test range may vary depending on the age, gender, health history, the method of test used, and other things. Different labs also have different procedures of testing, and therefore the results and normal ranges may vary.
Greater-than-normal values may express:

  • Medullary carcinoma of the thyroid
  • Insulinoma
  • VIPoma
  • Lung cancer

Elevated levels may be a risk factor of other thyroid diseases, and a person becomes more susceptible to developing MTC, such as:

  • C-cell hyperplasia, an illness with abnormal cell growth in the thyroid.
  • Multiple endocrine neoplasia type 2 (MEN 2), a rare genetic condition of the thyroid and other endocrine system glands that facilitate the growth of tumors. 

Higher values may also be found in people with kidney disease, overweight, and smokers. Furthermore, certain medicines to stop stomach acid production have also increased its level.
Low calcitonin levels may indicate the efficiency of the cancer treatment, or the person becomes harmless after cancer treatment. In a few cases, calcitonin levels drop but remain moderately high after treatment. This may show that the tissues remain which produces Calcitonin.

Related lab tests: RET Gene, Calcium test, Thyroid-stimulating Hormone (TSH), Triiodothyronine Free T3 Free, Thyroxine Free T4 Free, Thyroglobulin Carcinoembryonic Antigen (CEA)

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