• Also Known As:
  • Human Calcitonin
  • Thyrocalcitonin
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At a Glance

Why Get Tested?

To help diagnose and monitor C-cell hyperplasia and medullary thyroid cancer; to screen those at risk for multiple endocrine neoplasia type 2 (MEN 2)

When To Get Tested?

When a health practitioner suspects that you have medullary thyroid cancer or when you are being treated for it, or when a family member has medullary thyroid cancer or MEN 2

Sample Required?

A blood sample drawn from a vein

Test Preparation Needed?

Overnight fasting may be required; follow instructions provided by your healthcare practitioner or the laboratory.

You may be able to find your test results on your laboratory’s website or patient portal. However, you are currently at Testing.com. You may have been directed here by your lab’s website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab’s website or portal, or contact your healthcare practitioner in order to obtain your test results.

Testing.com is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”

For more information, please read the article Reference Ranges and What They Mean.

What is being tested?

Calcitonin is a hormone that helps regulate how the body uses calcium. It is produced by special cells in the thyroid called C-cells. The thyroid is a small butterfly-shaped gland located at the base of the neck. Besides calcitonin, the thyroid produces other hormones, primarily thyroxine (T4) and some triiodothyronine (T3), that help control the rate of metabolism.

In two rare conditions, C-cell hyperplasia and medullary thyroid cancer (MTC), excess amounts of calcitonin are produced. The calcitonin test measures the level in the blood and may be used to detect and monitor these conditions.

  • C-cell hyperplasia is a benign condition that causes abnormal growth of cells in the thyroid. It may or may not progress to become medullary thyroid cancer.
  • Medullary thyroid cancer is malignant – it can spread beyond the thyroid and can be difficult to treat if it is not discovered early.

Medullary cancer is a rare form of thyroid cancer that accounts for about 4% of all thyroid cancers in the United States. Approximately 52,000 people are diagnosed with thyroid cancer each year, and about 2,000 people die of the disease.

About 75% of medullary thyroid cancer cases are sporadic, occurring in people who do not have a family history of the disease. Most sporadic cases develop when people are in their 40s or 50s and are more common in women than men.

Up to 25% of cases of MTC are related to an inherited variant (mutation) in the RET gene that leads to multiple endocrine neoplasia type 2 (MEN 2). MEN 2 is a syndrome associated with several related diseases, including medullary thyroid cancer and pheochromocytomas. The RET gene variant is inherited in an autosomal dominant fashion. This means you only need to inherit one copy of the gene variant from either your father or mother to have a greatly increased risk of developing medullary thyroid cancer. This inherited form affects both men and women equally and can occur at a younger age.


Common Questions

How is the test used?

The calcitonin test is primarily used to help diagnose C-cell hyperplasia and medullary thyroid cancer, to help determine whether treatment has been effective, and to monitor for recurrence of thyroid cancer. Testing may be used to help detect medullary thyroid cancer in family members of people with multiple endocrine neoplasia type 2 (MEN 2).

A stimulation test is more sensitive than a single calcitonin measurement. This procedure involves collecting an initial blood sample (baseline), then giving an injection of intravenous calcium or pentagastrin, substances that stimulate the thyroid to produce calcitonin. Several more blood samples are collected over the next several minutes to measure the effect of the stimulation.

When is it ordered?

Calcitonin levels may be ordered when it is suspected that you have C-cell hyperplasia or medullary thyroid cancer. These conditions may be suspected when you have signs and symptoms, such as:

  • A lump or swelling at the front of your neck
  • Pain in your throat or front of your neck
  • A change in your voice, hoarseness
  • Difficulty swallowing or breathing
  • Persistent cough not associated with a cold

Calcitonin tests may be ordered periodically for family members of those who have MEN 2, starting at an early age, in order to detect medullary thyroid cancer or C-cell hyperplasia as early as possible.

When you have been treated for medullary thyroid cancer, calcitonin testing will usually be ordered at regular intervals to monitor treatment effectiveness and recurrence.

What does the test result mean?

Calcitonin levels are normally low. However, a low result does not rule out medullary thyroid cancer (MTC). While most people with sporadic MTC have high calcitonin levels, about 30% of people with familial MTC or MEN 2 have normal levels.

An elevated level of calcitonin means that excess amounts are being produced. Significantly elevated levels of calcitonin (e.g., greater than 20 times the upper limit) are a good indicator of C-cell hyperplasia or medullary thyroid cancer. Likewise, if you have early C-cell hyperplasia or medullary thyroid cancer, you will usually have very significant increases in your levels of calcitonin during a calcitonin stimulation test. However, your healthcare practitioner will use other procedures, such as a thyroid biopsy, scan, and ultrasound, to establish the diagnosis.

With successful treatment for medullary thyroid cancer, which may involve surgery to remove the thyroid gland and often some surrounding tissues, calcitonin levels will usually fall to very low levels. If the values stay low over time, then it is likely that the treatment was effective.

In some cases, calcitonin levels will fall but remain moderately elevated after treatment. This may mean that some tissue that produces calcitonin remains. Healthcare practitioners will monitor calcitonin and watch for increases over time. If calcitonin levels begin to rise, then it is likely that medullary thyroid cancer has returned.

Are calcitonin levels elevated in other conditions besides c-cell hyperplasia and medullary thyroid cancer?

Yes. Calcitonin levels may be elevated with lung, breast, and pancreatic cancers, insulinomas, and rare pancreatic tumors called VIPomas (associated with vasoactive intestinal peptide (VIP) hormone production).

Other conditions with elevated calcitonin include:

  • Intestinal, gastric, or bronchial carcinoid tumors
  • Chronic renal failure
  • Zollinger-Ellison syndrome
  • Pernicious anemia

Why isn’t calcitonin testing performed as a routine screen?

C-cell hyperplasia and medullary thyroid cancer are both sufficiently rare that it is not useful to screen for calcitonin in the general population.

If my thyroid is removed, will I need to replace my calcitonin?

No, the body can function without it. However, you will need lifelong thyroid hormone (usually T4) replacement therapy. This is manufactured thyroid hormone taken as a pill by mouth that replaces your body’s own thyroid hormone.

Is calcitonin ever used as a supplement?

Yes, but in a totally different context. Because it inhibits bone breakdown (resorption) when given in very large doses, calcitonin is sometimes given as a drug to people who have osteoporosis. It helps maintain bone density and has a pain-relieving effect on bone. The supplement is usually administered as an injection or nasal spray. Calcitonin is a protein and will be broken down by digestion, becoming inactive, so it cannot be taken by mouth.

Is there anything else I should know?

With medullary thyroid cancer and C-cell hyperplasia, other thyroid tests, such as T4, T3, and thyroid stimulating hormone (TSH), are usually normal while calcitonin levels are elevated.

Calcitonin levels may be increased with use of drugs such as epinephrine, glucagon, and oral contraceptives, and are normally higher in newborns as well as in women during pregnancy.

View Sources

Sources Used in Current Review

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(2018 November) What is Calcitonin? Endocrine Society. Available online at https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/calcitonin. Accessed October 2020.

Yadav, Mahima, Agrawal, Vinita, et al. (2018 October 10) C-Cell Hyperplasia in Sporadic and Familial Medullary Thyroid Carcinoma. Available online at http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=4;spage=485;epage=488;aulast=Yadav. Accessed October 2020.

Thyroid Cancer: Medullary Thyroid Cancer (MTC). The American Association of Endocrine Surgeons. Available online at http://endocrinediseases.org/thyroid/cancer_medullary.shtml. Accessed October 2020.

Gharib, Hossein, MD, MACP, MACE, Papini, Enrico, MD, FACE, et al. (2016 May) American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocrine Practice. Available online at https://journals.aace.com/doi/pdf/10.4158/EP161208.GL. Accessed October 2020.

(2019 February 1) Calcitonin (Nasal Route). Mayo Clinic. Available online at https://www.mayoclinic.org/drugs-supplements/calcitonin-nasal-route/description/drg-20067056. Accessed October 2020.

(March 14, 2019) American Cancer Society. Thyroid Cancer Statistics. Available online at https://www.cancer.org/cancer/thyroid-cancer/about/key-statistics.html. Accessed October 2020.

© 2020 ARUP Laboratories. Calcitonin. Available online at https://ltd.aruplab.com/Tests/Pub/0070006. Accessed October 2020.

(July 2020) MedlinePlus. Calcitonin Test. Available online at https://medlineplus.gov/lab-tests/calcitonin-test/. Accessed October 2020.

© 2020 Mayo Foundation for Medical Education and Research. Calcitonin, Serum, Clinical and Interpretive. Available online at https://test.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/9160. Accessed October 2020.

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Wiesner, G. and Snow-Bailey, K. (2005 March 7, Update). Multiple Endocrine Neoplasia Type 2. GeneReviews [On-line information]. Available online at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=men2. Accessed on 11/1/08.

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January 2016 review performed by Irene Shu, PhD, DABCC, Assistant Laboratory Director, USDTL.

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