Bone disorders

[misspiggyback]

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Having trouble understanding the connection between PTH and ALP in bone disorders.

Is it safe to say that, whenever you have an increase in PTH, ALP would also be increased? And when PTH decreased, ALP decreased?

But just because you have an increase in ALP does NOT mean that you will have an increase in PTH, right (like in Paget's disease)? This is confusing to me.

I also don't get why osteoporosis and osteopetrosis have normal values for calcium, phosphate, alkaphos and PTH. Don't you have increased bone resorption in osteoporosis (and hence increased PTH)? And in osteopetrosis, decreased bone resorption (and hence decreased PTH)?

Finally...
Vit D intoxication - would see decreased PTH and therefore decreased ALP?
Primary hyperparathyroidism - increased pTH and therefore increased ALP?
Renal disease - increased PTH and therefore increased ALP?

 

[OveractiveBrain]

Having trouble understanding the connection between PTH and ALP in bone disorders.

Is it safe to say that, whenever you have an increase in PTH, ALP would also be increased? And when PTH decreased, ALP decreased?

But just because you have an increase in ALP does NOT mean that you will have an increase in PTH, right (like in Paget's disease)? This is confusing to me.

I also don't get why osteoporosis and osteopetrosis have normal values for calcium, phosphate, alkaphos and PTH. Don't you have increased bone resorption in osteoporosis (and hence increased PTH)? And in osteopetrosis, decreased bone resorption (and hence decreased PTH)?

Finally...
Vit D intoxication - would see decreased PTH and therefore decreased ALP?
Primary hyperparathyroidism - increased pTH and therefore increased ALP?
Renal disease - increased PTH and therefore increased ALP?

Not step 1, but will help clear some things up, the path is pretty good.

Calcium Step 2

 

[Brotato]

Not step 1, but will help clear some things up, the path is pretty good.

Calcium Step 2

FYI that video was pretty basic and says nothing about Alk Phos levels at all. Still it's not bad for a free resource.

 

[hotchik]

Having trouble understanding the connection between PTH and ALP in bone disorders.

Is it safe to say that, whenever you have an increase in PTH, ALP would also be increased? And when PTH decreased, ALP decreased?

But just because you have an increase in ALP does NOT mean that you will have an increase in PTH, right (like in Paget's disease)? This is confusing to me.

I also don't get why osteoporosis and osteopetrosis have normal values for calcium, phosphate, alkaphos and PTH. Don't you have increased bone resorption in osteoporosis (and hence increased PTH)? And in osteopetrosis, decreased bone resorption (and hence decreased PTH)?

Finally...
Vit D intoxication - would see decreased PTH and therefore decreased ALP?
Primary hyperparathyroidism - increased pTH and therefore increased ALP?
Renal disease - increased PTH and therefore increased ALP?

Is that a tru relationship with PTH and ALP? The way I was taught is that ALP just suggests bone formation...never heard of any relationship with PTH...that'll be something interesting though

 

[beeitchness]

PTH stimulates osteoblast to release MCSF and RANKL which stimulates osteoclasts to break down bone.

Pay attention to the first part: PTH stimulates osteoblasts.
This means osteoblasts are involved first during PTH action in bone. Osteoblasts require alkaline environment to lay down bone, and it uses ALP to do that. Therefore ALP should be increased whenever PTH is increased.