Calcitonin Test

A calcitonin test measures the level of calcitonin in a sample of your blood. Calcitonin is a hormone that helps control the level of calcium in your blood. Calcitonin is made in your thyroid gland by cells called "C cells." Your thyroid is a small, butterfly-shaped gland in your neck.

Normally, you have a small amount of calcitonin in your blood. But if you have too much, it may be a sign of:

• Medullary thyroid cancer (MTC), a rare cancer that happens when C cells in your thyroid grow out of control. C cells grow in the inside part of your thyroid, which is called the medulla.
• C-cell hyperplasia, a rare condition that causes abnormal growth of C cells in your thyroid. C-cell hyperplasia can turn into medullary thyroid carcinoma.

Your health care provider may order a calcitonin test if you have symptoms of these conditions or if they run in your family.

Other names: thyrocalcitonin, CT, human calcitonin, hCT

What is it used for?

A calcitonin test is most often used to:

• Help diagnose C-cell hyperplasia and medullary thyroid cancer in people who have symptoms
• Find out if treatment for medullary thyroid cancer is working
• Check whether medullary thyroid cancer has returned after treatment
• Screen people who have a high risk of medullary thyroid cancer. The risk is high for people who have a family history of a rare genetic disorder called multiple endocrine neoplasia type 2 (MEN 2).

There are different types of MEN 2 that often cause tumors in certain glands that make hormones, including your thyroid. All types of MEN 2 increase your risk of medullary thyroid cancer. MEN 2 is caused by changes in a gene called RET. Changes in genes are also called gene variants or mutations.

You can inherit MEN 2 - and an increased risk for medullary thyroid cancer - if either of your parents passed a changed RET gene down to you. If MEN 2 runs in your family, regular calcitonin tests can help find cancer early when it may be easier to treat.

Why do I need a calcitonin test?

You may need a calcitonin test to help check for medullary thyroid cancer or C-cell hyperplasia if:

• You have symptoms of either condition which may include:
  • A lump in the front of your neck
  • Swollen lymph nodes in your neck (also called "swollen glands")
  • Pain in your throat
  • Trouble swallowing or breathing
  • A change in your voice, such as hoarseness
  • A long-lasting cough when you don't have a cold
  • Diarrhea
  • Fatigue
  • Depression
  • Aches and pains in bones and joints
  • Nausea and vomiting
  • Increased thirst and urination (peeing)
  • High blood pressure
  • Headaches
  • Arrythmia (a problem with the rate or rhythm of your heart)
  • Sweating

  If you've been diagnosed with medullary thyroid cancer, you'll need calcitonin testing to:

  • Find out how well your treatment is working.
  • Check whether the cancer has come back after you finish treatment.

  What happens during a calcitonin test?

  A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

  Will I need to do anything to prepare for the test?

  You may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if you need to fast and if there are any special instructions to follow.

  Are there any risks to the test?

  There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

  What do the results mean?

  The meaning of your calcitonin test results depends on the reason you were tested. If you had a calcitonin test:

  To help diagnose or screen for medullary thyroid cancer or C-cell hyperplasia:

  • A normal calcitonin level may mean that you don't have either condition, but it doesn't rule them out. That's because medullary thyroid cancer and C-cell hyperplasia don't always cause high calcitonin. Your provider may order other tests to learn more.
  • A high calcitonin level means that the C cells in your thyroid are making too much calcitonin. The higher the level, the more likely it is that you have medullary thyroid cancer or C-cell hyperplasia. But high calcitonin levels may be caused by other conditions, including certain other cancers, certain medicines, and pregnancy. To make a diagnosis, your provider will consider other information, including other test results.
  • A low calcitonin level is not known to be a medical problem.

  To monitor treatment for medullary thyroid cancer or to check whether cancer has come back after treatment: The meaning of your test results depends on the type of treatment you're having or had. Treatment usually starts with surgery to remove your thyroid gland. Other treatments include radiation therapy, chemotherapy, and/or medicines.

  • Calcitonin levels that decrease and stay low over time usually mean that your treatment is helping.
  • A calcitonin level that decreases but is still higher than normal may mean that you still have some cancer tissue left in your body. You may need more tests and treatment.
  • A calcitonin level that increases over time usually means that your cancer has returned or spread to other parts of your body.

  Ask your provider to explain what your test results mean for your health.

  Is there anything else I need to know about a calcitonin test?

  In certain cases, your provider may order a more accurate type of calcitonin test called a "calcitonin stimulation test." For this test, a sample of your blood will be taken as usual. Then you'll be given medicine to make your body produce calcitonin. The medicine is injected into a vein intravenously (by IV). Afterwards, more blood samples will be taken a few minutes apart. If your calcitonin increases by a lot in each blood sample, it may mean you have C-cell hyperplasia or medullary thyroid carcinoma, but you'll need other tests to find out for sure.

  References

  1. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2022. Tests for Thyroid Cancer; [updated 2020 May 5; cited 2022 Nov 23]; [about 4 screens]. Available from: https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/how-diagnosed.html
  2. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2022. What Is Thyroid Cancer?; [updated 2019 Mar 14; cited 2022 Nov 23]; [about 4 screens]. Available from: https://www.cancer.org/cancer/thyroid-cancer/about/what-is-thyroid-cancer.html
  3. Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2022. Calcitonin; [reviewed 2022 Feb 3; cited 2022 Dec 5]; [about 10 screens]. Available from: https://my.clevelandclinic.org/health/articles/22330-calcitonin
  4. Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2022.Medullary Thyroid Cancer (MTC); [reviewed 2022 Apr 28; cited 2022 Dec 5]; [about 13 screens]. Available from: https://my.clevelandclinic.org/health/diseases/22873-medullary-thyroid-cancer-mtc
  5. Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2022. Multiple Endocrine Neoplasia (MEN); [reviewed 2022 May 23; cited 2022 Dec 5]; [about 22 screens]. Available from: https://my.clevelandclinic.org/health/diseases/23088-multiple-endocrine-neoplasia-men
  6. Konstantakos AK. Medullary Thyroid Carcinoma. [Updated 2022 June 14; cited 2022 Dec 5]. In Medscape: Drugs & Diseases: Oncology [Internet]. Atlanta (GA): WebMD LLC; c1994-2022. Available from: https://reference.medscape.com/article/282084-overview
  7. Master SR, Burns B. Medullary Thyroid Cancer. [Updated 2022 Sep 26; cited 2022 Dec 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459354/
  8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. Thyroid cancer: Diagnosis and treatment; [cited 2022 Nov 23]; [about 15 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/thyroid-cancer/diagnosis-treatment/drc-20354167
  9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. Thyroid cancer: Symptoms and causes; [cited 2022 Nov 23]; [about 14 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/thyroid-cancer/symptoms-causes/syc-20354161
  10. Mayo Clinic: Mayo Medical Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995-2022. Test ID: CATN: Calcitonin, Serum: Clinical and Interpretive; [cited 2022 Nov 23]; [about 3 screens]. Available from: https://www.mayocliniclabs.com/test-catalog/overview/9160#Clinical-and-Interpretive
  11. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: calcitonin; [cited 2022 Nov 23]; [about 3 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/calcitonin
  12. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: multiple endocrine neoplasia type 2 syndrome; [cited 2022 Nov 23]; [about 3 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/multiple-endocrine-neoplasia-type-2-syndrome
  13. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Pheochromocytoma; [posted 2020 Feb 12; cited 2022 Dec 5]; [about 3 screens]. Available from: https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-endocrine-tumor/pheochromocytoma
  14. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Thyroid Cancer Screening (PDQ(r))- Patient Version; [updated 2021 Sep 29; cited 2022 Dec 5]; [about 7 screens]. Available from: https://www.cancer.gov/types/thyroid/patient/thyroid-screening-pdq
  15. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; c2022. Health: Blood Test; [cited 2022 Dec 5]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/blood-test
  16. National Center for Advancing Translational Sciences: Genetic and Rare Diseases Information Center [Internet]. Gaithersburg (MD): U.S. Department of Health and Human Services; Multiple endocrine neoplasia type 2; [updated 2021 Nov 8; cited 2022 Dec 5]; [about 8 screens]. Available from: https://rarediseases.info.nih.gov/diseases/3830/multiple-endocrine-neoplasia-type-2
  17. National Center for Advancing Translational Sciences: Genetic and Rare Diseases Information Center [Internet]. Gaithersburg (MD): U.S. Department of Health and Human Services; Thyroid cancer, medullary; [updated 2021 Nov 8; cited 2022 Dec 5]; [about 8 screens]. Available from: https://rarediseases.info.nih.gov/diseases/7004/thyroid-cancer-medullary
  18. National Organization for Rare Disorders [Internet]. Danbury (CT): NORD-National Organization for Rare Disorders; c2022. Multiple Endocrine Neoplasia Type 2; [cited 2022 Nov 23]; [about 16 screens]. Available from: https://rarediseases.org/rare-diseases/multiple-endocrine-neoplasia-type
  19. Sofronescu, AG. Calcitonin. [updated 2021 Jul 19; cited 2022 Dec 5].In: Medscape: Drugs & Disease: Laboratory Medicine [Internet]. Atlanta (GA): WebMD LLC; c1994-2022. Available from: https://emedicine.medscape.com/article/2087580-overview#showall
  20. Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. Calcitonin; [modified 2020 Nov 6; cited 2022 Nov 23]; [about 7 screens]. Available from: https://www.testing.com/tests/calcitonin/
  21. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2022. Calcitonin blood test: Overview; [reviewed 2019 May 6; cited 2022 Nov 23]; [about 2 screens]. Available from: https://ufhealth.org/calcitonin-blood-test
  22. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Calcitonin; [cited 2022 Nov 23]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=calcitonin
  23. Yasir M, Mulji NJ, Kasi A. Multiple Endocrine Neoplasias Type 2. [Updated 2022 Aug 22; cited 2022 Dec 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519054/