• Synthesis 
    • made in parafollicular cells (C cells) of thyroid in response to hypercalcemia
      • inferior parathyroid glands derived from the 3rd pharyngeal pouch
      • superior parathyroid glands derived from the 4th pharyngeal pouch
      • parafollicular C cells derived from ultimobranchial body (4th/5th pharyngeal pouch)
        • they are neural crest (ECTOdermal) cell derivatives that migrate to the ultimobranchial body but do not originate there (pharyngeal pouch is primarily ENDOdermal in origin)
  • Function
    • ↓ serum Ca2+ via
      • ↓ bone resorption
      • PTH antagonism
    • not essential in normal Ca2+ homeostasis
    • can be used in management of osteoporosis or hypercalcemia (not first line for either)
  • Pathology
    • medullary carcinoma of the thyroid
      • parafollicular C cells overproduce caltonin creating sheets of cells in an amyloid stroma
      • stains with Congo red
      • associated with MEN 2A and 2B (mutation in RET)

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