Parathyroid panel test is most often used to diagnose hyperparathyroidism, hypoparathyroidism  & monitor kidney disease. It is also used to diagnose cause for osteoporosis & kidney stones. It may also be used in cases of suspected malignancies of the parathyroid gland. 

A parathyroid test is usually done to check the levels of parathyroid hormone (PTH) and calcium in the blood. Abnormal levels of PTH and calcium can indicate a complication related to the parathyroid glands.

• A parathyroid panel test is done to evaluate and diagnose conditions related to the parathyroid glands, such as hyperparathyroidism and hypoparathyroidism.
• In addition, a parathyroid panel test is also done in cases of suspected or known bone diseases like osteoporosis, in patients with chronic kidney disease or patients undergoing dialysis, and also for monitoring and adjusting the treatment for a patient with parathyroid disease.

Parathyroid panel test measures the various parameters affecting bone, kidneys and liver along with the PTH levels. These include Proteins, Magnesium, Alkaline Phosphatase, Creatinine, Calcium-Total & Ionised, Urine Calcium levels.

Parathyroid panel lab test requires a blood sample. A tourniquet (elastic) band is placed tightly on the upper arm. The patient is then asked to make a fist. This helps in the build-up of blood filling the veins. The skin is disinfected before needle insertion and the blood sample is collected in vacutainer. Routine urine sample is collected in a sterile container.

High level of PTH (Hyperparathyroidism) is seen in:

• Hyperplasia or tumor of the parathyroid gland
• Chronic kidney failure
• Severe calcium or vitamin D deficiency

Low level of PTH (Hypoparathyroidism) is seen in:

• Neck surgery or irradiation
• Autoimmune disease
• Low level of magnesium

Low calcium levels may lead to dry skin, coarse hair, brittle nails, muscle cramps, tingling, and cardiac irregularities. Low calcium levels (hypocalcaemia) may occur due to hypoparathyroidism, kidney conditions, malnutrition. pancreatitis, low calcium diet and vitamin D deficiency.
High calcium levels may lead to constipation, abdominal pain, nausea, vomiting, and mental confusion. High calcium levels (hypercalcemia) may indicate hyperparathyroidism (overactive parathyroid gland), certain cancers, bone disorders like Paget’s disease or high vitamin D levels.
Increased serum ionized calcium values are seen in primary hyperparathyroidism, vitamin D therapy, various malignancies producing parathyroid hormone.
High levels of ALP are seen in:
Children during active bone formation, pregnant women, those with hepatobiliary disease like bile duct obstruction, hyperparathyroidism,  chronic kidney disease, vitamin D deficiency, rickets, osteomalacia, bacterial infection and malignant tumour. 
Low magnesium levels indicate magnesium deficiency. The symptoms maybe muscle twitching, irregular heart beats, confusion, and even seizures( in severe cases). Low magnesium levels may also be a sign of preeclampsia, a serious blood pressure condition affecting pregnant women. Magnesium deficiencies are often treated with magnesium supplements along with a magnesium rich diet. 
High magnesium levels may occur due to Addison disease, certain kidney complications, severe dehydration or even due to certain medications. 
High serum creatine levels signify poor functioning of the kidneys. This may occur due to kidney disorders, chronic diabetes, autoimmune disorders and metabolic syndromes. Temporarily high levels may also occur due to exercises, side effects of medications , certain diets and pregnancy. Low creatinine levels may occur due to muscular disorders (loss of muscle bulk), excessive fluid loss and certain medications.

There is usually no specific preparation required for a parathyroid test. You may be advised to fast for a certain period of time before the test, depending on the type of test ordered. You should inform your doctor if you are taking any medications, as some can affect the test results.