Of note, intermittent parathyroid hormone (iPTH) is highly correlated with its anti-apoptotic effect on both osteoblasts and osteocytes, however, production of excessive PTH following primary hyperparathyroidism or calcium deficiency could give rise to bone loss, which is attributed to the upregulation of fibroblast growth factor 23 (FGF23), and suppression of osteoblast differentiation and mineralization78,130,131. This evidence concerns the gene FGF23 and primary hyperparathyroidism.