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Journal of Clinical Endocrinology & Metabolism Vol. 42, No. 4 707-717
doi:10.1210/jcem-42-4-707
Copyright © 1976 by the Endocrine Society.
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Impaired Release of Parathyroid Hormone in Magnesium Deficiency

CONSTANTINE S. ANAST, JOHN L. WINNACKER, LEONARD R. FORTE and THOMAS W. BURNS

Division of Endocrinology, Departments of Child Health and Medicine, and Department of Pharmacology, University of Missouri and Veterans Administration Hospital Columbia, Missouri 65201

Reprints: Dr. Constantine S. Anast, Department of Child Health, University of Missouri, Medical Center, Columbia, Missouri 65201.

Parathyroid hormone release and endorgan responsiveness to parathyroid extract (PTE) were evaluated in a 25-year-old woman with magnesium deficiency associated with hypocalcemia and inappropriately low levels of serum immunoreactive parathyroid hormone (iPTH). End-organ responsiveness to PTE was demonstrated by increases in serum calcium and in urinary phosphorus, cyclic AMP, and hydroxyproline. When the serum calcium was increased from a baseline of 6.9 mg/100 ml to levels of 8.0 mg/100 ml and higher by calcium infusion, the serum iPTH decreased from the low normal range to below the limits of detectability. The intravenous administration of 3 mg/kg of body weight of magnesium led to an abrupt and striking increase in circulating iPTH with a 2-fold increase in one minute, a 6-fold increase in two minutes, and an 8-fold increase in five minutes. The very rapid increase in serum iPTH produced by magnesium infusion in this study suggests an effect of magnesium on hormone secretion rather than an effect on hormone synthesis. The evidence provided by this investigation indicates that the release of parathyroid hormone is impaired in magnesium deficiency and that the level of circulating calcium required for the suppression of parathyroid hormone secretion is lower than that in normal subjects.

Reported in part at the Fifty-seventh Annual Meeting of the Endocrine Society, June 1975.

Received August 19, 1975.




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