FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 313:1126-1130 October 31, 1985 Number 18 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

Previous studies have demonstrated a spectrum of parathyroid responsivity to alterations in the extracellular calcium concentration in patients with primary hyperparathyroidism, but studies employing physiologic amounts of calcium have not, to our knowledge, been reported. We studied 18 unselected patients with primary hyperparathyroidism at the lower (400 mg) and upper (1000 mg) limits of a normal dietary intake of calcium. The diet containing high-normal amounts of calcium induced only a slight increase in 24-hour calcium excretion (from 281 to 337 mg per day) yet was associated with significant reductions in fasting serum levels of immunoreactive parathyroid hormone (from 60 to 50 nleq per milliliter; P less than 0.001), nephrogenous cyclic AMP (from 3.52 to 2.63 nmol per deciliter of glomerular filtrate; P less than 0.001), and plasma levels of 1,25-dihydroxyvitamin D (from 74 to 58 pg per milliliter; P less than 0.001). A wide spectrum of responses was observed, with some patients appearing to have essentially autonomous parathyroid function and others having marked suppressibility (up to 50 per cent) of the parathyroid hormone-vitamin D axis. We conclude that parathyroid function may be suppressed by dietary calcium in some patients with primary hyperparathyroidism.

This article has been cited by other articles:

• Kerstetter, J. E., Wall, D. E., O'Brien, K. O., Caseria, D. M., Insogna, K. L. (2006). Meat and Soy Protein Affect Calcium Homeostasis in Healthy Women. J. Nutr. 136: 1890-1895 [Abstract] [Full Text]  
• Cifuentes, M., Riedt, C. S, Brolin, R. E, Field, M P., Sherrell, R. M, Shapses, S. A (2004). Weight loss and calcium intake influence calcium absorption in overweight postmenopausal women. Am. J. Clin. Nutr. 80: 123-130 [Abstract] [Full Text]  
• Kerstetter, J. E, Svastisalee, C. M, Caseria, D. M, Mitnick, M. E, Insogna, K. L (2000). A threshold for low-protein-diet-induced elevations in parathyroid hormone. Am. J. Clin. Nutr. 72: 168-173 [Abstract] [Full Text]