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Ionized and Total Serum Calcium and Parathyroid Hormone in Hyperthyroidism

KENNETH D. BURMAN, M.D.; JOHN M. MONCHIK, M.D., F.A.C.S.; JERRY M. EARLL, M.D., F.A.C.P.; and LEONARD WARTOFSKY, M.D., F.A.C.P.
[+] Article and Author Information

Unpublished data concerning the performance of the parathyroid hormone assay using antiserum GP-101 were obtained through the courtesy of Dr. S. Krutzik, Nichols Institute for Endocrinology, San Pedro, California.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.

▸Requests for reprints should be addressed to Kenneth D. Burman, M.D.; Department of Endocrinology and Metabolism, Walter Reed Army Medical Center; Washington, DC 20012.


Washington, D.C.


Ann Intern Med. 1976;84(6):668-671. doi:10.7326/0003-4819-84-6-668
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Total and ionized calcium concentrations as well as parathyroid hormone levels were measured in a group of hyperthyroid persons. Ionized and total calcium levels were elevated in 21 of 45 (47%) and in 12 of 45 (27%) thyrotoxic patients, respectively. Mean ionized and total calcium levels were higher in these 45 patients than in normal persons. Using two different radioimmunoassay systems for a total of 44 determinations, mean parathyroid hormone levels were lower in thyrotoxic patients than in subjects with proved hyperparathyroidism. These data suggest that [1] elevations of both ionized and total calcium concentrations occur frequently in thyrotoxic patients; [2] ionized calcium concentrations may be elevated in a higher percentage of hyperthyroid subjects than are total calcium concentrations; and [3] the hypercalcemia associated with thyrotoxicosis is not associated with elevated parathyroid hormone levels.

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