The effect of intravenous magnesium sulphate on parathyroid function in primary hyperparathyroidism

Gough, Ian; Balderson, Glenda A.; Lloyd, Helen; Galligan, John; Willgoss, D. A.; Fryar, Barry G.

doi:10.1007/bf01655421

Cited by 13 publications

(8 citation statements)

References 27 publications

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“…The slight rise in serum Ca 2+ was unexpected; previous studies of Mg infusions have reported a reduction in blood Ca 2+ [16][17][18], thought to be due to Mg-induced inhibition of parathyroid hormone (PTH) secretion [19,20]. However these reported reductions in blood Ca 2+ occurred several hours after the commencement of Mg infusion, whereas we found a small, rapid increase in serum Ca 2+ 15 min after the start of the infusion period.…”

Section: Discussioncontrasting

confidence: 62%

Infusion of Mg in humans acutely reduces serum insulin levels: a pilot study

Gow¹,

O'Donnell²,

Flint³

et al. 2011

Magnesium Research

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Background. Infusion of Mg for therapeutic purposes is still a matter for debate. Dosages vary considerably, yet subclinical effects on normal physiology are largely ignored. In human and animal models, interactions between Mg and insulin exist, thus we have investigated the effect of infusing Mg on serum insulin, ionised Mg (Mg 2+ ) and Ca (Ca 2+ ) and plasma glucose in human volunteers. Methods. Six male volunteers were infused with magnesium sulphate (MgSO 4 ) dissolved in normal saline, using a high-dose "loading" bolus, followed by a lower-level "maintenance" period. Findings. Serum Mg 2+ rose rapidly throughout the bolus infusion, declined during the maintenance phase, but remained higher than pre-infusion levels throughout the experimental period; serum Ca 2+ rose when serum Mg 2+ was highest. Infusion of MgSO 4 had no effect on heart rate or blood pressure, but caused a rapid, pronounced drop in circulating fasting insulin (p<0.0005), which slowly recovered to basal values during the course of the maintenance infusion. A slight, transient rise in plasma glucose (p<0.05) concomitant with the decline in serum insulin was also observed. Interpretation. It is possible that the effect of Mg 2+ on insulin may have been due to antagonism of Ca 2+ entry in pancreatic beta-cells, the insulin decline causing a subsequent rise in circulating glucose levels. We suggest that these effects of MgSO 4 infusions should be considered where the aim is to achieve high doses of blood Mg 2+ levels by clinical intervention.

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Section: Discussioncontrasting

confidence: 62%

Infusion of Mg in humans acutely reduces serum insulin levels: a pilot study

Gow¹,

O'Donnell²,

Flint³

et al. 2011

Magnesium Research

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“…The mechanism of action of Mg on PTH is unknown; an in vitro study has demonstrated that modifications of extracellular Mg may induce changes in intracellular Ca by two independent mechanisms that regulate PTH secretion [50]. In vitro [6] and in vivo [36,38,51] (animal and human) studies have demonstrated that Mg modulates PTH secretion in a way similar to that of Ca. This hypothesis was supported by recent studies on successful use of Mg salts to control hyperparathyroidism, and the use of Mgcontaining agents as phosphate binders [39,40,[52][53][54][55][56].…”

Section: Discussionmentioning

confidence: 96%

“…It was reported that intravenous Mg sulfate infusion depressed iPTH levels in a healthy population [36,37]. Gough et al [38] reported that intravenous Mg sulfate infusion significantly suppressed iPTH levels in patients with primary hyperparathyroidism. Also there are some reports [39,40] indicating that magnesium carbonate (MgCO 3 ) as a phosphate binder depressed serum PTH level.…”

Section: Discussionmentioning

confidence: 97%

Inverse correlation between serum magnesium and parathyroid hormone in peritoneal dialysis patients: a contributing factor to adynamic bone disease?

et al. 2006

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Serum Mg is lower and serum PTH higher in patients dialyzed with lower Mg concentration dialysis solution compared to those with higher Mg concentration dialysis solution. Our study confirms previous reports that serum Mg may have a suppressive role on PTH synthesis and/or secretion, and thus may play a role in pathogenesis of adynamic bone disease that often develops in patients on chronic PD with high calcium and high magnesium concentrations.

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“…Recently, in addition to these factors, magnesium is suggested to play an important role in regulating PTH level. An intravenous magnesium sulfate infusion significantly suppressed iPTH secretion in patients with primary hyperparathyroidism 19 ) . In addition, an intravenous magnesium sulfate infusion depressed iPTH levels in healthy men 20 , 21 ) .…”

Section: Discussionmentioning

confidence: 98%

Relationship between the Serum Parathyroid Hormone and Magnesium Levels in Continuous Ambulatory Peritoneal Dialysis CAPD Patients using Low - magnesium Peritoneal Dialysate

Cho

Lee

et al. 2002

Korean J Intern Med

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BackgroundPatients on continuous ambulatory peritoneal dialysis (CAPD) have increased risk of low-turnover bone disease and relative hypoparathyroidism. Recently, it has been believed that magnesium plays an important role in regulating secretion of parathyroid hormone (PTH). The aim of this study was to evaluate the relationship between serum PTH and serum magnesium as a factor increasing the frequency of relative hypoparathyroidism.MethodsWe analyzed the data of 56 patients who had been on CAPD for more than 6 months without any significant problems. No patient had been previously treated with vitamin D or aluminum hydroxide. The patients had used peritoneal dialysate with the magnesium concentration of 0.5 mEq/L. Biochemical parameters, such as BUN, creatinine, alkaline phosphatase bony isoenzyme, total protein, albumin, total calcium, ionized calcium and intact parathyroid hormone level were measured.ResultsThe mean serum magnesium level was 1,99±0.36 mEq/L. Among total 56 patients, 15 patients (26.8%) showed hypermagnesemia (serum magnesium >2.2 mEq/L) and 5 patients (8.9%) showed hypomagnesemia (serum magnesium <1.6 mEq/L). Among all 56 patients, serum iPTH (intact PTH) level was not correlated with serum magnesium level. However, it was inversely correlated with serum total calcium and ionized calcium levels, respectively (r = − 0.365, p = 0.006; r = − 0.515 p < 0.001). Among 49 patients whose serum iPTH level was less than 300 pg/mL, serum iPTH level was inversely correlated with serum magnesium level (r = − 0.295, p=0.039) and inversely correlated with serum total calcium and ionized calcium levels, respectively (r = − 0.546, p < 0.001; r = − 0.572 p < 0.001). Among 49 patients whose serum iPTH level was less than 300 pg/mL, lower iPTH group (serum iPTH < 120 pg/mL) showed higher serum magnesium level (p = 0.037), higher serum total calcium level (p < 0.001) and lower bone isoenzyme of alkaline phosphatase level (p < 0.001) than those of higher iPTH group (120 pg/mL≤serum iPTH < 300 pg/mL).ConclusionAmong the CAPD patients whose serum iPTH level was less than 300 pg/mL, there was a significant inverse correlation between serum iPTH level and serum magnesium level. This study indicates that not only serum calcium level but also serum magnesium level are important in the regulation of serum iPTH levels of CAPD patients who have been dialyzed by low-magnesium peritoneal dialysate.

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The effect of intravenous magnesium sulphate on parathyroid function in primary hyperparathyroidism

Cited by 13 publications

References 27 publications

Infusion of Mg in humans acutely reduces serum insulin levels: a pilot study

Infusion of Mg in humans acutely reduces serum insulin levels: a pilot study

Inverse correlation between serum magnesium and parathyroid hormone in peritoneal dialysis patients: a contributing factor to adynamic bone disease?

Relationship between the Serum Parathyroid Hormone and Magnesium Levels in Continuous Ambulatory Peritoneal Dialysis CAPD Patients using Low - magnesium Peritoneal Dialysate

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