Abstract

Although there seems to be an interrelationship between aluminum metabolism and toxicity and parathyroid function, this relationship is complex and complicated. At present, the data seem to be too variable to know with certainty what, if any, effect aluminum has on parathyroid function. It is more likely that parathyroid function determines aluminum skeletal toxicity than aluminum determines parathyroid function. This is suggested by the fact that patients with overt hyperparathyroidism are protected from developing aluminum-related bone disease even when they are given large parenteral loads of aluminum. And chronic, parenteral loads of aluminum seem to have little or no effect on the hyperparathyroid state. It remains to be elucidated just how parathyroid hormone might augment total body aluminum burden after oral loading of the element. Also unclear is how parathyroid hormone enhances bone aluminum uptake.

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