Chapter: Clinical Anesthesiology: Anesthetic Management: Anesthesia for Patients with Endocrine Disease

The Parathyroid Glands Physiology

Parathyroid hormone (PTH) is the principal regulator of calcium homeostasis.

The Parathyroid Glands

Physiology

Parathyroid hormone (PTH) is the principal regu-lator of calcium homeostasis. It increases serum calcium concentrations by promoting resorption of bone and teeth, limiting renal excretion of calcium, and indirectly enhancing gastrointestinal absorp-tion by its effect on vitamin D metabolism. PTH decreases serum phosphate by increasing renal excretion. The effects of PTH on calcium serum levels are countered in lower animals by calcito-nin, a hormone excreted by parafollicular C-cells in the thyroid, but a physiological calcium-lowering effect for calcitonin has not been demonstrated in humans (Table 34–6). Of total body calcium, 99% is in the skeleton. Of the calcium in the blood, 40% is bound to proteins and 60% is ionized or complexed to organic ions. Unbound ionized calcium is physi-ologically the most important fraction.

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Clinical Anesthesiology: Anesthetic Management: Anesthesia for Patients with Endocrine Disease : The Parathyroid Glands Physiology |