Ulcer disease, metabolic alkalosis and hyperparathyroidism: A mechanism of interrelationship?

In both normal volunteers and in patients with primary hyperparathyroidism, the induction of a metabolic alkalosis by infusion of sodium bicarbonate results in a decrease in serum calcium ion and in an increase of circulating parathyroid hormone concentrations. Bicarbonate infusion may serve in man as a new provocative test for release of parathyroid hormone. Furthermore, it is speculated that the metabolic alkalosis which is found at times in patients with the Zollinger Ellison syndrome and severe peptic ulcer disease may result in parathyroid gland stimulation.