Postpartum resolution of hypocalcemia in a lactating hypoparathyroid patient

A 24 year old woman with post-surgical hypoparathyroidism was studied during pregnancy and lactation. During pregnancy the patient required less vitamin D therapy for control of her hypoparathyroidism and, while lactating, maintained a normal serum calcium without any supplemental vitamin D. The serum parathyroid hormone concentration and plasma 1,25 (OH)2 vitamin D concentration were undetectable and low normal respectively at a time when the serum calcium concentration was normal and the patient was not on vitamin D therapy. Urinary calcium excretion was low during this period and may explain the normalization of the serum calcium. The mechanism by which the improvement in calcium metabolism occurred is unknown, but may be secondary to a direct effect of prolactin on calcium homeostasis.