Dynamic Control of Calcium, Phosphate, Citrate, and Glucose Levels in Blood Serum Effect of ACTH, Adrenaline, Noradrenaline, Hydrocortisone, Parathormone, Insulin, and Glucagon

The effect of ACTH, adrenaline, noradrenaline, insulin, parathormone, hydrocortisone, and glucagon on the homeostatic mechanism controlling serum glucose, citrate, calcium, phosphorus, and potassium was studied in fasting rabbits and children. Citrate levels are kept in balance by ACTH, adrenaline, and glucagon, which raise the levels, and by insulin, which lowers them. Stress alone raises citrate levels, probably through adrenaline and ACTH effects. Calcium levels in rabbits are markedly lowered by ACTH, given I.M., to tetany levels. Adrenaline has a similar, but mild, effect. I. M. parathormone raises calcium levels slowly. ACTH and parathormone may be the antagonists in keeping calcium levels constant. Insulin, adrenaline, ACTH, glucagon, and parathormone lower phosphate levels. Major factors in lowering phosphate levels acutely evidently are insulin, which moves phosphate into the cell, and parathormone, which moves it through the kidney. Insulin, adrenaline, ACTH, and glucagon lower potassium levels in the rabbit. Only noradrenaline causes a significant rise. In the normal child only citrate moves in the same direction (elevates) as in the rabbit after ACTH. Children with CNS abnormality behaved like normal children except for 3 with febrile convulsions. Homeostatic control of the constituents studied may be accomplished in the rabbit and the human by a balance of hormonal factors.