Response to Drs Koo and Chesney

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Heyman MB , Klein GL , Wong A. , et al: Aluminum does not accumulate in teenagers and adults on prolonged parenteral nutrition containing free amino acids. JPEN 10:86-87. 1986

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Portale AA , Halloran BP , Murphy MM , et al: Oral intake of phosphorus can determine the concentration of 1,25-dihydroxyvitamin D by determining its production rate in humans. J Clin Invest 77:7-12, 1986

Klein GL , Horst RL , Norman AW , et al: Reduced serum levels of 1-α, 25-dihydroxyvitamin D during long-term total parenteral nutrition. Ann Intern Med 94:638-643, 1981

Klein GL , Horst RL , Slatopolsky E. , et al: Attempts to modify PTH and vitamin D status in patients receiving long-term total parenteral nutrition. IN Metabolic Bone Disease in Total Parenteral Nutrition, Coburn JW, Klein GL (eds). Urban and Schwarzenberg , Baltimore and Munich; 1985, pp 91-100

Clarkson TW: Mercury: An element of mystery. N Engl J Med 323:1137-1139, 1991

Needleman HL , Schell A. , Bellinger D. , et al: The long-term effects of exposure to low doses of lead in childhood. An 11-year follow-up report. N Engl J Med 322:83-88, 1990