In 30 controls and 30 patients with primary hyperparathyroidism 25-OH-vitamin D in serum and urinary cyclic AMP were determined by competitive protein binding assays. Removal of hyperplastic or adenomatous parathyroid glands resulted in hypocalcemia with 1. low urinary cyclic AMP in surgical hypoparathyreoidism 2. high urinary cyclic AMP in skeletal calcium deficiency, 3. high urinary cyclic AMP in 25-OH-vitamin D deficiency. In calcium or vitamin D deficiency, therapy with calcium or calcium and vitamin D corrected hypocalcemia and urinary cyclic AMP.