Calcium regulation in metabolism

Why is calcium important

-provides skeletal strength (99% of Ca are stored in the bones as

hydroxyapatite)
-chelated Ca can be absorbed by the tissued as a serum form
(protein-bound can not be absorbed)
-ionized calcium plays an important function in muscle contraction

Regulation

-homeostasis is maintained by 3 actions of hormones

(1,25-dihydroxyvitamin D-3: vitamin D3, Parathyroid hormone: PTH,
calcitonin)
-Parathyroid hormone (PTH)
● PTH releases from the parathyroid glands in response to a decrease
in serum calcium
● PTH acts on the kidneys to increase the Ca intake and also increases
the vitamin D3 secretion (which stimulates the absorption through
the gut)
-Calcitonin
● Is released form the paradollixular cells (C-cells) in response to an
increase in serum calcium
● Calcitonin acts on the bones to stimulate osteoblasts (bone breaking
macrophages) to deposit Ca in the bones
● Inhibits renal reabsorption (increasing urinary Ca excretion)
● Inhibits the Ca absorption in intestines too

Clinical significance

-hypercalcemia
● Too much Ca content in the blood
● Usual symptoms are nonspecific: headache, irritability, depression,
fatigue, nausea
● Diagnosis are divided into PTH-mediated (due to increased intestinal
Ca absorption in response to elevated PTH levels) and
non-PTH-mediated (due to malignancy, granulomatous disorders,
genetic causes)
-hypocalcemia
● Not enough Ca content in blood
● Usual symptoms: muscle spasms, seizures, depression, dry skin,
brittle nails
● Diagnosis can be achieved by blood test (hormonal measures)