Example 4:

Homeostasis of [Ca ]
2+

in blood

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Learning Objectives – [Ca+] in blood
▪ Review the components that provide physical strength to bone, but
understand that control over concentrations of calcium ions in plasma is
the primary concern, and explain why this is so.
▪ Draw the homeostatic flow diagram the involves hormones and tissues
involved when blood concentrations of calcium either rise or fall, noting
where the primary stimulus is monitored in each case
▪ Understand that while parathyroid (PTH) and calcitonin are produced in
the young, calcitonin is less important in adults; understand these
circumstances and how homeostasis is maintained.
▪ Describe what the term hypophosphatemia means, and under what
conditions would it likely occur
▪ Discuss how PTH also affects the kidneys and the GI tract and what it
achieves.
▪ Describe how PTH influences vitamin D activation.
▪ Predict what event is likely to occur if too many calcium ions are allowed
to accumulate in plasma.

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Homeostatic control of blood [Ca2+]
Role of calcium in the body - review

▪ Recall bone lectures: blood [Ca2+] must be maintained within

tolerable ranges because..

▪ Very many metabolic roles of Ca2+ are crucial to life (e.g. heart
contraction, nerve action, blood coagulation, cell division….)

▪ And as a result Ca2+will be taken off bone if blood levels are low,
with little regard as to how strong the bones are to begin with
…..what might result from this?

▪ Remember also that osteoclasts resorb bone to release calcium

(and phosphate, inadvertently), while osteoblasts remove
calcium from blood to build bone

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The role of calcitonin
Hint: calcitonin = on
bone


Calcitonin
secreted

Note limited range

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 The Role of Parathyroid
Hormone

Fig 6.12

Note that this is a more complex control system than the previous 34
Notes on Ca2+ homeostasis
This system
▪ does not require a distant integrating centre,
▪ does involves two hormones with essentially opposite roles:
calcitonin to deposit bone, PTH to dissolve bone (note,
however, that calcitonin appears to have only a small role in
healthy adults)
▪ Release of Ca2+ from bone is necessarily associated with
hyperphosphatemia (split term to understand it); this is not
a desired outcome.
▪ In addition, vitamin D increases uptake of Ca2+ from the gut

▪ Note: PTH is involved with 3) and 4), in predictable ways;

see next slide

35
PTH – effects on gut & kidney

PTH activates vitamin D,

& increases renal
excretion of phosphate -
understand why

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PTH & Balance of Phosphates
▪ If PTH is released excessively can lead to other ion
concentration changes i.e. phosphate (PO4-3)
▪ Hypophosphatemia – low levels of phosphate in
the blood
▪ PTH will trigger reabsorption of calcium in the
kidneys but that will result in excretion of of
phosphate by the kidneys
▪ Hyperparathyroidism (excess PTH) is usually caused
by tumors

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Calcium homeostasis - overview

Calcitonin
secreted

Calcitonin is not
very important to
Ca2+ homeostasis
in adults – control
is mostly mediated
via increasing and
decreasing PTH
levels

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Readings
▪ Blood Calcium Concentration - Chapter 26 Fluid,
Electrolyte and Acid-Base Balance (10e: pg. 1010-
1011, 11e: 1057-1058) & Chapter 16 Endocrine
System Section 16.8, Calcitonin section (10e: pg.
615, 11e: pg. 653).

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