Vitamin calcium absorption

Age, calcium intake, hormonal status, exercise and vitamin status have all been implicated in the development of osteoporosis. Estrogen levels represent an important factor in skeletal calcium retention and homeostasis. In therapeutic trials in which post-menopausal women were given daily doses of estrogens, such therapy has been demonstrated to be partially effective in reducing the rate of bone resorption. However, this therapy has the concomitant hazard of endometrial cancer (10). Vitamin D and its hormones have been given considerable attention in the more recent studies. Without adequate dietary and tissue levels of such vitamins, calcium absorption and bone status will be impaired. 

Vitamins A, D, and E are required by mminants and, therefore, their supplementation is sometimes necessary. Vitamin A [68-26-8] is important in maintaining proper vision, maintenance and growth of squamous epitheHal ceUs, and bone growth (23). Vitamin D [1406-16-2] is most important for maintaining proper calcium absorption from the small intestine. It also aids in mobilizing calcium from bones and in optimizing absorption of phosphoms from the small intestine (23). Supplementation of vitamins A and D at their minimum daily requirement is recommended because feedstuffs are highly variable in their content of these vitamins. 

The steroid hormone 1,25-dihydroxy vitamin D3 (calcitriol) slowly increases both intestinal calcium absorption and bone resorption, and is also stimulated through low calcium levels. In contrast, calcitonin rapidly inhibits osteoclast activity and thus decreases serum calcium levels. Calcitonin is secreted by the clear cells of the thyroid and inhibits osteoclast activity by increasing the intracellular cyclic AMP content via binding to a specific cell surface receptor, thus causing a contraction of the resorbing cell membrane. The biological relevance of calcitonin in human calcium homeostasis is not well established. 

In addition to its role in regulating calcium homeostasis, vitamin D is required for the intestinal absorption of calcium. Synthesis of the intracellular calciumbinding protein, calbindin, required for calcium absorption, is induced by vitamin D, which also affects the permeability of the mucosal cells to calcium, an effect that is rapid and independent of protein synthesis. 

Vitamin D is not strictly a vitamin since it can be synthesized in the skin, and under most conditions that is its major source. Only when sunlight is inadequate is a dietary source required. The main function of vitamin D is in the regulation of calcium absorption and homeostasis most of its actions are mediated by way of nuclear receptors that regulate gene expression. Deficiency—leading to rickets in children and osteomalacia in adults—continues to be a problem in northern latitudes, where sunlight exposure is poor. 

Stimulating activation of vitamin D by 1-a-hydroxylase to cal-citriol (1,25-dihydroxyvitmin D3) to promote calcium absorption in the GI tract and increased calcium mobilization from bone... 

Supplemental vitamin D maximizes intestinal calcium absorption and has been shown to increase BMD it may also reduce fractures. 

Might antagonize verapamil Might induce hypercalcemia with thiazide diuretics Fiber laxatives (variable), oxalates, phytates, and sulfates can decrease calcium absorption if given concomitantiy Phenytoin, barbiturates, carbamazepine, rifampin increase vitamin D metabolism... 

G9. Grasbeck, R., Kantero, I., and Srurala, M., Influence of calcium ions on vitamin B12 absorption in steatorrhea and pernicious anaemia. Lancet i, 234 (1959). 

Other selective forces may also have been at work. Flatz (1987) has suggested that calcium absorption was a factor in northern Europe. Lactose is known to facilitate calcium absorption in the intestine. The northerly climate frequently prevented skin exposure to sunlight, thereby reducing the body s production of vitamin D. With little vitamin D available, calcium was poorly absorbed and conditions such as rickets could result. The ability to digest lactose would not only allow adults to use an excellent source of calcium, but the lactose would also facilitate its absorption. 

Based on limited epidemiologic evidence, fluoride supplements, with or without calcium, estrogen and vitamin D, are used by clinicians for the treatment of osteoporosis. However, knowledge of the effects of fluoride on calcium and phosphorus metabolism in normal animals is limited although Spencer et al. (32) reported that ingestion of fluoride by three osteoporotic men did not affect calcium absorption but caused a decrease in urinary excretion. Moreover, there is a need to determine the long-term effects of fluoride treatment on bone strength and on soft tissues ( ). 

Bile acids and salts have been found to enhance the absorption of both calcium and vitamin D hence, to increase calcium absorption both directly and indirectly (3,37). However, the ability of some dietary fibers such as lignin and pectin to absorb conjugated and deconjugated bile salts onto their surfaces to be excreted in the feces (a mechanism credited to the hypocholesterolemic effect of some dietary fibers) may result in an overall decrease in calcium absorption from the gastrointestinal tract (7,33,38-40). 

Ultraviolet light causes a chemical change in dihydrocholesterol to produce cholecalciferol, a precursor of vitamin D. The latter conforms better to the definition of a steroid hormone than a vitamin. Indeed, the classification of vitamin D as a vitamin is an historical accident. The precursor is released from the skin and is further modified in the liver and kidney to form dihydroxycholecalciferol, which is the active form of the hormone (see Chapter 15 for the reactions). It increases calcium absorption from the... 

Absorption - Calcium is absorbed from the Gl tract by passive diffusion and active transport. Calcium must be in a soluble, ionized form for absorption to occur. Vitamin D is required for calcium absorption and increases the absorptive mechanisms. 

Abrams, S. A., Griffin, I. J., Hawthorne, K. M., Chen, Z., Gunn, S. K., Wilde, M., Darlington, G., Shypailo, R. J., and Ellis, K. J. (2005a). Vitamin D receptor Fokl polymorphisms affect calcium absorption, kinetics, and bone mineralization rates during puberty. JBMR 20, 945-953. 

Ames, S., Ellis, K., Gurm, S., Copeland, K., and Abrams, S. (1999). Vitamin D receptor gene Fokl polymorphism predicts calcium absorption and bone mineral density in children. JBMR 14, 740-746. 

Gallagher, J. C., Riggs, B. L., Eisman, J., Hamstra, A., Arnaud, S. B., and DeLuca, H. E. (1979). Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients. /. Clin. Invest. 64, 729-736. 

Heaney, R. P. (2003c). Vitamin D depletion and effective calcium absorption. JBMR18,1342. 

Kinyamu, H. K., Gallagher, J. C., Balhorn, K. E., Petranick, K. M., and Rafferty, K. A. (1997). Serum vitamin D metabolites and calcium absorption in normal young and elderly free-living women and women living in nursing homes. Am. ]. Clin. Nutr. 65, 790-797. 

Wasserman, R. H. (2004). Vitamin D and the dual processes of intestinal calcium absorption. /. Nutr. 134, 3137-3139. 

PTH is secreted from the parathyroid glands in response to a low plasma concentration of ionized (free) calcium. PTH immediately causes the transfer of labile calcium stores from bone into the bloodstream. PTH increases rates of dietary calcium absorption by the intestine indirectly via the vitamin D3 system activation of enterocyte activity. Within the kidney, PTH directly stimulates calcium reabsorption and a phosphate diuresis. 

Vitamin Dj, through its active metabolite, 1,25-(0H)2D3, also plays an important role in maintaining calcium homeostasis by enhancing intestinal calcium absorption, PTH-induced mobilization of calcium from bone, and calcium reabsorption in the kidney. 

Large doses of glucocorticoids have been associated with the development of peptic ulcer, possibly by suppressing the local immune response against Helicobacter pylori. They also promote fat redistribution in the body, with increase of visceral, facial, nuchal, and supraclavicular fat, and they appear to antagonize the effect of vitamin D on calcium absorption. The glucocorticoids also have important effects on the hematopoietic system. In addition to their effects on leukocytes, they increase the number of platelets and red blood cells. 

Cholecalciferol Regulate gene transcription via the vitamin D receptor Stimulate intestinal calcium absorption, bone resorption, renal calcium and phosphate reabsorption decrease parathyroid hormone (PTH) promote innate immunity inhibit adaptive immunity Osteoporosis, osteomalacia, renal failure, malabsorption Hypercalcemia, hypercalciuria the vitamin D preparations have much longer half-life than the metabolites and analogs... 

The administration of a small dosis of 1.25-dihydroxycholecalciferol normalizes calcium absorption, but not bone mineralization556,557. EHDP might inhibit the renal 1-hydroxylase directly553, 558. The EHDP-induced inhibition of 1.25-(OH)2D3 production has been shown to be reduced by a low Ca diet or by vitamin D deficiency554, 55S. The influence of EHDP on the renal 1-hydroxylation is indirect and dependent on dietary vitamin D, calcium, and phosphorus559. ... 

Vitamin D is the most toxic of all vitamins. Like all fat-soluble vita mins, vitamin D can be stored in the body and is only slowly metab olized. High doses (100,000 IU for weeks or months) can cause loss of appetite, nausea, thirst, and stupor. Enhanced calcium absorption and bone resorption results in hypercalcemia, which can lead to deposition of calcium in many organs, particularly the arteries and kidneys. 

Milk is one of the best dietary sources of calcium, not only because of the significant quantity of the mineral present but also because of (1) its calcium-to-phosphorus ratio (1.3 1), which is conducive to optimal skeletal growth, and (2) the presence of nutrients such as lactose and vitamin D in vitamin D-fortified milk, which promote calcium absorption (Ziegler and Fomon 1983 Schaafsma 1983 Renner 1983). 

With normal exposure to sunlight enough 7-dehydrocholesterol is converted to cholecalciferol in the skin that it was concluded that no dietary vitamin D is required by most adults except during pregnancy. However, recently it has been recognized that old and sick adults probably need 400-600 I.U. per day to maintain calcium absorption arid to prevent osteoporesis and fractures/ " 1 It is usual-... 

Vitamin D action antagonized by cortisol by reducing calcium absorption in intestine... 

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