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Updated: Sep 19 2019

Vitamin D

Images d.jpg
  • Introduction
    • Calcium homeostasis controlled by a combination of
      • Vitamin D pathway (this topic)
      • PTH pathway
  • Vitamin D Pathway
    • Synthesis
      • vitamin D3
        • synthesized in skin from sun exposure
      • vitamin D2
        • ingested from plants in the diet
      • both are prehormones that must be converted in 2 steps
        • 25-hydroxylation in liver
        • 1-hydroxylation in the peritubular capilliaries of the kidney
      • only 1,25-(OH)2 vitamin D is active
      • 24,25-(OH)2 vitamin D is an inactive form
    • Function
      • ↑ serum Ca2+ and phosphate via
        • ↑ absorption of calcium and phosphate from the intestine
        • ↑ bone resorption of Ca2+ and phosphate
      • recall PTH functions to ↑ serum Ca2+ but ↓ serum phosphate
    • Regulation
      • PTH stimulates 1,25-(OH)2 vitamin D production
      • hypocalcemia/hypophoshatemia stimulates 1,25-(OH)2 vitamin D production
      • 1,25-(OH)2 vitamin D feedback negatively on itself
    • Pathology
      • rickets / osteomalacia
  • Clinical Conditions
    • Hypoparathyroidism
    • Hyperparathyroidism
    • Rickets
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