From the dietary calcium consumed, approximately 30% to 60% is absorbed. The ileum is the most important site of calcium absorption. Prolonged deficiency or affluence in this range can result in various side effects.
When serum calcium levels go below 8.5mg/dl, it is considered ‘hypocalcemia,’ which is a calcium deficiency disorder. The symptoms include the following:
Osteoporosis and osteopenia
Weak bones, teeth, and nails
Numbness and tingling sensation in feet and hands
Poor calcium intake, restrictive dietary patterns, hormonal fluctuations, certain medications, and medical conditions can cause calcium deficiency.
Excess calcium is usually excreted from the body. Kidneys are the main site of calcium excretion. About 100 to 200 mg of calcium is excreted in the urine in normal adults. A high amount of calcium in the blood is called ‘hypercalcemia,’ which is rare. The symptoms include nausea, vomiting, lethargy and muscle weakness, and kidney stones.
Balance of calcium
Maintaining the serum calcium level in the blood is done by various hormones. such as:
Para thyroid hormone (PTH)
PTH and calcitonin are produced in the thyroid, whereas calcitriol is produced by the kidneys. Calcitriol is a form of active vitamin D, which is a long-term regulator of calcium in the body. Calcium levels can be controlled by factors, such as absorption, bone mineralization, and excretion. The concentration of calcium is maintained by tweaking these factors, which are monitored by the hormones. Calcium balance is maintained by balancing calcium absorption from the intestines, calcium transport into and out of the bones and teeth, and calcium resorption and excretion by the kidneys.
When the serum calcium level drops, the parathyroid glands release PTH into the blood. The PTH sends a signal to the bone cells called osteoclasts, which release calcium from the surface of the bones. PTH also sends signals to the kidneys to reabsorb more calcium before it gets excreted in the urine. Some of the calcium is bound to phosphate, which makes it unavailable. Hence, the PTH also stimulates the excretion of phosphate. Kidneys are also the site where the inactive form of vitamin D is converted to active vitamin D3. Vitamin D3 is said to enhance calcium absorption. Thus, an increase in calcium levels is achieved.
When the calcium and vitamin D levels increase, the thyroid secretes more calcitonin, which disrupts the function of osteoclasts. The body also increases phosphate reabsorption and calcium excretion in the kidneys. This results in a reduction of calcium levels. This regulation of calcium levels is made every minute, by an orchestra of hormones, with the parathyroid gland as the head. Thus, homeostasis is achieved.
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