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The average adult human body contains about 1 kg of calcium, 99% of which resides in the skeleton in the form of hydroxyapatite and 1% of which is found in soft tissues and the extracellular space. Since calcium plays a critical role in neuromuscular function, blood coagulation, and intracellular signaling, circulating calcium concentrations are maintained within a very tight physiologic range (about 9 to 10 mg/dL [2.25 to 2.5 mmol/L]).

Ionized calcium concentration is closely regulated by two separate but related hormone systems: parathyroid hormone (PTH) and 1,25-dihydroxycholecalciferol (1,25(OH)2D3), or calcitriol.

These data suggest that 1,25-dihydroxycholecalciferol is able to increase bone resorption independently of parathyroid hormone

Bone resorption is the process by which osteoclasts break down bone and release the minerals, resulting in a transfer of calcium from bone fluid to the blood.

so, you take vitamin d3 at high levels, and it releases more calcium from your skeleton. unless it already has some handy in the blood because you supplemented.

Natl Med J India. 2003 Nov-Dec;16(6):298-302.
Comment in:
Natl Med J India. 2003 Nov-Dec;16(6):294-7.
Natl Med J India. 2004 Jan-Feb;17(1):55-6.
Natl Med J India. 2004 Mar-Apr;17(2):114; author reply 114-5.
Bone mineral parameters in healthy young Indian adults with optimal vitamin D availability.

BACKGROUND: Several recent studies indicate a marked prevalence of vitamin D deficiency in asymptomatic, apparently healthy urban subjects from different socioeconomic groups in north India. METHODS: To further examine this trend, we studied 40 men and 50 women, 20-30 years of age, from the Indian paramilitary forces. These individuals consume a nutritious, high-protein diet, have optimal exposure to sunlight and undertake strenuous outdoor physical exercise. RESULTS: The mean serum calcium, phosphorus and alkaline phosphatase levels were normal in both men and women. The mean (SD) serum intact parathyroid hormone and 25-hydroxyvitamin D3 levels were 19.3 (8.2) pg/ml and 18.4 (5.3) ng/ml in men, and 11.9 (6.6) pg/ml and 25.3 (7.4) ng/ml in women. Bone mineral density estimated in 20 men and 22 women revealed that in comparison with white Caucasians, 35%-50% of men and 14%-32% of women were osteopenic at different sites, while an additional 10% of men had osteoporosis of the lumbar spine. CONCLUSION: We found that with optimal nutrition, good sunlight exposure and regular physical exercise, healthy young individuals have normal bone and mineral biochemical values. The reasons for the abnormalities detected in bone mineral density in them needs further study. The impact of childhood nutrition on accumulation of peak bone mass may contribute to our findings. There is a need for establishing normative bone mineral density data for Indians.

Use of vitamin D in clinical practice.

Cannell JJ, Hollis BW.

Director, Vitamin D Council. Correspondence address: 9100 San Gregorio Road, Atascadero, CA 93422 Email: jjcannell@gmail.com.

The recent discovery - from a meta-analysis of 18 randomized controlled trials - that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) is the only way to make the diagnosis and to assure treatment is adequate and safe. Three treatment modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D3 supplementation. Treatment of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin D per day should be sufficient to maintain year-round 25(OH)D levels between 40-70 ng per mL. In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25(OH)D levels between 55 -70 ng per mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH)D and serum calcium. Vitamin D should always be adjuvant treatment in patients with serious illnesses and never replace standard treatment. Theoretically, pharmacological doses of vitamin D (2,000 IU per kg per day for three days) may produce enough of the naturally occurring antibiotic cathelicidin to cure common viral respiratory infections, such as influenza and the common cold, but such a theory awaits further science.

PMID: 18377099 [PubMed - in process]

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