This document discusses calcium and phosphorus metabolism and disorders related to their imbalance. It notes that hypercalcemia and hypercalciuria can lead to kidney stones. Phosphorus is the second most abundant mineral in the body after calcium, and its levels are regulated by hormones like vitamin D, calcitonin, and parathyroid hormone. An imbalance can result in disorders like osteomalacia and osteoporosis. Osteomalacia is caused by vitamin D or phosphorus deficiency and results in softening of bones. Osteoporosis is caused by calcium or estrogen deficiencies and results in reduced bone density and mass. Risk factors, signs, treatments, and prevention strategies are described.

1.  Hypercalcemia (excess calcium in the blood)
 Hypercalcinuria (excess calcium in the urine)
 Kidney stones (result in high levels of calcium
in the serum and urine calcification of soft
tissues)
 Hyperparathyroidism

2.  One of the most essential elements of the
body
 Available in all foods of plant and animal
origin
 Second most abundant mineral in body, after
calcium
 >600 g of phosphorus in the normal human
body, 80-90% combined with calcium to form
bones and teeth

3.  Dietary phosphorus intake : 1.5 g/day
 Phosphorus balance is regulated by the
metabolic and hormonal factors vitamin D,
calcitonin, parathyroid hormone
 Amount of phosphorus in the body is
controlled by excretion in the urine rather
than by absorption

4.  Major functions:
-formation of bone and tooth mineral
-production and transfer of high-energy phosphates
 Plays a role in absorption and transport of nutrients
 Regulates the acid-base balances
 Plays an important role in cell protein synthesis (part
of the nucleic acids DNA and RNA, the substances
that control heredity)
 Buffers in blood and tissue (chemicals that prevent
change in the concentration of other chemicals)

5.  Attachment of phosphate to the matrix of bone
and teeth is one of the initial steps in their
mineralization
 Failure of bone calcification results from a lack of
phosphorus as often as from a lack of calcium
 Increase in serum alkaline phosphatase is
associated with poor bone calcification as seen
in rickets (vitamin D deficency disease resulting
in bone deformities) and osteomalacia
(softening of the bone in adults)

6.  Intakes of 800 to 1200 mg of phosphorus daily
are recommended
 Animal foods rich in protein are also rich in
phosphorus (meat, fish, poultry, eggs and milk)
 Nuts, legumes and whole-grain cereals are also
good sources of phosphorus
* Excess dietary phosphorus in animals will increase bone loss
and bone porosity (significantly decrease bone mineral and
cause calcification of the kidney, tendons, heart and thoracic
aorta)

7.  A condition in which the rate of bone
resorption is greater than the rate of bone
formation, resulting in decreased bone
density and a reduction in the total bone
mass
 Caused by deficiencies of calcium and
estrogen hormone

8. OSTEOMALACIA OSTEOPOROSIS
 Abnormal organic matrix formation
 Abnormal bone calcification
 Due to:
 Due to:
-deficiencies of calcium and estrogen
- deficiency of Vitamin D,
 Results in:
Calcium and phosphates
-decreased ossification (forming
 Results in:
activity)
- excessive uncalcified osteiod
-mineral composition of bone remains
-Abnormal bone mineral
normal
composition
 Clinical Manifestations:
 Clinical Manifestations:
-hip and back pain
-weakness
-decreased height
-aching
-tendency to bone fracture
 Treatment
 Treatment
-dietary calcium and vitamin D
-estrogens, protein, calcium, vitamin D
and fluoride

9.  Heredity
 Smoking
 Alcohol
 Coffee(5 or more cups daily)
 Low calcium intake
 Certain levels of hormones, PTH, calcitonin,
estrogen, androgen, insulin, growth
hormone, throid hormones, protein
 Drugs like phenytoin (anticonvulsant) and
phenobarbital

10.  Osteoporosis occurs most commonly in older
people, >60 age
 Osteoporotic individuals tends to have a
lower intake and a higher urinary excretion of
calcium than normal persobs
 Loss of height because of shortening of the
trunk and collapsed of the vertebrae

11.  Ingestion of high calcium diets , estrogen,
fluoride, calcitonin, PTH, active form of
vitamin D
 Estrogen and diet: reduces vertebral, hip and
forearm fractures
 Fluoride: large doses of fluoride can stimulate
bone formation
 Calcitonin: can increase bone mass
 PTH increases with age, also found to
increase bone mass