Sunshine

vitamin

D r. Vi j a y M a r a k a l a , MBBS, MD.
Assistant

professor
BI O CHEMISTRY
SIMS & RC
Chemistry Sources RDA Metabolism

Functions Deficiency Toxicity

 Vitamin D is a sterol

PROVITAMIN VITAMIN
Vitamin D3
7- Dehydrocholesterol
[Cholecalciferol
]
Vitamin D2
Ergosterol
[Ergocalciferol]
 200 – 400 IU /day
[5 – 10µg/day]

1microgram of vitamin D = 40 International Units

 ABSORPTION

Forms Site Mechanism

Along with
D3
Upper small lipids
intestine Requires
D2
bile
salts
TRANSPORT

Binding to vitamin D
binding globulin
 Synthesis of active form of vitamin D

ACTIVE FORM 1, 25-dihdroxy cholecalciferol or calcitriol

1- α- hydroxylase
Calcitriol is the biologically active form of
vitamin D

Regulation of plasma
calcium and
phosphorus
 Action of Action of Action of
calcitriol on calcitriol on calcitriol on
the intestine the bone the kidney
Action of calcitriol on the
intestine
• Increases the intestinal absorption
of calcium and phosphate
• By increased synthesis of calcium
binding protein
Action of calcitriol on the bone
• Mineralization of bone at low doses
• Mobilization of calcium from bone at high doses
Action of calcitriol on the
kidney
• Increased reabsorption of
calcium and phosphorus
• Decreased excretion of calcium
and phosphorus
Causes Inadequate supply

Impaired absorption

Impaired production of 25hydroxy vitamin D3

Impaired production of 1, 25 dihydroxy vitamin D3

Resistant to the effects of 1, 25 dihydroxy vitamin D3

CLINICAL FEATURES

Children
Children

Adults
Rickets
Adults Osteomalacia
Features Delayed milestones
Delayed closure of anterior fontanelle
Delayed dentition
Deformities of bones
Decreased serum calcium
Bone Craniotabes
deformities
Frontal bossing
Rachitic rosary
Pegion chest
Knocked knee
Bowed legs
Frontal bossing
Bowed legs –
Characteristic of
rickets

Fig. 7-5a, p. 222

Beaded ribs –

Characteristi
c of rickets

Fig. 7-5b, p. 222

Rachitic rosary
Causes Inadequate exposure to sunlight
Inadequate dietary intake

Features Demineralization occurs mainly in spine, pelvis

and lower extremities

Increased softness & susceptibility to fracture

Bowing of long bones
Causes

Over ingestion

Features
Hyper calcemia
Metastatic calcification