MINERAL METABOLISM

- SHIVANAND
 Define minerals, classify and mention biological roles of
minerals…..,,,,

• Minerals are inorganic substances which occur in nature and are

required in small amounts for the normal growth and functioning of the
body.
 CLASSIFICATION:

Major elements Trace elements

(Requirement is > 100 mg/day) (Requirement is <100 mg/day)
{Ca,P, Mg, Na, K, Cl and S} {Iron, copper, iodine, manganese, zinc,Mo,Se}
 Biological Role:
• Though the minerals occurs in smaller amounts they play crucial role
in several body functions viz.,
o Mineralisation of bones.
o Acid-base balance.
o Neuromuscular function.
o Osmotic regulation.
o Blood coagulation.
 I. Calcium:

• Most abundant among minerals.

• adult- 1 to 1.5 kg
• Majorly(99%) present in the bones and teeth and a small fraction (1%)
found outside the skeletal tissue and performs a wide variety of functions.
Mention the Biochemical functions, RDA & Dietary sources of Ca 2+..,,,,
Biochemical Functions:-
1. Formation of bone and teeth:- 99% of the body’s calcium is present in bone & teeth in
the form of hydroxyapatite crystal due to which bone and teeth are hard & rigid.
2. Blood coagulations: Calcium present in platelets involved in blood coagulation, the
conversion of an inactive protein prothrombin into an active thrombin requires calcium
ions.
3. Muscle contraction: Muscle contraction is initiated by the binding of calcium to
troponine.
4. Release of hormones: The release of certain hormones like parathyroid hormone,
calcitonin, etc. requires calcium ions.
5. Release of neurotransmitter: Influx of Ca2+ from extracellular space into neurons causes
release of neurotransmitter.
6. Regulation of enzyme activity: Activation of number of enzymes requires Ca2+ as a
specific cofactor.
For example: 1. Activation of enzyme glycogen phosphorylase kinase which then
triggers glycogenolysis.
2. Activation of salivary and pancreatic α-amylase.
7. Second messenger: Calcium acts as a second messenger for hormone action. For
example, it acts as a second messenger for epinephrine and glucagon.
8. Membrane excitability: Calcium ions activate the sodium channels.
Deficiency of calcium ions lead to decreased activity of Na-channels, which ultimately
leads to decrease in membrane potential so that the nerve fiber becomes highly excitable
causing muscle tetany.
9. Cardiac activity: - Cardiac muscle depends on extracellular Ca2+ for contraction.
Myocardial contractility increases with increased Ca2+ concentration and decreases with
decreased calcium concentration.
10. Membrane integrity and permeability: Calcium is required for maintenance of integrity
and permeability of the membrane.
11. Hydrolysis of casein of milk: Calcium is required for the formation of Ca-paracaseinate
(insoluble curd).
• Dietary sources:
• The Best dietary sources of calcium are milk and dairy products, (half a liter of milk
contains approximately 1,000 mg of calcium) cheese, cereal grains, legumes, nuts and
vegetables.
• Good sources are Beans, leafy vegetables, fish, cabbage, egg yolk.
• Recommended dietary allowance (RDA) per day
• Infants: 300–500 mg/day.
• Child: 1200 mg/day.
• Adults: 500 mg/day.
• Women during pregnancy and lactation : 1200 mg/day and a child about day.
• After the age of 50, there is a general tendency for osteoporosis, which may be prevented
by increased calcium (1500 mg/day) plus vitamin D (20 mg/day).
 Write a note on Ca Absorption & factors affecting it..,,
•Absorption-
•Calcium is taken in the diet principally as calcium phosphate, carbonate and tartarate.
•About 40% of average daily dietary intake of Ca is absorbed from the gut.
•Calcium is absorbed mainly from the duodenum and first half of jejunum against electrical
and concentration gradients.
•MECHANISM-
•Two mechanisms have been proposed for absorption of calcium by gut mucosa.

1. Simple diffusion
2. An “active” transport process involving energy and Ca++ pump.
Both the processes require 1, 25-di hydroxy-D3 (calcitriol) which regulates the synthesis of
Ca-binding proteins and transport and also a Ca++- dependent ATPase.
 Factors that stimulate calcium absorption

1. Vitamin D stimulates absorption of calcium from intestine by inducing the synthesis of

calcium binding protein, necessary for the absorption of calcium from intestine.
2. Parathyroid hormone (PTH) stimulates calcium absorption indirectly via activating
vitamin D.
3. Acidic pH: Since, calcium salts are more soluble in acidic pH, the acidic foods and
organic acids (citric acid, lactic acid, pyruvic acid, etc.) favors the absorption of calcium
from intestine.
4. High protein diet favor the absorption of calcium. Basic amino acids, lysine and
arginine increase calcium absorption.
5. Lactose is known to increase the absorption of calcium, by forming soluble complexes
with the calcium ion.
 Factors that inhibit calcium absorption:

1. Phytates and Oxalates bind dietary calcium forming insoluble salts which cannot be
absorbed from the intestine.
2. High fat diet decreases the absorption of calcium. High amounts of fatty acids derived
from hydrolysis of dietary fats react with calcium to form insoluble calcium soaps which
cannot be absorbed.
3. High phosphate content in diet causes precipitation of calcium as calcium phosphate
and thereby lower the ratio of Ca: P in the intestine.
4. High fiber diet decreases the absorption of calcium from intestine.
• Excretion - through the kidneys but mostly by way of the small intestine through
feces. Small amount of calcium may also be lost in sweat.
Mention the normal Plasma Ca level & write a note on it’s regulation….,,,,
• The plasma calcium concentration in normal individual is 9–11 mg/dL.

• About half of this (5 mg/dl) is in the ionized form which is functionally the most active .
• At least 1 mg/dl serum Ca is found in association with citrate and/or phosphate.
• About 40% of serum Ca (4-5mg/dl) is bound to proteins, mostly albumin and, to a lesser
extent, globulin.
• Ionized and citrate (or phosphate) bound Ca is diffusible from blood to the tissues
• while protein bound Ca is non-diffusible.
 • Regulation of Plasma Calcium Level : Depend on

Function of three Main organs Function of three main hormones Four major processes
Bones PTH Absorption of calcium from the intestine,
mainly through the action of vitamin D.

Kidneys Vit D Reabsorption of calcium from the kidney,

mainly through the action of parathyroid
hormone and vitamin D.

Intestine Calcitonin Demineralization of bone mainly through

action of parathyroid hormone, but
facilitated by vitamin D.

Mineralization (calcification) of bone

through the action of calcitonin.
 Role of parathyroid hormone (PTH)
• It is secreted by the parathyroid in response to drop in the blood calcium level. It acts on
two main target organs, bone and kidney and indirectly on intestine via activation of
vitamin D to increase the plasma calcium concentration.
• Action on bone: PTH stimulates mobilization of calcium and phosphate from bones by
stimulating osteoclast activity. Osteoclast activity results in demineralization of the bone.
• Uptake of calcium and phosphate by bone is also decreased by PTH resulting in an
increase in blood calcium and phosphate level.
• Action on kidney: In kidney PTH increases the tubular reabsorption of calcium and
decreases renal excretion of calcium.
• PTH increases excretion of phosphate by inhibiting its renal reabsorption.
• Action on intestine: Action of PTH on intestine is indirect via the formation of calcitriol,
active form of vitamin D.
• PTH stimulates the production of calcitriol. Calcitriol then increases absorption of calcium
from intestine.
 Role of vitamin D (calcitriol):
• It is the active form of vitamin D, which causes the increase in plasma calcium and
phosphate concentration by stimulating the following processes:
- Absorption of calcium and phosphorus from intestine by inducing synthesis of calcium
binding protein necessary for the absorption of calcium from intestine.
- Reabsorption of calcium and phosphorus from the kidney.
- Mobilization of calcium and phosphorus from the bone.
• Thus, overall effects of PTH and calcitriol elevate plasma calcium and phosphate level.
 Role of Calcitonin:
• Role of Calcitonin: The secretion of calcitonin (By thyroid) is stimulated by increase in
blood calcium level.
• Action of calcitonin on the bones is opposite to that of the PTH. It inhibits calcium
mobilization from bone and increases bone calcification (mineralization) by increasing
the osteoblasts activity.
• In the kidney it stimulates the excretion of calcium and phosphorus, thereby decreasing
the blood calcium level.
Regulation of Ca
 Discuss the Clinical Conditions Related to Plasma Calcium Level Alterations..,,
• Hypocalcemia - characterized by lowered levels (<7mg/dL) of plasma calcium.
• Causes:-
1). Hypoparathyroidism: The commonest cause of hypoparathyroidism is neck
surgery, ,removal of thyroid and magnesium deficiency.
2). Vitamin D deficiency: This may be due to dietary deficiency, malabsorption or fail to
synthesize calcitriol due to impaired hydroxylation.
• Clinical features of hypocalcemia
 Neuromuscular irritability.
 Neurologic features such as tingling, tetany, numbness (fingers and toes).
 Muscle cramps.
 Cardiovascular signs such as an abnormal ECG.
• Rickets(Children)
• Rickets is a disorder of defective calcification of bones. This may be due to a low levels of
vitamin D in the body or due to a dietary deficiency of Ca and P —or both. The
concentrations of serum Ca and P may be low or normal.

• Osteoporosis (Elders)
• Osteoporosis is characterized by demineralization of bone resulting in the progressive loss
of bone mass.
 Hypercalcemia
• Increased plasma calcium level is known as Hypercalcemia.
• Causes of hypercalcemia are
- Hyperparathyroidism
- Malignant disease.

• Clinical features of hypercalcemia

• Neurological symptoms such as depression, confusion, inability to concentrate.
• Muscle weakness, Gastrointestinal problems such as anorexia, abdominal pain, nausea and
vomiting and constipation.
• Renal features such as polyuria and polydypsia.
• Cardiac arrhythmias.
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