[dropcap]C[/dropcap]alcium is the most abundant mineral in the body, with 99% residing in teeth and bones where it constitutes 40% of skeletal bone weight along with 45% phosphorus.
As a component of hard tissues, calcium fulfills a structural role to maintain body size and acts as attachments for musculoskeletal tissues.
Q: What does the non-skeleton calcium do in the body?
A: The remaining 1% of calcium is present in blood and soft tissues. Calcium levels in the blood are maintained within very strict limits by dietary intake, hormonal regulation and a rapidly exchangeable pool in bone tissue. The many important functions are described below.
What Is Calcium Deficiency In Celiac Disease and/or Gluten Sensitivity?
[dropcap]V[/dropcap]itamin D is the principle regulator of calcium homeostasis (balance) in the body. This “vitamin” is really a prohormone, meaning it acts like a hormone but is not. Vitamin D does, however, contain cholesterol in its molecular structure like steroid hormones.
The physiological importance of vitamin D encompasses much more than the regulation of bone metabolism although this is a mighty function.
Q: How does vitamin D regulate bone metabolism?
A: In regulation of bone metabolism, vitamin D works in three ways: 1) enables active absorption of calcium from the small intestine, 2) enhances reabsortion of calcium by the kidneys that would otherwise be excreted in urine, and 3) plays an active role in skeletal development and bone mineralization. Mineralization gives strength to living bone tissue.
Vitamin D interacts with receptors within cells to effect transcriptional changes in many cell types including those in gut, bone, breast, prostate, brain, skeletal muscle, and the immune system.1
In regards to the essential role of vitamin D in muscle tissue, it has been recently shown that vitamin D regulates both muscle function and structure of primary myofibers.2
Vitamin D is converted in the body to a molecule that is biologically active. The active form is 1,25-dihydroxyvitamin D, usually referred to as vitamin D3. About 80% comes from sun exposure and the remaining from food.
Vitamin D3 is synthesized in the skin from 7-dehydrocholesterol via photochemical reactions requiring UV light (sunlight). That is, light that contains energy from the sun is incorporated into molecules of 7-dehydrocholesterol in the underlying dermis of skin to make this vitamin. This is why inadequate exposure to sunlight contributes to vitamin D deficiency.
Blood concentration of 25(OH)D is the best indicator of vitamin D status. It reflects vitamin D produced in the skin and that obtained from food and supplements and has a fairly long circulating half-life of 15 days.3
What Is Vitamin D Deficiency In Celiac Disease and/or Gluten Sensitivity?
Sources:
McCarty DE, Chesson AL Jr, Jain SK, Marino AA. The link between vitamin D metabolism and sleep medicine. Sleep Med Rev. 2014 Aug;18(4):311-9. doi: 10.1016/j.smrv.2013.07.001. [↩]
Girgis CM, Mokbel N, Cha KM, Houweling PJ, Abboud M, Fraser DR, Mason RS, Clifton-Bligh RJ, Gunton JE. The vitamin D receptor (VDR) is expressed in skeletal muscle of male mice and modulates 25-hydroxyvitamin D (25OHD) uptake in myofibers. Endocrinology. 2014 Sep;155(9):3227-37 [↩]
[dropcap]P[/dropcap]hosphorus is an essential mineral present in every cell of the body mostly in the form of phosphate.
About 85% of phosphorus is present in bone making up a major component of bone formation. As a component of calcium phosphate, phosphorus constitutes 45% of skeletal bone weight while calcium constitutes 40% to support the body.1.
Phosphorus is required for normal tooth development. Inadequate phosphorus in early childhood development makes for defective tooth enamel in permanent teeth.
Phosphorus is crucial for the production of ATP (adenosine triphosphate), a molecule within cells that the body uses to store energy, and is required for production of phosphocreatine to power muscles. Functions are more fully described below.
One gram of protein in food provides approximately 15 mg of phosphorus. In an adult, the body content of phosphorus ia about 700 grams.
What Is Phosphorus Deficiency In Celiac Disease and/or Gluten Sensitivity?
Rickets With Characteristic Bowed Legs In A Young Child. Courtesy of Wikipedia
What Is Rickets?
[dropcap]R[/dropcap]ickets is a disorder of cartilage cell growth and enlargement of epiphyseal growth plates in young children that is characterized by inadequate mineralization of developing cartilage and newly formed bone.
The epiphyseal growth plate is located at the ends of the long bones of the arms and legs and controls the growth of these bones. Enlargement of the plate area gives the physical appearance of thick joints at the wrists, knees, and ankles.
Q: What is inadequate mineralization of bone tissue?
A: Inadequate mineralization means there is not sufficient calcium, magnesium, phosphorus and other minerals available to give bone that is replacing cartilage in a young child its necessary strength during the period of enchondral bone formation. Consequently, long bones bend under the weight of the body and become deformed.
Children 4 to 18 months of age worldwide are at risk of developing rickets.
What Is Rickets In Celiac Disease and/or Gluten Sensitivity?
Parathyroid Glands in the Neck. Courtesy Wikipedia.com
What Is Secondary Hyperparathyroidism?
[dropcap]S[/dropcap]econdary hyperparathyroidism is a parathyroid disorder resulting from hypocalcemia (low blood calcium level) that is characterized by excessive production of parathyroid hormone in the attempt to normalize the low blood calcium by releasing calcium from bone.
Parathyroid hormone is produced by the four pea sized parathyroid glands that are located on the thyroid gland in the front of the neck. In part, because the thyroid and parathyroid glands share the same anatomic place in the body and because they have similar names, they are often confused although they have completely different actions.
Parathyroid hormone regulates calcium and the opposing mineral phosphorus in the blood. In secondary hyperparathyroidism, calcium blood levels are low to normal while phosphorus levels are increased which stimulates the outpouring of parathyroid hormone.
Q: How does secondary hyperparathyroidism differ from primary hyperparathyroidism?
A: In primary hyperparathyroidism blood calcium is high and phosphorus is low, which is the opposite of secondary hyperparathyroidism.
The most common cause of secondary hyperparathyroidism is kidney disease causing failure to reabsorb calcium followed by vitamin D deficiency and malabsorption.
What Is Secondary Hyperparathyroidism In Celiac Disease and/or Gluten Sensitivity?
[dropcap]F[/dropcap]ailure to thrive (FTT) and growth retardation are conditions affecting children characterized by weight consistently below the 3rd percentile for age or a decrease in the expected rate of growth based on the child’s previously defined growth curve, irrespective of whether below the 3rd parcentile.1
Q: Why do failure to thrive and growth retardation occur?
A: Failure to thrive and growth retardation occur because there is inadequate nutrition for weight gain and growth to occur.
What Is Failure To Thrive And Growth Retardation In Celiac Disease and/or Gluten Sensitivity?
Sources:
Arnason JA, Gudjonsson H, Freysdottir J, Jonsdottir I, Valdimarsson H. Do adults with high gliadin antibody concentrations have subclinical gluten intolerance? Gut. 1992 February; 33(2): 194–197. [↩]
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What Is Calcium?
