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