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Maintaining Calcium Levels in the Bone The body uses the bones not only for structure and protection, but also for calcium storage. Approximately 99 percent of the body's calcium is stored in the bone, and calcium plays an important role in most of the body's functions. Free calcium levels must remain at a set point for proper body functions. The extracellular levels of calcium are affected by calcium intake from foods, excretion of calcium as waste, and the storage and release of calcium from the bones. Hormones regulate these processes to maintain balanced calcium levels in the extracellular fluid, which is necessary to maintain homeostasis. Small changes in blood calcium levels can have significant effects on body function. For example, if extracellular calcium levels are too low, the nervous system becomes overexcited, resulting in tetany (rigid, locked muscles). On the other hand, if calcium levels in the body are above normal, the nervous system becomes sluggish. Muscle activity of the heart and gastrointestinal tract slows down. Milk and dark green vegetables are rich in calcium, and an adequate supply of calcium helps maintain healthy bones. When we eat calciumrich foods, some calcium is absorbed into the small intestinal wall, and some of the calcium becomes soluble in the blood stream. However, calcium and other divalent cations (ions that are missing two electrons) are poorly absorbed by the small intestine. For this reason, vitamin D is an important dietary supplement. Vitamin D increases calcium absorption in the small intestine. By altering the function of the osteoblasts and osteoclasts, hormones help regulate calcium levels in the blood. There are three hormones that control osteoblast and osteoclast activity: • parathyroid hormone or PTH, which increases bone resorption by stimulating osteoclasts, leading to increased calcium release from bone. • • calcitonin, which acts in children to decrease bone resorption, leading to less calcium entering the blood. calcitriol, (vitamin D) which increases absorption of dietary calcium. Parathyroid hormone (produced in the parathyroid glands) controls extracellular calcium by regulating how calcium is reabsorbed in the intestines, excreted from the body, and exchanged between the extracellular fluid and the bone. The cells of the parathyroid gland synthesize and release parathyroid hormone in response to low blood calcium levels. To bring blood calcium levels into the normal range, the release of parathyroid hormone stimulates osteoclasts to reabsorb bone mineral, therefore releasing calcium into the blood. Parathyroid hormone also enhances calcium absorption by the intestines, and prevents calcium loss in urine to increase calcium levels in the blood. When parathyroid cells sense that blood calcium levels are above normal, cellular receptors are activated and the synthesis and release of parathyroid hormone is inhibited. Calcitonin is produced in the thyroid gland. The function of this hormone is to decrease bone resorption and retain calcium in the bones. Therefore, the effects of calcitonin counteract the effects of parathyroid hormone. When blood calcium levels are high, the thyroid releases calcitonin into the blood. Calcitonin decreases bone resorption by decreasing the activity of osteoclasts and decreasing the formation of new osteoclasts. In this way, calcitonin shifts the bone balance in favor of bone deposition, which requires the removal of calcium from the blood and into the bone. Calcitonin also has minor effects on how the intestines and kidney tubules handle calcium. In adult humans, calcitonin has weak effects on the regulation of calcium levels. We know this because if the thyroid gland is removed, calcium levels are not adversely affected.