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Calcium Absorptive Effects of Vitamin D and Its Major Metabolites¹

Creighton University (R.P.H.), John A. Creighton University Professorship, School of Medicine (M.J.B.-L.), Osteoporosis Research Center, and School of Nursing (M.S.D.), Omaha, Nebraska 68131; Boston University Medical Center, Vitamin D Research Laboratory (T.C.C., M.F.H.), Boston, Massachusetts 00000

Address all correspondence and requests for reprints to: Robert P. Heaney, M. D., Creighton University, 601 North 30th St., Suite 4841, Omaha, Nebraska 68131.

The absorptive response to graded doses of vitamin D₃, 25(OH)D, and 1,25(OH)₂D was measured in healthy adult men after treatment periods of eight, four, and two weeks, respectively. While no relationship was found between baseline absorption and serum vitamin D metabolite levels, all three vitamin D compounds significantly elevated ⁴⁵Ca absorption from a 300 mg calcium load given as part of a standard test meal. 1,25(OH)₂D was active even at the lowest dose (0.5 µg/day), and the slope was such that doubling of absorption would occur at an oral dose of approximately 3 µg/day. 25(OH)D was also active in elevating absorption and did so without raising total 1,25(OH)₂D levels. On the basis of the dose response curves for 1,25(OH)₂D and 25(OH)D, the two compounds exhibited a molar ratio for physiological potency of approximately 100:1. The absorptive effect of vitamin D₃ was seen only at the highest dose level (1250 µg, or 50,000 IU/day) and was apparently mediated by conversion to 25(OH)D. Analysis of the pooled 25(OH)D data from both the 25(OH)D- and vitamin D₃-treated groups suggests that approximately one eighth of circulating vitamin D-like absorptive activity under untreated conditions in winter may reside in 25(OH)D. This is a substantially larger share than has been predicted from studies of in vitro receptor binding.

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