Endocrinology - Calcium and Phosphate Regulation

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[@MelbourneMaster]

If you're looking for a few extra steps and more in-dept: The precursers of vit D comes from foods (like oily fish; D3), plants (D2) and the sun D3. In the skin the suns UV-rays converts 7-dehydrocholesterol into cholecalciferol D3 (done non-enzymatically by heat). Cholecalciferol then moves into the liver (transported from the skin by vitamin D-binding-protein (DBP), and by cholemicrons from the diet) for the first part of its activation. Here it is converted by the enzyme (cytochrome P-450-based enzyme) into 25-hydroxy vit D3 (25-OH-D) (calcidiol) the step is called 25-hydroxylation, it then moves to the kidney for its second and last activation. Here the 25-OH-D/DBP complex is taken up at the surface by renal proximal cells by a specific mechanism involving cell surface receptors; megalin and cubulin. In the kidney 25-OH-D is converted to 1,25 dihydroxy vit D (1,25-(OH)2D) (calcitriol) by renal-1α-hydroxylase - this activation is called 1α-hydroxylation (patients with renal failure therefore cannot perform this step). The 1α-hydroxylase comprises 3 proteins: Cyt P-450, a ferredoxin and a ferredoxin reductase for activity. 1α-hydroxylase is strongly downregulated by 1,25-(OH)2D (calcitriol) and strongly upregulated by PTH as a calcium homeostatic loop.

[@KeirDickson706]

This video just taught me more in 11 minutes than my lecturer has in like 235 powerpoint slides :))))))) ur the best

[@user-dd4vo3ik6n]

Exactly 👌🏻

[@kingbobbie5196]

Asweer chale 😂

[@kingbobbie5196]

U dey UG?

[@KeirDickson706]

@@kingbobbie5196 ye

[@kingbobbie5196]

Oh nice... which year?

[@aboutmedicine]

I think its worth mentioning phosphate doesn't need Vitamin D for uptake from the diet. This is part of the reason why in chronic kidney disease, you have low serum calcium but high serum phosphate. The kidney can't make Vitamin D if its diseased, so calcium uptake is not enough, but phosphate can still get across from the intestines into the blood. Cheers Armando you rock by the way : )

[@samuelbenson1]

CKD - Decreased GFR, Kidney cannot excrete enough phosphate, phosphate increases FGF-23 which blocks 1-alpha-hydoxylase. Decrease Calcitriol, decrease intestinal absorption of ca and phosphate, yet kidney cannot excrete enough phosphate so phosphate remains high and binds free calcium. Decreased calcium stimulates increase in PTH, PTH increases bone turnover, leads to metabolic bone disease, pt over time has bone pain, fractures. PTH normally stimulates kidney to lose phosphate, but decreased GFR and kidney injury causes phosphate to not be excreted.

[@zaman54321]

I was looking for this. Thank you so much.

[@pilatesyogataichifit]

Anything apart from kidney disease that causes low serum calcium and high serum phosphate?

[@kelseymcginnis5673]

ahh thank you!

[@MegaEpicdanny]

@@samuelbenson1 saved my life thank you!

[@adnanbashi9793]

You forgot to mention that PTH reduces the reabsorption of phosphate from the proximal tubule of the kidney, which means more phosphate is excreted through the urine!

[@nurkoleptik_art]

Adnan Bashi I think he included that in one of his older videos which is the "bonehomeostasis (calcium phosphate) hormones" video :D

[@bihishtasozan1903]

exactly what i was confused about okay so i did understand the concept

[@nellyhoffman6194]

Thanks adnan

[@cescrosado]

Adnan Bashi that's the fosfaturic action of PTH, exactly!! On the other hand, calcitriol does not do that treating equally calcium and phosphate (reabsobring both of them, PTH only reabsorbed calcium) and so, if there's an excess of calcitriol (vit D), they can precipitate.

[@tonyboroni6949]

not true i have both high phosphate and pth with low low t4 wich i take meds for but nothing i can do for my pth issues so im fct, this condition was missed for years now i have perment bone and liver problems now and heart racing issues.

[@zeynepecearslan4000]

what would i do in med school without your videos

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Zeynep Ece Arslan Tra

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[@windiandini6919]

trueee

[@obviouslytwo4u]

go vegan and work it out for yourself

[@cristymendez9385]

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[@panashechitsike1236]

you are such a lifesaver. this was so clear. cleared a lot of confusion I had on the main hormone that controls bone growth and remodeling. keep up the great work! looking forward to more of your work.

[@chrisland97]

I'm studying this stuff and it's great to see it in easy to see pictures and descriptions/words. And you have pretty impressive hand skills!

[@Nina21_]

this is truly an amazing explanation in a short amount of time compared to long complicated lectures ! thank you so much sir

[@sarasultana9804]

You've got some wonderful content in here!!! I discovered this channel a few weeks ago and my whole study game has changed ever since! Thank you so much @armandohasudungan

[@FlyingPiesOmg]

your endocrinology videos are second to none, great job!

[@dominiquelee3923]

You have a gift of teaching! Your videos are so clear and easy to comprehend! THANK YOU!!!!!!!!

[@Unknown-ft6wz]

1 to 2 hours lecture in just 11 minutes... Thanx a lot....🥰

[@abrahamkinsmanamoakoh4077]

Thank you so much for the presentation and more importantly having a camera focus on all the drawings and labels at the end of the presentation. It helps a lot

[@Partycornchips]

I just love this guys handwriting. It's so regular and consistent.

[@33bien]

yes he is great writer and draws beatifully

[@desifeminism4576]

Truuuuuuuu

[@angelarebelo166]

i had an eyegasm while watching this, also your accent is so good!! tysm for this, i search everywhere for a good video about calcium homeostasis and here i am. tysm for explaining it this way. also, the drawings, i loved them!! thank you thank you

[@iSisiblog]

Thank you so much! Clear and easy to understand - I really loved it!

[@33bien]

Thank You! Finally a good explanation of the calcium system. I wonder why it is often claimed that one cannot feel when bone is decreasing or osteoporosis sets in. The acid that "eats" the bone due to the osteoclast activity must be painful. Acid/nerves=pain.

[@jasminmehrabi4117]

amazingly well explained, thank you!

[@rajeshreggie2396]

Thank you very much , after i watched this video i felt ur the best teacher who can ever exist. you made it soooooooo easy to understand

[@bushrakhalid7688]

This is so amazing, I don't know why I couldn't find it before, but it's really very helpful , Thank you 😊😊

[@user-ld9dk6nd4m]

Brief, clear, and knowledgeable. Keep up the good work.

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I just cant tell how happy i m to find ur channel

[@zeshanansari8720]

Possible Correction: I may be wrong about this but after some researching, I found that C-FMS you mentioned on osteoclast is actually the gene that encodes CSFR-1 which is the receptor on osteoclast. If someone else could also research and confirm or deny this, that would be great! Thanks! Your videos are awesome!

[@dennis.zinner]

definitely very helpful for my upcoming nutritional physiology exam!

[@annaso6747]

Beyond helpful!! Didn't realize I was a visual learner until I stumbled upon your videos and everything clicked into place! Thank you so much :))

[@tilak231]

Came here for Rank Ligand actvt and did a quick review of The 3 hormones!! Thanks a lot! ✊

[@ruigomesxp]

I mean, after watching so many of your videos I must thank you for all your effort to put this out there. I know that you get revenue from this and that all video images are outsourced from an artist that works in partnership with you, but that does not take any merit from it. Huge Thank you

[@nisakutluay4931]

It could not be explained better than this 👏🏻

[@langeo.2383]

when he is more of an artist and a scientist combined in one human entity... Respect Boss...

[@hawraaf6634]

THANK YOU for such an organized way Really helpful!!

[@samuelbenson1]

Awesome! Better than any class in Medical School.

[@johndytiapco7817]

OH MY GOD, I LOVE YOU DUDE, U MADE THIS CONCEPT SO EASY TO LEARN

[@anaschreiner2568]

Thanks! Great quick review of physiology. Just what I was looking for.

[@yogeshgondalia5676]

This video is a great way to recap physiology of Ca2+. Pictures help alot. Thanks!

[@shivanagpal1163]

Sir no words in your praise....🙏 Thanks a lot😊

[@skyassil7689]

although my studies are in French but this explanation was very helpful.. Thank U Mr. Armando /big hi from Algeria :)/

[@ubongumoren1856]

This is just too good! Thank you very much and keep it up!!

[@suzieajayi8424]

Excellently put together.Well done

[@mich12346]

You help me pass nursing school! Thank you

[@ashitabhasin8434]

This video is amazing...i mean i was about to spend 3 hrs on this metabolism now with this video in just 20 min i gain all concept regarding ca metabolism ...thanks...thanks alot

[@barbrauwaifo6941]

Everything about your videos are perfect

[@dr-asaa7445]

thanks aloooot ... you always help me on my medical study .. thanks again

[@ritikasehrawat4767]

This video is super awesome And has proved to be so much helpful to me. Thanks for this video.

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A lot of Love from Kenya♥️🇰🇪

[@maisoonazzam8830]

Amazing diagram and explanation. Bless you 🙏

[@AndiiiMa]

Thank you so much, your video is really helpful...keep up the good work

[@mahbubulalam2067]

U r just soo talented! I like your vedios very much. God bless u.

[@leak7161]

Great video Armando, love your drawings as well !

[@ManpreetKaur-wh6rw]

Tanks sir...without this vedio i can't to do anything....in my endocrinlogy thanks

[@ravulanikhileshwari2204]

This video helped me a lot,thank you very much.

[@danielcastilo1840]

great video ,thank you Armando.

[@ibrahimjouni3458]

thanks, very informative. PTH also reduces phosphate reabsorption by the proximal tubule, resulting in an enhanced excretion of phosphate in urine.

[@__h629]

videos like this in youtube became my teachers in online class.. I shouldn't enroll in school 😂.. I should enroll in youtube😂

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You and ninja nerd have saved my LIFE !!!!

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I can understand whats actually happening thanks to you. please upload more and more vidss

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Absolutely fantastic! I get it! Big thanks from Ireland ☘️👍🏻☘️

[@Jjtt7]

just great work . thanks very much

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Thank you sooo much for this great channel!!!

[@khayyam3000]

Really enjoyed this video

[@Ali_r1999]

Brilliant, that's very helpful. I appreciate you

[@lenepilegaard5132]

Thanks - again!!!! very good explanation

[@ridaasif6324]

Great! :) Please explain rapid and slow action of calcium homeostasis as well

[@ademanou4708]

thank you man ! your videos are really helpful for us med students keep up the good work 😁😁

[@4488Elizabeth]

that was amazing. thanks so much for sharing.

[@mohamadtarq1800]

this is so helpful man, thanks

[@sarajohn1215]

Thank you for this video😭🙏🏻

[@jothikhanna7666]

good explanation...thank you armando

[@christinakakoulli1783]

Thank you soo much, that was incredibly helpful

[@mayo2708]

Buena clase, rápido y al grano

[@pushkarnigupta9609]

Explanation was awesome along with drawing 👍👌

[@shahmirkhan8200]

Continue ur great work sir 🙂👍ur the best

[@thisbushnell2012]

facing possible parathyroidectomy after years of hyperparathyroidism (maybe my lifetime) and this is the FIRST explanation of the why of the many attempts over the years for the various 'treatments' tried to little avail. I've doubled my D3 intake, for starters, now that I understand its role.

[@anamikakumar4814]

this was soooo helpful thank you so much!!

[@user-ld9dk6nd4m]

Nice work. Keep on going.

[@MrDjhume]

This is amazing - thanks for helping me decipher Ca/Mg/P regulation for my second year med school course :)

[@DrHistoryV]

+David John Hume helped me in physiology first year too

[@alishka0109]

thank you for ur efforts

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You make awesome video Concepts cleared stay blessed ❤️

[@Mpf1012]

Great lecture!

[@fatimamb6499]

So helpful ❤ Thank you so much .

[@emmalynjimenez5422]

Thank you..i understand it even better than reading books or in class😅...Gracias❤

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thank you so much sir... very helpful for me...

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how would i Be Studying microbiology without your Videos< Make More..

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Thanks a bunch 🌷🌷 it helped a lot

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GREAT WORK !!

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The best explanation ever 👏

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Nicely Drawing and Nice Class❣️

[@sarahbrandao6028]

Perfect as usual.

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We owe you so much man

[@annamarie6712]

That was great!!! Thank you!

[@hannashapriyadarshini4893]

Awesome video!Thank you!!!!!

[@LilibethPinto]

Excellent!! thanks!!

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very helpful ! thank you!

[@aimz_med]

Thanks ... that was very clear

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Armando is Heaven Sent! ☆☆☆☆☆

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WAHT AMAZING!THANKS!YOU ARE SO KNID!

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Great video, thanks

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Amazing video , thank you so much , waiting for new videos sir

[@ImU13]

You are the best sir :) very interesting explanation

[@ahmedemad8386]

Thank you so much....you have made it like a piece of cake😊

[@passionareeramshaikh9396]

Mind-blowing explanation.:))