A clinically precise term referring to the initial forms of Vitamin D, specifically cholecalciferol or ergocalciferol, that must undergo two sequential hydroxylation steps in the liver and kidneys to become the biologically active steroid hormone, calcitriol. It emphasizes that Vitamin D is not merely a vitamin but a critical prohormone essential for calcium homeostasis, immune function, and endocrine health. This clarifies its fundamental role in human physiology.
Origin
Derived from endocrinology, which classifies calcitriol as a steroid hormone due to its synthesis pathway and its mechanism of action via a nuclear receptor that regulates gene expression. The term clarifies the molecule’s role in the hormonal hierarchy, distinguishing it from simple micronutrients. This perspective informs clinical dosing and monitoring.
Mechanism
Following synthesis or ingestion, the precursor is first hydroxylated in the liver to 25-hydroxyvitamin D (calcidiol), the storage form, which is the primary measure of status. It is then converted in the kidney to the active hormone, calcitriol. Calcitriol acts by binding to the Vitamin D Receptor (VDR), influencing the transcription of hundreds of genes and directly impacting parathyroid hormone and bone metabolism.
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