Vitamin A Antagonizes Calcium Response to Vitamin D in Man

For unknown reasons, the highest incidence of osteoporosis is found in northern Europe. In these populations, the sunlight exposure is limited and the vitamin A intake is high. The interaction between vitamin A and D has been the subject of several in vitro and animal studies. We have studied the acute effects of vitamin A and D on calcium homeostasis in 9 healthy human subjects. We compared the effect of (i) 15 mg of retinyl palmitate, (ii) 2 μg of 1,25‐dihydroxyvitamin D 3 [1,25(OH) 2 D 3 ], (iii) 15 mg of retinyl palmitate plus 2 μg of 1,25(OH) 2 D 3 , and (iv) placebo in a double‐blind crossover study. The subjects took vitamin preparations at 10:00 p.m. and the following day blood samples were collected five times from 8:00 a.m. to 4:00 p.m. Serum levels of 1,25(OH) 2 D 3 and retinyl esters increased (1.7‐fold and 8.3‐fold, respectively; p < 0.01). As expected, serum calcium (S‐calcium) increased (2.3%; p < 0.01) and S‐parathyroid hormone (PTH) decreased (−32%,; p < 0.05) after 1,25(OH) 2 D 3 intake. In contrast, retinyl palmitate intake resulted in a significant decrease in S‐calcium when taken alone (−1.0%; p < 0.05) and diminished the calcium response to 1,25(OH) 2 D 3 after the combined intake (1.4%; p < 0.01). S‐PTH was unaffected by retinyl palmitate. No significant changes in serum levels of the degradation product of C‐telopeptide of type I collagen (CrossLaps), or U‐calcium/creatinine levels were found. In conclusion, an intake of vitamin A corresponding to about one serving of liver antagonizes the rapid intestinal calcium response to physiological levels of vitamin D in man.