Concurrently, alcohol disrupts calcium-regulating hormones: acute intoxication induces transient hypoparathyroidism, leading to hypocalcemia and hypercalciuria, while chronic abuse is associated with impaired vitamin D metabolism, including reduced serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. This results in diminished intestinal calcium absorption and compensatory secondary hyperparathyroidism, which fails to adequately stimulate bone remodeling due to alcohol-induced skeletal resistance to parathyroid hormone. Here, PTH is linked to secondary hyperparathyroidism.