Synthesis and activation of vitamin D (cholecalciferol) Synthesis and activation of vitamin D (cholecalciferol). Vitamin D is supplied from the diet and by synthesis from cholesterol-based precursors in the skin. Activation of vitamin D occurs in two stages: 25-hydroxylation in the liver (not regulated) and 1-hydroxylation in the kidney (stimulated by parathyroid hormone and hypophosphatemia). Source: Endocrine Physiology, Medical Physiology: The Big Picture Citation: Kibble JD, Halsey CR. Medical Physiology: The Big Picture; 2015 Available at: http://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/Books/1291/p9780071485678-ch008_f038.png&sec=75577990&BookID=1291&ChapterSecID=75577697&imagename= Accessed: December 28, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved