• Physiology
  1. Peptide Hormone, secreted by parafollicular cells of the Thyroid Gland
    1. Secreted in response to Hypercalcemia
  2. Lowers Serum Calcium levels (esp. in children)
    1. Decreases Osteoclast formation and bone resorptive activity (bone breakdown)
    2. Increases renal Calcium excretion
    3. Weakly opposes Parathyroid Hormone
  1. Weak Osteoporosis Management alternative for women not on Estrogen Replacement
  2. Painful Vertebral osteoporotic Fracture
  • Efficacy
  1. Not as effective as Estrogen Replacement
  2. Reduces Vertebral Fractures 30-60% for >2 years
  3. Increases BMD of spine 3% in osteoporotic women
  • Preparations
  1. Calcitonin-Salmon
    1. Dosing: 100 IU SQ/IM daily ($195/mo)
  2. Miacalcin
    1. Dosing: 200 IU (1 spray) intranasally daily in alternating nares ($50/mo)
  • Precautions
  1. Anaphylaxis risk (use test dose in clinic)
  2. Possible increased risk of cancer
  • Adverse Effects
  1. Skin Flushing
  2. Skin rash
  3. Nausea
  4. Dizzy