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Calcitonin

Calcitonin

Overview

Calcitonin is a 32-amino-acid peptide hormone produced by parafollicular C-cells of the thyroid gland that regulates calcium homeostasis and bone metabolism. Salmon calcitonin (salcatonin) is FDA-approved for treatment of osteoporosis Paget's disease and hypercalcemia and has been used clinically for decades. Calcitonin has a well-established clinical evidence base from its bone disease applications and is additionally studied for analgesic effects in bone pain and as a reference compound for understanding bone mineral metabolism.

Mechanism of Action

Calcitonin acts through the calcitonin receptor (CTR) a G-protein-coupled receptor expressed primarily on osteoclasts — the bone-resorbing cells. CTR activation rapidly inhibits osteoclast activity reducing bone resorption and lowering blood calcium. In the kidneys calcitonin increases calcium and phosphate excretion further reducing serum calcium. The net effect is protection against hypercalcemia and prevention of excessive bone resorption. Salmon calcitonin is approximately 40-50 times more potent than human calcitonin at the receptor due to structural differences and is the form used therapeutically. Beyond calcium regulation calcitonin has central analgesic effects particularly for bone pain — mediated through calcitonin receptors in the central nervous system and modulation of endorphin systems — that are independent of its effects on bone metabolism.

Where does Calcitonin sit?

See how this peptide compares across all 85 peptides in our database.

Dosage Information

Typical Dose

100-200 IU daily (osteoporosis), 4 IU/kg every 12 hours (hypercalcemia)

Frequency

Daily or every other day depending on indication

Administration

Subcutaneous or intramuscular injection, or intranasal spray (Miacalcin)

Notes

Intranasal formulation is most commonly used for osteoporosis — 200 IU daily alternating nostrils. Injectable forms used for acute hypercalcemia. Resistance can develop with long-term use due to receptor downregulation.

Compound Data

Calcitonin structure

Molecular Formula

C151H226N40O45S3

Molecular Weight

3417.90 g/mol

IUPAC Name

(3S)-4-[[(2S)-1-[[(2S)-4-amino-1-[[(2S)-6-amino-1-[[(2S)-1-[[(2S)-1-[[(2S,3R)-1-[[(2S)-1-[(2S)-2-[[(2S)-5-amino-1-[[(2S,3R)-1-[[(2S)-1-[[(2S,3S)-1-[[2-[[(2S)-1-[[2-[[(2S)-1-[(2S)-2-carbamoylpyrrolidin-1-yl]-1-oxopropan-2-yl]amino]-2-oxoethyl]amino]-3-methyl-1-oxobutan-2-yl]amino]-2-oxoethyl]amino]-3-methyl-1-oxopentan-2-yl]amino]-1-oxopropan-2-yl]amino]-3-hydroxy-1-oxobutan-2-yl]amino]-1,5-dioxopentan-2-yl]carbamoyl]pyrrolidin-1-yl]-1-oxo-3-phenylpropan-2-yl]amino]-3-hydroxy-1-oxobutan-2-yl]amino]-3-(1H-imidazol-4-yl)-1-oxopropan-2-yl]amino]-1-oxo-3-phenylpropan-2-yl]amino]-1-oxohexan-2-yl]amino]-1,4-dioxobutan-2-yl]amino]-1-oxo-3-phenylpropan-2-yl]amino]-3-[[(2S)-5-amino-2-[[(2S,3R)-2-[[(2S)-2-[[(2S,3R)-2-[[2-[[(2S)-2-[[(2S)-2-[[(4R,10S,13S,16S,22R)-22-amino-16-(2-amino-2-oxoethyl)-7-[(1R)-1-hydroxyethyl]-10-(hydroxymethyl)-13-(2-methylpropyl)-6,9,12,15,18,21-hexaoxo-1,2-dithia-5,8,11,14,17,20-hexazacyclotricosane-4-carbonyl]amino]-4-methylsulfanylbutanoyl]amino]-4-methylpentanoyl]amino]acetyl]amino]-3-hydroxybutanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]-3-hydroxybutanoyl]amino]-5-oxopentanoyl]amino]-4-oxobutanoic acid

PubChem CID

118984394

Potential Side Effects

Nausea and vomiting (common with injectable form)Facial flushing (common, transient)Nasal irritation with intranasal use (common)Hypocalcemia at high doses (uncommon)Potential increased malignancy risk with long-term use (controversial — under review)

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Quick Facts

Administration
Subcutaneous or intramuscular injection, or intranasal spray (Miacalcin)
Typical Dose
100-200 IU daily (osteoporosis), 4 IU/kg every 12 hours (hypercalcemia)
Frequency
Daily or every other day depending on indication
References
0 curated + 41 from PubMed
Clinical Trials
49 registered
Evidence Score
70.2 / 100