Calcitonin osteoporosis benefit and risk of treatment
June 29 2016 by
Ray Sahelian, M.D.

Calcitonin is a naturally occurring peptide hormone which acts via specific receptors to strongly inhibit osteoclast function. An osteoclast is a large bone cell that absorbs bone tissue during growth and healing. Calcitonin has been used in the treatment of osteoporosis for many years. Historically, calcitonin was administered as a parenteral (administered or occurring elsewhere in the body than the mouth and alimentary canal.) injection, but the intranasal formulation is now the most widely used because of its improved tolerability. Click the link if you would like to learn causes of osteoporosis and more natural ways to treat osteoporosis.

Caution using newer drugs
Until recently, calcium supplementation with vitamin D and hormone replacement therapy were the mainstays of treating osteoporosis associated with menopause. Hormone replacement therapy, indeed, was (and is) effective in preventing fracture, but is no longer to be considered to be a primary indication for this purpose. Thus, while continuing with calcium and vitamin D, drug therapy now consists of the antiresorptive agents: raloxifene (Evista), calcitonin hormone, and the bisphosphonates. These drugs reduce bone turnover, and do prevent fractures, but are limited to halting further deterioration of skeletal microarchitecture. However, recent evidence points to potential long term serious side effects to the use of bisphosphonates, and caution is being advised by many medical professionals regarding waiting more time until more research determines the safety of these newer agents. For instance, it is now clear that the use of bisphosphonates increases the risk of osteonecrosis.
   It may just turn out that the traditional treatment for osteoporosis which included more exercise, vitamin D, and calcium supplements are probably sufficient in the majority of older individuals.

Back pain
Asian Spine J. 2015. The efficacy of intramuscular calcitonin injection in the management of lumbar spinal stenosis. It seems that an intramuscular injection of low dose of calcitonin may have some beneficial effects on the pain due to lumbar spine stenosis, especially in patients who suffer from severe or very severe low back pain.

Human Calcitonin and osteoporosis
Calcitonin is a naturally occurring peptide which acts via specific receptors to strongly inhibit osteoclast function. Historically, calcitonin was administered as a parenteral injection, but the intranasal formulation is now the most widely used because of its improved tolerability. New approaches are currently being investigated to enhance the bioavailability and effects of calcitonin, including oral, pulmonary, and transdermal routes of administration, and novel allosteric activators of the calcitonin receptor. Several controlled trials have reported that calcitonin stabilizes and in some cases produces a short-term increase in bone density at the lumbar spine level. The most relevant clinical trial to evaluate the effect of calcitonin in the prevention of fractures was the Prevent Recurrence of Osteoporotic Fractures (PROOF) study, a 5-year double-blind, randomized, placebo-controlled trial showing that salmon calcitonin nasal spray at a dosage of 200 IU/day can reduce the risk of vertebral osteoporotic fractures by 33%.

Calcitonin function
Calcitonin and its receptor are well known for their ability to regulate osteoclast-mediated bone resorption. It has been suggested to be a renal Ca(2+) and Mg(2+)-conserving hormone and may share similar signaling mechanisms with PTH.

Oral Calcitonin
Calcitonin is approved in nasal spray form for treating the bone-thinning disease osteoporosis, and works by preventing the body from re-absorbing bone tissue. Recently an oral formulation has been developed to side-step the tissue irritation that can occur with the spray. To investigate the oral drug's effectiveness in osteoarthritis, Dr. Daniel-Henri Manicourt of the Universite Catholique de Louvain in Brussels, Belgium and colleagues randomly allocated 41 knee arthritis patients to placebo, 0.5 milligrams of calcitonin daily, or 1 milligram daily for 84 days. The developer of both the nasal and oral form of calcitonin, Novartis, helped fund the study. Levels of several of the arthritis progression biomarkers dropped significantly in patients taking 1 mg of calcitonin, while holding steady in patients on placebo. Reduction in pain was similar among all three groups, but only the patients taking calcitonin showed significant improvements in function. Arthritis & Rheumatism, October 2006.

Calcitonin side effects
Oral calcitonin has side effects of headache and stomach irritation.

Emails
Q. Can a calcitonin spray be taken the same day as resveratrol?
   A. Probably but there is no research combining the two.