Calcitonin – Hormone, Function and Medical Use
Calcitonin is a hormone produced by the thyroid gland that regulates calcium levels in the blood and plays a key role in bone metabolism.
Things worth knowing about "Calcitonin"
Calcitonin is a hormone produced by the thyroid gland that regulates calcium levels in the blood and plays a key role in bone metabolism.
What is Calcitonin?
Calcitonin is a peptide hormone secreted by the parafollicular cells (also known as C-cells) of the thyroid gland. It is one of the key hormones involved in calcium and phosphate regulation in the human body. Calcitonin acts as a physiological antagonist to parathyroid hormone (PTH) and lowers elevated blood calcium levels (hypercalcemia) back to normal.
Mechanism of Action
Calcitonin exerts its effects primarily on two organs:
- Bone: It inhibits the activity of osteoclasts – cells responsible for breaking down bone tissue – thereby reducing the release of calcium from bone into the bloodstream.
- Kidneys: Calcitonin promotes the excretion of calcium and phosphate through the urine, further lowering blood calcium levels.
The secretion of calcitonin is directly stimulated by a rise in blood calcium concentration. Once calcium levels normalize, hormone production decreases accordingly.
Biological Importance
Calcitonin plays a significant role in bone metabolism and helps protect against excessive bone resorption, particularly during periods of increased calcium demand such as pregnancy and breastfeeding. In adults, however, its physiological importance is considered smaller compared to that of parathyroid hormone and vitamin D.
Medical Applications
Synthetic calcitonin – most commonly derived from salmon (salmon calcitonin), which has a stronger effect in humans than the human form – is used therapeutically in several conditions:
- Osteoporosis: To inhibit bone loss, especially in postmenopausal women.
- Hypercalcemia: For the acute reduction of dangerously elevated blood calcium levels.
- Paget disease of bone: A disorder of excessive and disorganized bone remodeling, in which calcitonin can help slow the process.
- Pain management: Calcitonin has analgesic (pain-relieving) properties, particularly useful in vertebral fractures.
Diagnostic Relevance
Measuring calcitonin levels in the blood is an important tumor marker. Elevated calcitonin concentrations may indicate a medullary thyroid carcinoma, a tumor originating from the C-cells of the thyroid. Therefore, calcitonin levels are routinely measured in patients with thyroid nodules or a family history of thyroid cancer.
Side Effects in Therapeutic Use
When used as a medication, calcitonin may cause the following side effects:
- Nausea and vomiting
- Facial flushing
- Dizziness and headache
- With long-term use: potential loss of efficacy due to antibody formation
Due to safety concerns – including a possible increased cancer risk with prolonged use – the European Medicines Agency has restricted the approved indications for calcitonin-containing medicines in the EU.
References
- European Medicines Agency (EMA) – Calcitonin-containing medicines: restrictions on use. EMA/CHMP/2012. Available at: https://www.ema.europa.eu
- Goltzman, D. – Approach to hypercalcemia. In: UpToDate, Wolters Kluwer, current edition.
- Becker, K.L. – Principles and Practice of Endocrinology and Metabolism. Lippincott Williams and Wilkins, 3rd edition.
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