Salmon calcitonin is a synthetic peptide hormone, originally derived from salmon. It regulates calcium levels and bone health, and is used in medical treatments due to its impact on bone remodeling and calcium balance.
How Salmon Calcitonin Works
Salmon calcitonin influences bone cells and kidney activity. It primarily inhibits osteoclasts, specialized cells responsible for breaking down bone tissue and releasing minerals like calcium into the bloodstream. By binding to specific receptors on osteoclasts, it reduces their ability to resorb bone, helping to increase bone density and reduce bone loss.
The hormone also impacts calcium and phosphate regulation in the kidneys. It increases the excretion of calcium, phosphate, and sodium through the urine by decreasing their reabsorption in the kidney tubules, which helps to lower elevated blood calcium levels. Salmon calcitonin is often preferred over human calcitonin due to its significantly greater potency (40 to 50 times more active) and longer duration of action, contributing to its effectiveness.
Medical Conditions Treated
Salmon calcitonin is used to manage several medical conditions, particularly those involving abnormal bone turnover and calcium imbalances. It is an approved treatment for Paget’s disease of bone, a chronic disorder characterized by excessive bone breakdown and formation, leading to weakened and deformed bones. In Paget’s disease, salmon calcitonin helps to normalize the rate of bone remodeling, reducing bone pain and improving bone structure.
The hormone is also utilized in cases of severe hypercalcemia, a condition where there are abnormally high levels of calcium in the blood. By promoting the excretion of calcium through the kidneys and inhibiting its release from bones, salmon calcitonin helps to lower elevated calcium levels. Additionally, it is prescribed for postmenopausal osteoporosis, a condition where bone density decreases, increasing the risk of fractures. For women who are at least five years past menopause, salmon calcitonin can help mitigate bone mineral density loss, particularly in the lumbar spine, and reduce the risk of new vertebral fractures.
How Salmon Calcitonin is Administered
Salmon calcitonin is available in different forms for administration, allowing for flexibility in treatment. It can be given as an injectable preparation, typically administered subcutaneously (under the skin) or intramuscularly (into a muscle). These injections are generally given daily, with dosages varying based on the specific condition being treated.
A common and convenient method is a nasal spray, such as Miacalcin, approved by the US FDA for postmenopausal osteoporosis. The nasal spray is usually administered once daily, with patients alternating nostrils. While its bioavailability is lower compared to injections (3% to 5%), it offers a less invasive option for long-term management. Oral preparations are also being investigated in clinical trials, offering a potential future non-injectable and non-nasal route.
Potential Side Effects
Like all medications, salmon calcitonin can cause side effects, although these are generally mild. Common adverse effects include nausea (sometimes accompanied by vomiting) and flushing (a sensation of warmth or redness, often in the face or neck). These effects may be mitigated by administering the medication at bedtime or with food.
For individuals using the nasal spray form, local nasal irritation is a frequent occurrence, manifesting as dryness, itching, congestion, or nosebleeds. Less commonly, injection site reactions, such as redness, swelling, or pain, can occur with injectable forms. There is also a weak association with an increased incidence of cancer with long-term intranasal use of salmon calcitonin. This potential risk has been observed in meta-analyses of clinical trials, and while the overall incidence remains low, it is a consideration that should be discussed with a healthcare provider to weigh the benefits against the potential risks of prolonged therapy.