Calcitonin and its Clinical Applications

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Abstract
Calcitonin is a 32-amino acid pepride hormone secreted by the C-cells of the thyroid gland. Its major physiological function appears to be inhibition of bone resorption. Basal and stimulated plasma calcitonin measurements are useful in the diagnosis and management of medullary thyroid carcinoma and premalignant C-cell hyperplasia. Naturally occurring or iatrogenically induced calcitonin deficiency may contribute to the development of osteoporosis, but there is little evidence that this is a factor of major importance in this common disease. Calcitonin, given in pharmacological doses, stabilizes or increases bone mass in patients with established osteoporosis, particularly high-turnover osteoporosis, and prevents the rapid bone loss which occurs after menopause and during corticosteroid therapy. It also reduces pain from acute and chronic osteoporotic fractures, probably through endogenous opioid release. In Paget's disease, calcitonin therapy reduces the excessive bone turnover, prevents or reverses some complications, and decreases pain, probably through local vascular effects and central opioid release. Calcitonin may also be used to rapidly lower elevated serum calcium levels in patients with hypercalcemia of malignancy. (C) Lippincott-Raven Publishers.

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