Introduction
Calcitonin is a hormone that regulates calcium metabolism in the body. It has been used to improve bone mineral density and reduce fracture rates. Apart from this function, calcitonin also exhibits analgesic effects in many painful situations. The role of acting as an analgesic is not related to the action of calcium metabolism.
What Is Calcitonin?
Calcitonin is a peptide hormone containing 32 amino acids. It is secreted from parafollicular cells of the thyroid gland. Its main function is to regulate calcium balance and bone metabolism. Calcitonin is secreted in response to hypercalcemia.
Functions of calcitonin include
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It binds to osteoclast receptors to inhibit calcium release from the bone.
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It stimulates the urinary excretion of calcium, reducing serum calcium levels.
Many studies have shown that calcitonin plays an essential role in the analgesic effects in many painful situations.
What Are the Analgesic Effects of Calcitonin?
Calcitonin, in spite of having an action in calcium metabolism, also has effects in painful circumstances like vertebral fractures, metastasis, migraine, reflex sympathetic dystrophy, and neuropathic pains related to spine injury. It is also used with local anesthesia as an additive to control postoperative pain or trigeminal neuralgia.
In recent years, it has also been included in the following conditions as an analgesic.
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Diabetic neuropathy.
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Postoperative pain.
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Spinal cord-related neuropathy.
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Trigeminal nerve neuropathy.
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Adhesive shoulder.
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Adhesive capsulitis.
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Lumbar canal stenosis.
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Phantom limb pain.
Mechanism of Action of Calcitonin as an Analgesic Effect:
In a study, it was found that calcitonin inhibits signals related to receptors called melastatin-8 and ankyrin-1. This exhibited the analgesic effect of calcitonin in peripheral neuropathy.
According to a theory, nerve injuries activate a calcitonin-dependent signal. This signal is activated by calcitonin administration and results in decreased transcription of the sodium channel in the dorsal root ganglion neurons. Hence, calcitonin can control excitability in the peripheral nervous tissues through sodium channels. Calcitonin signals are generally inactive. Nerve injuries or ovariectomy can induce these targets.
According to another theory, calcitonin tends to reduce serotonin transporters and increase the expression of serotonin receptors in the thalamus.
Calcitonin reduces pain by changing the sodium channels and receptor expression in neuropathic pain and osteoporosis.
Endorphin levels were found to be higher in individuals receiving calcitonin.
In migraine, when calcitonin was given, there was an increase in levels of endorphins, adrenocorticotropic hormone, and corticosteroid hormones in serum.
Calcitonin inhibits inflammatory substances like thromboxane and prostaglandins, thereby exhibiting an anti-inflammatory effect.
Another study revealed that calcitonin could act on the trigeminal nucleus caudalis, inhibit c-fos expression, and exhibit an analgesic effect by suppressing the trigeminovascular system.
Calcitonin also inhibited the degranulation of mast cell meninges. Stabilizing dural mast cells with calcitonin also exhibited analgesic effects.
A study stated that calcitonin could be used in treating acute pain due to vertebral fractures but may not be very effective in treating chronic pain due to vertebral fractures.
Another study showed a decrease in radicular pain in patients with lumbar spinal canal stenosis.
A study showed that calcitonin significantly reduced the acute pain associated with a radius fracture in osteoporotic patients. In the case of adhesive capsulitis, calcitonin effectively reduced pain and improved shoulder function.
Calcitonin showed its analgesic effects in the case of severe pain in malignancy because of the progression of malignant tumors into bones.
In the case of complex regional pain syndrome ( CRPS), its use for pain was considered controversial. This was because the results from different studies were controversial. Some studies showed that calcitonin effectively reduces pain in the case of CRPS Type 1. However, some studies showed opposite results of this and showed inconsistent calcitonin effectiveness.
Many studies suggested calcitonin as a good analgesic for treating phantom limb pain and also in treatment-resistant phantom limb pain.
Syndromes:
In the case of McCune-Albright syndrome, one can suffer from multiple fractures and treatment-resistant bone pain to opioids and other drugs. Calcitonin, used to treat or reduce severe pain, effectively reduces pain.
When treated with calcitonin, camurati-Engelmann disease, a syndrome, there was optimum pain control.
In the case of spinal cord injuries, there will be neuropathic pain associated, which is very complex. Calcitonin use was effective in reducing neuropathic pain associated with calcitonin.
In the case of atypical facial pain, when calcitonin was administered, a side effect was observed despite its pain-relieving action.
When given to those with painful diabetic neuropathy, calcitonin was effective in relieving pain.
Calcitonin use in the case of herpetic neuropathy was effective in alleviating pain associated.
When calcitonin was used in the case of lower back pain ( LBP), calcitonin was more effective than diclofenac sodium. This was found effective in treating osteoporosis.
Calcitonin was used successfully in postoperative pain. Calcitonin helped eliminate hyperglycemia ( increased sugar) after the operation.
Calcitonin was found to be more effective in reducing pain after maxillofacial surgery. This helped reduce pain caused by chronic osteomyelitis after the third molar extraction.
Calcitonin was an effective treatment in the case of trigeminal neuralgia.
It was also found that calcitonin is effective in treating and preventing migraine.
What Are the Adverse Effects of Calcitonin?
Calcitonin is very safe and has been used by millions of people.
Adverse effects include
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Flush or nausea.
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Tingling in the nasal route.
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Irritation of the nasal mucosa.
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Sneezing.
There are no serious adverse effects of calcitonin observed on the skeletal system and other organs of the body, even when there is long-term medications were given. This can be used safely without any adverse effects and in cases, where other analgesics fail to control pain.
Conclusion
Calcitonin is a hormone that exhibits analgesic effects. This can effectively treat acute and neuropathic pains where other analgesics fail to reduce pain. Hence it is important to know about calcitonin, its mechanism of action, uses, adverse effects, and safety. Knowing about it may help a person seek a healthcare provider's help early for treatment. Early diagnosis helps in getting effective treatment. This, in turn, helps in achieving a good quality of life.
