Calcitonin
Calcitonin is a 32-amino acid peptide hormone produced by parafollicular C-cells of the thyroid gland that inhibits osteoclast-mediated bone resorption. Salmon calcitonin (sCT), which has 40-50 times greater potency than human calcitonin, is the therapeutic form approved for osteoporosis and Paget's disease. Available as nasal spray (Miacalcin/Fortical) and injection, calcitonin directly reduces bone breakdown, provides analgesic effects for bone pain, and helps maintain calcium homeostasis. While largely superseded by bisphosphonates and denosumab for osteoporosis, calcitonin retains a role for acute vertebral fracture pain management.