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Peptide

Calcitonin Salmon

Calcitonin salmon is a 32-amino acid peptide hormone analog used for postmenopausal osteoporosis and hypercalcemia. FDA-approved since 1975 as nasal spray (200 IU daily) and injection (100 IU daily). A-GRADE evidence: PROOF trial showed 33% reduction in vertebral fractures at 200 IU daily. A-GRADE for bone turnover marker reduction and acute fracture pain relief. B-GRADE for BMD increase and chronic bone pain. Has unique analgesic properties making it useful for acute osteoporotic fracture pain. Salmon calcitonin has 40-50x greater potency than human calcitonin. PRESCRIPTION ONLY - second-line osteoporosis treatment after bisphosphonates.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
2
Outcomes
14
Graded outcomes
4235

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

Bone Health

Bone Health: outcomes studied for Calcitonin Salmon
GradeOutcomeEffectSizeStudiesPeopleStudies list
Bone Turnover Markers

Calcitonin reduces bone resorption markers through direct inhibition of osteoclast activity.

Improves (the measure goes down)Moderate effect16 studies

Studies that measured bone turnover markers

and 6 more in the citations list

Hypercalcemia

Calcitonin is FDA-approved for acute treatment of hypercalcemia, rapidly lowering serum calcium through inhibition of bone resorption.

Improves (the measure goes down)Large effect3 studies

Studies that measured hypercalcemia

Chronic Bone Pain

Calcitonin provides pain relief in osteoporosis and other painful bone conditions through central and peripheral analgesic mechanisms.

Improves (the measure goes down)Moderate effect16 studies

Studies that measured chronic bone pain

and 6 more in the citations list

Osteoporosis

Osteoporosis: outcomes studied for Calcitonin Salmon
GradeOutcomeEffectSizeStudiesPeopleStudies list
Vertebral Fracture Risk

PROOF trial showed 33% reduction in new vertebral fractures with 200 IU nasal spray (RR 0.67, P=0.03) over 5 years. 36% reduction in women with 1-5 prevalent fractures.

Improves (the measure goes down)Moderate effect15 studies

Studies that measured vertebral fracture risk

and 5 more in the citations list

Acute Fracture Pain

Multiple RCTs demonstrate significant analgesic effect in acute osteoporotic vertebral compression fractures, with reduced pain scores and analgesic requirements.

Improves (the measure goes down)Moderate effect15 studies

Studies that measured acute fracture pain

and 5 more in the citations list

Bone Mineral Density

Calcitonin produces modest increases in lumbar spine BMD, though effects are less pronounced than bisphosphonates or other antiresorptives.

Improves (the measure goes up)Small effect16 studies

Studies that measured bone mineral density

and 6 more in the citations list

General

General: outcomes studied for Calcitonin Salmon
GradeOutcomeEffectSizeStudiesPeopleStudies list
Liver Protection

9 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Moderate effect11 studies

Studies that measured liver protection

and 1 more in the citations list

Anti-Cancer Activity

4 systematic reviews and preclinical studies support this finding. Evidence includes systematic reviews/meta-analyses. Primarily preclinical evidence.

Improves (the measure goes up)Small effect6 studies

Studies that measured anti-cancer activity

GI Protection

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect5 studies

Studies that measured gi protection

Blood Glucose Control

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect5 studies

Studies that measured blood glucose control

Kidney Function

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies

Studies that measured kidney function

Lipid Profile

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect4 studies
Safety/Tolerability

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies
Seizure Activity

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect4 studies

Key findings

  • Bone Turnover MarkersBone HealthImproves (the measure goes down)
  • Vertebral Fracture RiskOsteoporosisImproves (the measure goes down)
  • Acute Fracture PainOsteoporosisImproves (the measure goes down)

Studies cited

44 studies from PubMed

  1. Quantitative Analysis of Salmon Calcitonin Hydroxyapatite Nanoparticle Permeation to substantiate Non-Invasive Bone Targeting via Sublingual Delivery.AAPS PharmSciTech, 2025 · PMID 40102334
  2. A trilayer microneedle patch for transdermal delivery of the peptide salmon calcitonin for osteoporosis therapy.Journal of controlled release : official journal of the Controlled Release Society, 2025 · PMID 40845924
  3. Tuning the double lipidation of salmon calcitonin to introduce a pore-like membrane translocation mechanism.Journal of colloid and interface science, 2024 · PMID 38713958
  4. Composite Separable Microneedles for Transdermal Delivery and Controlled Release of Salmon Calcitonin for Osteoporosis Therapy.ACS applied materials & interfaces, 2023 · PMID 36576723
  5. Enhancing the gastrointestinal stability of salmon calcitonin through peptide stapling.Chemical communications (Cambridge, England), 2023 · PMID 37186112
  6. Examination of Effective Buccal Absorption of Salmon Calcitonin Using Cell-Penetrating Peptide-Conjugated Liposomal Drug Delivery System.International journal of nanomedicine, 2022 · PMID 35210769
  7. Involvement of nitric oxide pathway in the acute anticonvulsant effect of salmon calcitonin in rats.Epilepsy research, 2022 · PMID 35066437
  8. Calcitonin (FORTICAL, MIACALCIN) for the treatment of vertebral compression fracturesOrthop Rev, 2021 · PMID 34745472
  9. The effect of salmon calcitonin against glutamate-induced cytotoxicity in the C6 cell line and the roles the inflammatory and nitric oxide pathways play.Metabolic brain disease, 2021 · PMID 34370176
  10. Effects of Teriparatide versus Salmon Calcitonin Therapy for the Treatment of Osteoporosis in Asia: A Meta-analysis of Randomized Controlled Trials.Endocrine, metabolic & immune disorders drug targets, 2021 · PMID 33109070
  11. A meta-analysis of the therapeutic effect of intranasal salmon calcitonin on osteoporosis.European journal of medical research, 2021 · PMID 34879875
  12. Noradrenaline signaling in the LPBN mediates amylin's and salmon calcitonin's hypophagic effect in male rats.FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2020 · PMID 32985027
  13. Thermosensitive Hydrogel Based on Poly(2-Ethyl-2-Oxazoline)-Poly(D,L-Lactide)-Poly(2-Ethyl-2-Oxazoline) for Sustained Salmon Calcitonin Delivery.AAPS PharmSciTech, 2020 · PMID 31953574
  14. Bone targeted delivery of salmon calcitonin hydroxyapatite nanoparticles for sublingual osteoporosis therapy (SLOT).Nanomedicine : nanotechnology, biology, and medicine, 2020 · PMID 31988038
  15. Transdermal Delivery of Salmon Calcitonin Using a Dissolving Microneedle Array: Characterization, Stability, and In vivo Pharmacodynamics.AAPS PharmSciTech, 2020 · PMID 33215299
  16. Flash Fabrication of Orally Targeted Nanocomplexes for Improved Transport of Salmon Calcitonin across the Intestine.Molecular pharmaceutics, 2020 · PMID 32011888
  17. The effects of salmon calcitonin on epileptic seizures, epileptogenesis, and postseizure hippocampal neuronal damage in pentylenetetrazole-induced epilepsy model in rats.Epilepsy & behavior : E&B, 2020 · PMID 33220584
  18. The Interaction between Amyloid Prefibrillar Oligomers of Salmon Calcitonin and a Lipid-Raft Model: Molecular Mechanisms Leading to Membrane Damage, Ca(2+)-Influx and Neurotoxicity.Biomolecules, 2019 · PMID 31905804
  19. Salmon calcitonin ameliorates migraine pain through modulation of CGRP release and dural mast cell degranulation in rats.Clinical and experimental pharmacology & physiology, 2018 · PMID 29344989
  20. Does salmon calcitonin cause cancer? A review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016 · PMID 26438308
  21. Analgesic effect of nasal salmon calcitonin during the early post-fracture period of the distal radius fracture.Journal of musculoskeletal & neuronal interactions, 2015 · PMID 26032211
  22. Acylation of salmon calcitonin modulates in vitro intestinal peptide flux through membrane permeability enhancement.European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V, 2015 · PMID 26347924
  23. Oral salmon calcitonin enhances insulin action and glucose metabolism in diet-induced obese streptozotocin-diabetic rats.European journal of pharmacology, 2014 · PMID 24858364
  24. Salmon calcitonin in the treatment of elderly women with type 2 diabetes complicated with osteoporosis.Pakistan journal of pharmaceutical sciences, 2014 · PMID 25410076
  25. Salmon calcitonin use and associated cancer risk.The Annals of pharmacotherapy, 2013 · PMID 24259626
  26. Salmon calcitonin: a review of current and future therapeutic indications.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2008 · PMID 18071651
  27. Calcitonin for osteoporosis and bone painCurr Pharm Des, 2002 · PMID 14529539
  28. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study GroupAm J Med, 2000 · PMID 10996576
  29. Nasal salmon calcitonin reduces the incidence of new vertebral fractures regardless of prevalent vertebral deformity severityOsteoporos Int, 2000 · PMID 11139556
  30. Calcitonin for preventing and treating corticosteroid-induced osteoporosisCochrane Database Syst Rev, 2000 · PMID 12797841
  31. Transdermal iontophoretic delivery of salmon calcitonin.International journal of pharmaceutics, 2000 · PMID 10845691
  32. Analgesic effect of salmon calcitonin suppositories in patients with acute pain due to recent osteoporotic vertebral crush fractures: a prospective double-blind, randomized, placebo-controlled clinical studyClin J Pain, 1999 · PMID 10617256
  33. [Therapy of phantom pain with salmon calcitonin and effect on postoperative patient satisfaction].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 1999 · PMID 10427454
  34. Managing acute osteoporotic vertebral fractures with calcitoninSpine, 1998 · PMID 9805171
  35. Intrapulmonary drug delivery of salmon calcitonin.Calcified tissue international, 1997 · PMID 9312206
  36. A randomized controlled trial of salmon calcitonin to prevent bone loss in corticosteroid-treated temporal arteritis and polymyalgia rheumaticaCalcif Tissue Int, 1996 · PMID 8998681
  37. Total and regional bone mineral content and fracture rate in postmenopausal osteoporosis treated with salmon calcitonin: a prospective studyCalcif Tissue Int, 1995 · PMID 7750020
  38. Salmon calcitonin reduces vertebral fracture rate in postmenopausal crush fracture syndromeBone Miner, 1992 · PMID 1576488
  39. Effect of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose-response studyBMJ, 1992 · PMID 1393035
  40. Salmon calcitonin induces pituitary tumor in rats.Endocrinologia japonica, 1991 · PMID 1823038
  41. Intranasal salmon calcitonin. A review of its pharmacological properties and potential utility in metabolic bone disorders associated with aging.Drugs & aging, 1991 · PMID 1794028
  42. Analgesic effect of salmon calcitonin in osteoporotic vertebral fractures: a double-blind placebo-controlled clinical studyClin Ther, 1989 · PMID 1818759
  43. Evaluation of salmon calcitonin treatment in bone metastases from breast cancer--a controlled trial.Bone, 1988 · PMID 3288258
  44. Immunoreactive salmon calcitonin-like molecule in crustaceans: high concentrations in Nephrops norvegicus.General and comparative endocrinology, 1987 · PMID 3817440