Strontium and Bone Scan Readings

If I decide to go on a regimen of strontium citrate for 2 years instead of the Forteo that my physician recommends, how will I be able to assess any improvement after the next bone scan given the fact that the readings after taking strontium citrate might be elevated? I have just slipped into the osteoporosis range in the spine, having taken various bisphosphonates for some 10 years (and who knows what that's done to my body??).

Evidently, even if I do the Forteo instead, I will still have to take something to maintain any improvement after that 2 year period. These are such difficult decisions.

11 replies    Reply

If you are really close to -2.5 on the Tscore right now, taking strontium might boost you into osteopenia numbers and then you might not qualify for Forteo if insurance is paying?

No, I'm actually -3.4 on the worst lumbar spine area.

Once you start down the strontium road, DXA becomes unreliable for determining effectiveness of treatment but it may still be useful to check for loss. A repeat on strontium that shows NO increase is probably a real loss in bone.
Think of DXA as a scale, and strontium as having someone put a few rolls of coins in your pockets, but you don't know how much they weigh. If your weight goes down or even stays the same with extra stuff in your pockets, you know you have actually lost weight. If your weight on the scale in increased, you can never know how much of it was the coins and how much of it was you. None, some, or all of the increase could be real or artifact.

We currently have no way of separating the two with any of the methods we currently use to measure bone density (DXA or QCT. ) So after a first DXA to at least show the BMD is going up, further DXA's are a waste of money.

As Lilypads has said on here, the next scan will be your baseline strontium scan and every scan after that will be comparable.

Thanks for the explanation, dxaguru. And I had never heard of the QCT (which I just looked up).

That makes sense, Lorrieanne. Thanks.

That makes sense, Lorrieanne. Thanks.

Why did you decide not to do Forteo?

I wish you success no matter what you decide.

Thanks, ScottishIrishGreenEyes. Actually, I haven't decided, but I'm now leaning toward the Forteo.

Maybe after that two-year period there will be some new choices out there if I have to follow up with something to maintain whatever better numbers I can get to. At this point I'm hesitant to "experiment" with a strontium/calcium program, but I'm convinced there is something positive to the strontium. What's happened to the strontium malonate trials? Why does the FDA not approve strontium ranelate?

orientalrug, here's a link to dxa adjustments if you'd like to read it. My doc uses this, for those taking strontium. I've never taken it so I don't have any personal experience. This adjustment has been around for a very long time, so it's not in the current news, but it's from very well thought of bone journals. http://www.osteopenia3.com/Strontium-dexa-scan.html

Good luck! If your score should improve above -2.5 it's doubtful any insurance will approve Forteo, unless you have a history of fraxs, like highimpactlover mentioned.

Windblown, thanks for the helpful link. I have decided to start with the Forteo, continuing to follow the Strontium Citrate information closely since I will need to follow up with something afterward--as well as having the SC as a Plan B in case I cannot tolerate the Forteo.

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