strontium therapy for osteoporosis

• By duranee1
• Posted July 18, 2008 at 1:10 pm

I have to agree with sdivas, not everyone will have the same response to a drug and the fractures and 'brittle bones' being reported are still quite rare.

If you are thinking about using strontium, I don't know how much you have read about it, but the clinical trials do show a significant reduction in fracture with the strontium ranalate. BUT, they also show blood clots as adverse events.
Also, strontium binds to the bone like calcium, but absorbs the x-ray from a DXA differently. It makes the bone seem denser even if it is unchanged, so you can't just go have a DXA and assume the results will be correct. There is a calculation that has to be made to adjust for the strontium. You have to tell the people doing the DXA that you're taking strontium, how much and for how long so they can make the adjustment.

To be absorbed well, the strontium ranalate (at 2 g of strontium a day) is dosed away from food. If it is given with other minerals, especially calcium, they compete for absorption, reducing the absorption of all of them. So a multiple that contains strontium and calcium is pretty useless. You need a strontium supplement that you can take away from your other minerals and food.

Keep reading and talking to people here. There's a lot of good information and support. With a little help, you'll make the best choices for you.

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• By linnyd531
• Posted July 18, 2008 at 8:43 pm

thanks for your reply. i am aware of the need to take calcium away from strontium supplements. i am taking a strontium supplement that is by itself. i was not aware of an increased risk for blood clots or the need for adjustment in DXA results. i will research those points. thanks again......Linda NY

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• By linnyd531
• Posted July 18, 2008 at 8:55 pm

i misspoke. you are right...obviously not everyone on a bisphosphonates will sustain femur fxs or have brittle bones, but there are occurences. this cases have been found in those who are taking these meds >5yrs. i am only 42 and really unsure where the endpoint would be for me w/this type of therapy. i didn't expect to have to deal w/this issue at my age and i am researching and learning all avenues of therapy. my vitamin d level is borderline low which could very well be causing me to not adequately absorb calcium. now the question is am i malabsorbing vitD....this could be possible w/a hidden celiac disease issue. (non-symptomatic) i work in a hospital and have access to some great doctors including a gastroenterologist who i've been discussing my situation with. he plans on testing my IgA antibodies among other things to check for celiac disease. If anyone else has info on strontium therapy it would be greatly appreciated. thanks linda NY

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• By DeannaB
• Posted July 19, 2008 at 10:41 am

Thanks to all for the thoughtful and intelligent discussion!
I have been puzzled by the contradictory things I read. I was on fosamax for 12 years. This past year my bone scan dropped from osteopenia to -2.9 in my spine.
After reading a bit I decided to start strontium citrate, the only form available in the USA. I discussed this with my doctor and he agrees that a trial will do not harm.
On my own, after realizing that fosamax is not studied in long-term treatment, I have decided to stop the fosamax.
I take a low dose of strontium well away from my calcium. I changed the calcium to a more absorbable type...I hope. I quit fosamax. Of course I exercise and try to do the "right" things. So I'll just wait until February now, for the next bone scan.
But I wonder whether bone scans give an accurate picture. I have never had a broken bone even though I have fallen hard a few times. My mother had spinal fractures but no hip fractures. No-one in my family has fractured, except for mother. My bones are naturally very small. They look like they belong to a skinny person! This has always been true of me.
I hope I am doing the best things. It is hard to know!

Deanna

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• By Nita
• Posted July 19, 2008 at 2:49 pm

It is always important to look and see if people and studies are talking about Strontium Ranelate or Strontium Citrate. ALWAYS pay attention to that fact when you are reading a study.

I have taken Stontium Citrate for 3 years. I have taken it in conjunction with Fosamax and in the last two years, with Forteo. My DXA finally pulled up into the osteopenia category this last month. I will never know if it is the Forteo or the Strontium Citrate or the combination. But I do not plan to stop the Strontium Citrate. Now I have to decide if I will go back on the Fomax to maintain my gain.

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• By Dandelion
• Posted July 19, 2008 at 3:29 pm

What is Strontium Citrate? Is it available over the counter or only by prescription? I was offered strontium ranelate a couple of years ago but it was so new and I'd had bad side effects from biophosphonates I decided to wait and see until I found out more about it. How does strontium citrate differ from strontium ranelate? Does anyone know?

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• By windblown
• Posted July 19, 2008 at 4:24 pm

Hi Dandelion: The only difference that I know of between the 2 Strontium Ranelate and Strontium Citrate, is the Ranelate and Citrate. Ranelate is a patentable additive and Citrate isn't because it's a naturally occuring substance. The rx version Protelos (strontium ranelate) is available in Europe and Canada, but not in the US. Strontium Citrate which is an OTC product, is available here in the US. Strontium Malonate is currently in drug trials, so maybe that will be available in the US if the FDA approves it.

It is important to remember to tell the dxa tech's that your taking it when you have your next scan so they can apply the adjustments. If you go to NIH you can look up the adjustments that should be applied. Strontium makes your bones appear more dense than they are, so you need the mathematical equation for adjusting the score.

Good luck...

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• By JoanL
• Posted July 20, 2008 at 10:00 am

Anyone have any experience with bio identical hormones?

Joan C

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• By nkerr
• Posted July 20, 2008 at 3:42 pm

Hi Windblown,
You said if we go to NIH we can look up the adjustments. What is NIH? I took strontium citrate for a few months before my last DEXA scan and had some amazing changes from the one 2 years before, but did not tell them I had been taking strontium for a short time. Would like to find out about the adjustments. Thank you.

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• By Dandelion
• Posted July 20, 2008 at 5:48 pm

Dear Windblown,

This is probably a really daft question but is OTC over the counter? I'm writing from Wales which isn't really an excuse!

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• By Dandelion
• Posted July 20, 2008 at 6:03 pm

Yet another question..does anyone take strontium citrate with calcium and vit. d? I take calcium and vit. d supplement that I get as a prescription. I'm just wondering if it's alright to take both of them.

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• By windblown
• Posted July 20, 2008 at 6:37 pm

Hi nkerr and dandelion: Below is the article from the NIH (National Institute of Health) for the adjustments. Sorry I can't explain the equation, but a radiologist
should understand it.

http://www.ncbi.nlm.nih.gov/pubmed/17543560?ordinalpos=1&itool=EntrezSystem 2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery _RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

Dandelion I don't believe in daft questions, all questions are relevant as far as I'm concerned ;) and yes OTC means over the counter.

You can also take the two references below with you to your scan and make sure you tell them how much strontium you take a day:

Journal Clinical Densitom. 1999 Winter;2(4):371-9.

Influence of strontium on bone mineral density and bone mineral content measurements by dual X-ray absorptiometry.

Department of Clinical Physiology, Hillerod Hospital, Hillerod, Denmark. spni@fa.dk

"The presence of Sr in bone influences bone mineral density (BMD) and content (BMC) measurements by dual-energy X-ray absorptiometry (DXA). This interaction is of interest, since strontium ranelate (S12911) demonstrated positive effects on bone metabolism in various animal models of osteoporosis, and is currently being evaluated for treatment of post menopausal osteoporosis. The present in vitro study aimed to determine adjustment factors for DXA measurements of BMC and BMD at different Sr concentrations in order to estimate the corresponding values that would have been measured without Sr. A series of mixtures of Ca and Sr hydroxyapatites were prepared, with biologically relevant Sr/Ca ratios ranging from 0 to 3.5 mol/mol%, and a constant total concentration of divalent cations (145 mmol). The mixtures were conditioned in plastic dishes 4.5 cm in diameter, to obtain an a real density close to the human vertebral mineral density of 0.7-1.1 g/cm(2). DXA measurements of the mixtures were made with a wide range of different instruments and various acquisition modes. A direct linear relationship (r(2) > 0.99) was found between strontium content and overestimation of BMD and BMC. There were no significant differences in adjustment factors for BMC or BMD between the different machines or acquisition modes, and the presence of Sr in the water bath used to mimic soft tissues did not affect the accuracy and precision of the method. This demonstrates that reliable DXA determinations of BMD may be carried out in the presence of Sr, and may be interpreted in terms of calcium hydroxyapatite equivalent if the bone Sr content of the measured bone is known. The same adjustment factor (10% overestimation for 1 mol/mol% Sr) can be used for all presently available types of instrument and acquisition modes."


Bone. 1997 Jan;20(1):47-54.

Effects of strontium ions on growth and dissolution of hydroxyapatite and on bone mineral detection.

By Christoffersen J, Christoffersen MR, Kolthoff N, Barenholdt O. Institute for Medical Biochemistry and Genetics, Faculty of Health Sciences, University of Copenhagen, Denmark. cchpanum@biobase.dk


"Preparation and analyzes of a series of hydroxyapatites (HA) containing 1-10 mol % of Ca2+ replaced by Sr2+ is reported. The solubility of these apatites is found to increase with increasing content of Sr2+, 10% SrHA dissolves faster than CaHA at given values of Ca2+ and phosphate concentrations, but with a similar rate at the same degree of saturation. Sr2+ is found to inhibit the rates of both dissolution and growth of CaHA and 10% SrHA at pH 7.2, CaHA being more strongly inhibited by Sr2+ than 10% SrHA."

"The effect of partial substitution of Ca2+ in hydroxyapatite by Sr2+ on bone mineral content (BMC) and bone mineral density (BMD) measured by dual energy X-ray absorptiometry has been studied using three commercial densitometers. Extrapolating the absorption data for up to 10% replacement of Ca2+ by Sr2+ to 100% substitution of Ca2+ by Sr2+ in HA leads to an apparent increase in BMC or BMD of about a factor of 10. This factor is in agreement with theoretical calculations using attenuation coefficients of the atoms concerned. It is concluded that existing BMC scanners register artificially high values of BMC if the bone contains significant amounts of Sr2+ or other metal ions with atomic number larger than calcium."

Source: National Center for Biotechnology Information

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• By windblown
• Posted July 20, 2008 at 7:42 pm

Hi again: To clarify the above Sr is (strontium ranelate) Ca is (Calcium).

I don't take Strontium, but I like to read a lot about all these meds, and in the course of my treatment and testing I've asked dxa tech's about this equation and neither of the two I asked knew what I was talking about :) Now this could be due to the fact that I live in a small town and no one is taking Strontium Citrate, or I talked to the wrong person-meaning I should have asked the Radiologist if he/she was aware of this adjustment.

Don't be surprised if you run into the same situation, but if you live in a metro type of city and go to a large imaging center hopefully they will be aware of this.

Read the last sentence of the second reference, which I believe simplifies this explanation into understandable language. Here it is again:

"The same adjustment factor (10% overestimation for 1 mol/mol% Sr) can be used for all presently available types of instrument and acquisition modes."

So Strontium Ranelate causes a 10% overestimation of bmd.

If you are interested, I have a link on the New Five Year Study on SR in my Fav Links section. To reach the link, click my screen name, wait for the page to load and scroll down to #11 link on Strontium.

If you have any questions, fire away!!!

Good Luck...

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• By BoneLady
• Posted August 5, 2008 at 11:46 am

Hi, everyone!

This is one of the best sites I have found for discussing strontium therapy for osteoporosis. I took Fosamax once weekly for seven months, nothing for the following month, and 680 mg strontium citrate daily since January 21, 2008. I plan to continue the strontium therapy, which, unlike Fosamax, is not causing me any physical problems.

My first dexa scan on May 8, 2007, determined I have osteoporosis. I am hoping my next scan shows improvement. I plan to post my original and subsequent scan results on my blog at http://strontiumforbones.blogspot.com/. My blog offers useful posts which you may reply to, information concerning the use of strontium, and an extensive link library of references. Please visit and post your comments.

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• By gimeebone
• Posted August 6, 2008 at 1:41 pm

Hi everyone!

I am 57 going on 47. My doctors have urged me to take these awful drugs since 2001 when my BMD was -2.5 in the spine. Today it is -4.1 and a rheumatologist told me that I should inject myself every day for 2 years with Forteo because I could merely "cough" and fracture a vertabrae. He was not enthralled with Fosamax since the news just came out that it may actually increase the risk of fractures...that long-term use may overly suppress bone metabolism. Another doctor said that I have a 50% chance of a fracture (which made me think doesn't everyone have a 50% chance?) There is also a 50% chance I will never have one. Bottom line is the doctors just don't know.

Since 2001 I have lifted weights, changed my nutrition habits and feel physically strong, look great! Although this is a silent disease, I still feel as though I should "trust the organism". However, this doctor scared the sxxx out of me so with the help of my nutritionist, who thinks along the same line as myself, (to be drug free) I have made a decision to take Strontium Citrate for 1 year and then, instead of waiting for 2 years to do the scan, I will do the scan after 1 year and see if there is any improvement...if it stays the same, that could also mean an improvement. She has done extensive research to find me the best quality Strontium and the best time of day to take the calcium, vit d, Magnesium/Potassium Taurate, Boron, Ipriflavone and a multivitamin.

Maybe it's a gamble but that's my plan and I'm sticking to it. I will continue to keep you all posted with my "experiment". Good luck to you all!

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• By KathleenAlford
• Posted August 6, 2008 at 3:51 pm

Yes, I am currently taking liquid Strontium, along with liquid Calcium-Magnesium and liquid Cell-Ready Minerals. I mix it all together with pomegranate juice in a delicious concoction that I fondly call, "Bone Cocktail." Here's the link to the recipe: http://osteodiet.com/2007/12/27/recipe-bone-cocktail. It's part of my natural effort to reverse osteoporosis. My last Dexascan showed an increase in bone density of the spine, but not in the hip...yet. My doctor encouraged me to increase weight bearing exercise, while sticking with the alkaline diet (OsteoDiet). My next bone scan is in November, and I am very hopeful of a further increase in bone density!

God bless you,
- Kathleen Alford
- The Osteoporosis Diet

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• By Jacqueline
• Posted August 7, 2008 at 8:10 am

Kathleen, be careful about taking strontium, calcium, and magnesium at the same time. I understand that strontium and calcium when taken together negate each other.

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• By KathleenAlford
• Posted August 8, 2008 at 10:30 am

Jacqueline, where did you hear that or read that? I would be interested in checking out the research.
God bless you,
- Kathleen Alford
- The Osteoporosis Diet

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• By BoneLady
• Posted August 8, 2008 at 11:50 am

Hi Kathleen and Jacqueline!

Jacqueline is correct about not taking strontium at the same time as calcium because they compete with each other for absorption. I take Strontium Bone Maker distributed by Doctor's Best, Inc. The label states, "Do not take this product at the same time as a calcium supplement, as these minerals may compete with each other for absorption."

My blog contains a link library of references on strontium. Please visit http://strontiumforbones.blogspot.com/

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• By BoneLady
• Posted August 8, 2008 at 12:11 pm

Hi! Kathleen,

One other thought...Be sure you are getting the recommended dosages of each vitamin and mineral. For strontium, the optimal dose is 680 mg daily. I also get 1500 mg calcium and 500 mg magnesium daily from a combination of food and supplements.

To reiterate my previous message, don't take strontium and calcium at the same time.

Best wishes for a healthy life.

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