Something I don't understand about Strontium...

I have tried to read up on it and yet, what I don't understand is how anyone knows if strontium is really any safer than bisphosphonates?

Yes, I know that long term bisphosphonates may result in atypical fractures and that they also prevent bone turnover, and coat the bone etc- all of which is not too appealing. I also know that strontium helps to add new bone, not just prevent more bone loss.

So on first glance, it would seem that Strontium is a better choice, but what if strontium also has negative effects that just haven't been discovered yet? I think it has only been used since 2004? I think the negative side effects of the bisphosphonates weren't discovered for a number of years.

So I just really want to ask that question..... it is the same question going through my mind over and over since joining this website. You sound like a bunch of very intelligent people. What am I missing about the safety of strontium?

thank you!

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219 replies. Join the discussion

http://tahomaclinicblog.com/strontium/#art I suggest you read this.

I have been taking strontium citrate for 6 1/2 years. My BMD has increased more than 25% and is now normal. I suppose there may be some risk, but to me the risk of osteoporosis is FAR greater.

When I was put on prednisone for lupus in 2005, and learned that I had osteopenia, and that strontium citrate and DHEA could prevent bone loss, I was willing to take whatever risk there was. I still am.

An endocrinologist told me not to take DHEA because it would "put hair on my chest," and my voice would change. I had a life-threatening disease, and I was going to worry about hair on my chest or saving my life?

I'm still taking 50 mg DHEA. I have NO lupus symptoms. And no hair on my chest and no changed voice! I am going to be 70 in a couple weeks and I'm still working. I went skiing at 8000 feet last spring, I spent the afternoon working in my garden.

I watched my aunt suffer with fracture after fracture until she died last April at 89. I told her about strontium in 2005 but she wouldn't take it because her doctor didn't know anything about it. My doctor sent me my December DXA results which showed the 26 and 27% BMD increases, and DIDN'T ASK how I had done that.

Do whatever you like, but everything in life has some kind of risk.

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Is strontium any safer than bisphosphonates??? - On balance and from what I've read I'd say yes strontium is safer than bisphosphonates but long term who knows.

Studies on strontium begain in 1910 by a German researcher and more studies on and off since that date with conflicting reports about the effects of strontium. In 1952 Cornell University concluded that strontium and calcium were better than calcium alone and the Mayo Clinic carried out a clinical trial in 1959 showing good results for the group taking strontium. Then things died down whilst the patent medicine industry tried its best to come up with a synthetic version that they could trade mark and make a profit from - they couldn't find one then and gave up. Years later in 1985 researchers reported results showing all measurements of bone formation increased while bone resorption remained unchanged. Then foward a few years again and Servier came up with Strontium Ranelate. Strontium itself isn't patentable but when combined with a patented synthetic substance called ranelic acid the combination becomes patentable. More profit for big Pharma.

I think it was Servier who came up with the 680 mg dose of strontium and that's when the OTC strontium citrate etc. followed with the same high doses. These high pharmacological doses of 680 mg of elemental strontium is more than 100 times the average nutritional amount - Nature does not make strontium available in foods at higher levels perhaps for a reason. Calcium and magnesium are involved with hundreds of activities in human metabolism but strontium is found only in the bones and teeth in minute amounts with no verified essential functions. There have been studies showing 170 mg of strontium per day reduced bone fracture risk more than 680 mg even though BMD did not increase as much.

The fact that I would have to supplement with calcium (which I don't want to do for all the reasons already spoken about on this forum) and that DXA T-scores would come out much higher than they really are or the fact that we don't really know if much denser bones become more brittle over time, inclines me to leave strontium out of my vit regimen for the time being. Though if I had severe osteoporosis and either have fractures or in danger of fracture then I think this high dose of strontium would be safer than any other bone drugs, especially bisphosphonates.

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@ Lorette. I pretty much have the same rationale on strontium, though I do believe some recently posted research followed participants for 10 yrs and saw decreased fractures. I'll have to try to find which discussion it was posted under. But I am not sure I want to replace my bones with strontium, though like you would definitely pick over bisphosphonates. I am on the edge now, at -2.5 so trying all the vitamin/mineral supplements first. If that doesn't at hold me, I am leaning toward adding lactoferrin, which has shown to increase bone mass - though small trials. Although not popular yet as a bone supplement, it has been researched and used for quite awhile to combat viral, bacterial, and fungal issues, and I haven't come across any negative reactions to its use.

Here's an overview of Lactoferrin regarding bone growth
http://www.ncbi.nlm.nih.gov/pubmed/20232111

Do you happen to have the research link of the study showing that 170 mg of strontium reduced fracture more than 680? That ould be beneficial. Thanks, Karan

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Good questions always amazes me the people who say they won't try a new drug until it has been out a long time jump right on a supplement like Strontium which has not been studied very long for osteoporosis either. The heart complications starting to turn up worry me about strontium as well. It is not hard to see the bias on the board.

Unfortunately it is possibly a double edge sword to be sure and most of the treatments for Osteo seems to have some risk. We all make our own choices and then have to live with those choices. Sure seems to be no real clear cut answer here.

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The COMB study points out that strontium works not because it replaces calcium in bone but because it stimulates the osteoblasts. The bisphosphonates work by disabling the osteoclasts--a completely different process. And that's why the bone becomes brittle. Healthy bone is always remodeling.

And the calcium that is replaced by strontium is in the neighborhood of 1%. Not a lot.

Once again, the "risk" of taking strontium is a risk I'm happy to take if it means I don't suffer from the terrible osteoporosis I witnessed in my patients when I worked as a home health aide. One woman who was then 59 had lost 6 inches between her sternum and her pelvis. She was a smoker with emphysema and on oxygen.

The others were older, and got vertebral fractures while simply moving slightly when they were sitting on the couch.

Everyone gets to choose. My patient chose to smoke.

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http://www.lmreview.com/articles/view/Vitamin-K2-Essential-for-Prevention-o f-Age-Associated-Chronic-Disease/

For those concerned about the QUALITY of bone, Lara Pizzorno discusses that near the end of this excellent article on Vitamin K.

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Thank you for your responses so far. I am still hoping to hear more opinions. Thank you for the links- I didn't know it had such a long history. Too bad none of those subjects were followed long term. I do keep in mind lilypads description of the older patients with osteoporosis, I have read that before, thank you for painting that picture, it really does send the message home, especially since I have a "probable" fracture at T12- maybe I am in denial but I am finding that hard to believe, still, it is really bothering me and the fear is making me old. I would like to go skiing. I find strontium very enticing,,,, but am trying hard to resist the urge to go buy a bottle until I make a really informed decision- or about as informed as I can.


What I am still confused about is

********
the choice between a
~~~~known risk~~~~ with bisphosphenates (or HRT)
versus an
~~~~unknown risk~~~~ with strontium.
*********

Do you get what I mean?

I think there used to be a TV show like this- there were 3 doors on stage, you would know the contents behind 2 of the doors but the contents behind the 3rd door would be unknown. You could either decide to chose a known door or go with the unknown door- the prize behind which could be either much better than the other doors or much worse.

The day I was diagnosed with osteoporosis I began bioidentical hormones, I knew the risks associated with HRT so I could decide to take them. Likewise, I know the risks with bisphosphenates, and while the whole mechanism of their action seems really really wrong to me, the actual risks of aytypical fractures etc is very very low.

Like, it is a devil I at least know.....

Strontium, otoh, is an unknown? It is door #3! That is my concern.

I really shouldn't stay on HRT more than 5 years so I will have to consider strontium sooner or later so why not now- that is my logic. I will most likely transfer to DHEA when stopping the hormones. I want to take strontium now, but but but...

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There are still other options than those you list (forteo or prolia) - again all with risks. I agree its difficult since none are the wonder drug we so desire. Penicillin was/is a wonder drug and even there, some had severe allergic reactions to it and died. It is a choice to do something rather than do nothing.

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Your risk with bioidentical hormones may be much lower than you think. Did you read DXAGURU's comments in this discussion? http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/n atural-hormones/

The numbers from the Women's Health Initiative were misinterpreted by the mass media.

And those numbers were based on SYNTHETIC hormones. There hasn't been much research on the unpatentable bioidentical hormones because there's no money in those.

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Here are a few links to bioidentical hormones, including the ones that are now offered as a prescription through a regular pharmancy. These articles are a few years old so there may even be more options but I thought it was well explained - I will be talking to my endocrinologist about it at my next appointment. Sorry the second one starts with Oprah (only a few sentences), but I think it has a good overview from an MD. Hopefully traditional medicine will continue to move in this direction.

http://women.webmd.com/news/20090115/oprah-and-bioidentical-hormones-faq
http://women.webmd.com/news/20090115/oprah-and-bioidentical-hormones-faq

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Hi Thanx, I will check out those links in a bit. I just wanted to clarify that I got my HRT from a gynocologist, not a compounding pharmacy- personally I do not feel comfortable going to a compounding pharmacy. THe MD actually gave me a free bottle of the estrogen, so I think it is over the counter- I will soon find out as I have almost finished it. But the progesterone is prescription for sure.

The estrogen is
Estrogel
17beta- estradiol 0.06% transderamal gel
applied twice daily. It is about $55 a bottle (80 g). I started the bottle Jan 24 so that is 6 weeks and I am almost finished.

I say it is "bioidentical" because it is not Premarin. I also like the fact that it is a gel and not a pill. I have read somewhere- perhaps even here- that breast tissue does not distinguish where the estrogen comes from- whether horse's urine or not. I may have even read that here. So there are people out there who claim that if you understand the physiology of it all (which I do not) estrogen is estrogen is estrogen. Just fyi. Hard to know what to believe. But regardless, I feel more comfortable with a gel than a pill and if it does the trick just as well, and it is my understanding that it does, then why not go bioidentical route. The gynocologist I saw thought I was being a bit silly by wanting to avoid Premarin, but he thinks this gel is just fine. Just fyi, not that get the idea that he is an expert, because I don't think he is.


The progesterone is Medroxyprogesterone -2.5mg. I am fuzzy on what this is exactly. I had previously wanted to take Promethium but it is $70 for a month dosage (I think) and medroxyprogesterone is only $20/month. The pharmacist here says that everyone takes the medroxyprogesterone. BTW, just in case someone doesn't know, the only reason I am taking the progesterone is to protect the uterus- since I no longer have periods.

The best thing I have read on this subject is written by an MD. If fact, her entire web site is amazing. I feel at some point I just need to put my faith somewhere and this is where I am putting it. Unfortunately she does not have much on strontium.

I got the link to her website from this forum btw and I thank you enormously for that!

http://courses.washington.edu/bonephys/opestrogen.html

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oh ya, just reviewing what she wrote- she blames progestin for the cons of HRT. I am not taking it every day though. Also, the directions for the progesterone say to take 2hrs after eating and 2 hrs before eating and I realize there is rarely a 4hr period in my day where I am not eating anything. (apparently it won't work properly if mixed with food/stomach acid)

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The reason Dr. John Lee M.D.'s first book was called "Natural Progesterone: The Multiple Roles of a Remarkable Hormone," and had a picture of a progesterone molecule on the cover is because NOTHING ELSE IS BIOIDENTICAL. And NOTHING ELSE WORKS THE SAME WAY. If you get that book and read it, you'll understand why. That book was written for doctors. He later wrote books for the lay reader. But I think that one was the best.

I immediately started using Emerita natural progesterone cream (that was about 1995) and I still use it. I have never used estrogen.

Estrogen is a little more complicated, because there are several forms of bioidentical estrogen, each with its own function. But in order to create a patentable molecule in the lab, it has to be a NEW molecule. Bioidentical molecules CANNOT be patented and that's why they are less expensive and, I believe, safer.

If you are serious about self-education, go to Dr. Lee's website www.johnleemd.com (he passed away in 2003 but his wife maintains the site) and start reading. His books have been around for a while, and can probably be found used at Amazon.

Anything with a name other than progesterone, estradiol, estrone, or estriol (there are some combinations of these with names like Tri-est and Bi-est and those ARE bioidentical) is NOT BIOIDENTICAL. One of the wonderful things about chemistry is that the words used in chemistry MEAN SOMETHING. They are not vague and wishy washy. Every substance has a name that tells a chemist what molecule is being referred to. "Progestin" is NOT progesterone. And I bet "medroxyprogesterone" isn't either. And they DO NOT WORK the same way as natural progesterone because the receptors in our bodies can tell the difference, unlike the sadly duped patients who get them prescribed by doctors who have been educated by the drug companies.

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I apologize, I posted 2 of the sames articles. This one goes into detail every option of estrogen and progesterone and her evaluation of advantages/disadvantages of different ones. Most importantly, it is fine to use progesterone alone, and it is much less of a balancing act than the estrogen side. But if you have an intact uterus it is unafe to only use estrogen. What I liked about the first article is the physician talked about compounding pharmacies and working with ones she has researched and "quality approved". It's ok to get a low dose bio-identical estrogen from your endo, and get your progesterone from a compounding pharmacy, but be sure to check into their quality assurance measures since they have different standards than FDA approved prescriptions. it is good they are all agreed that the new bio-identical hormones are much safer and should not be seen in the same light as past studies on some specific synthetic estrogen replacement drugs. For someone like me with a mother who died of breast cancer I will have to be more careful, but again each case is individual. Most likely she wasn't taking progesterone either, it's been 27 yrs since she passed so I have no idea. My personal experience (only limited to a few visits) is that my OB's isntant reaction was that she only considers HRT for someone with extreme menopausal symptoms. But the endocrinologist said it was something that may prove helpful to me, so I surmise she is more up to date on the latest findings. She also said she very rarely prescribes bisphosphonates. I am going for a second visit in a few months. I don't think I asked her about strontium, but I know they both had heard about MK-4.

I think in the end it is as Lilypads and others stated, there is a risk with each option and we have to try to figure which one has the least risk, and most benefit, for us. We are each unique in our causes for osteoporosis, combined with our age, our other medical issues, and additional inherited risk factors. Additionally, one body may have a negative response to a drug or supplement that 100 others had no problem with. Bottom line, there isn't one answer that fits all, but this board at least provides a large amount of information on the many possibilities that are available. I, for one, am extremely thankful for all the research that others do and share.

http://www.womentowomen.com/bioidentical-hrt/options-alternatives.aspx

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"Progestin" is NOT progesterone.

gosh thank you for that. I have been so overloaded with information on this I am forgetting what I learnt! I actually bought and read the book by Ophra's Dr Christine Northrup.

***THAT*** is why I initially wanted to go on ***Promethium***- it is "progesterone"! But it was $70 and the gynocologist poo-pooed it so I went with the cheaper medroxyprogesteron, which you are correct- I just checked, is progestin but by the time I made the decision I had forgotton about the difference between the 2 words! ***arg*** .I guess I will find the extra $50 a month for the promethium, which is an RX btw.

Thank you
and thank you for the links! Thank you for taking the time to explain things.

this has become totally off-topic (strontium) but thank you so much!

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ty also 711retake.


well my previous family doctor did not want to prescribe anything more than Promethium- ie, she said her policy for everyone was to make them try that for 3 months first and then if they insist, they could go on estrogen. That was a year ago before I knew I had osteoporosis but I knew something was feeling very different with my whole musculoskeletal system- that was why I was asking about HRT- just instinctively I felt something wrong with my body. I asked her for a bone density test at the time and she said I did not qualify.

Fast forward a year and I got the new doctor who said it was a no-brainer that I have a bone density scan- my mother had osteoporosis, I am an ex-smoker (quit 10 years ago) and my back is killing me. It came back with a 10 year moderate FRAX probability of fracture so I think I fall into the category of getting whatever I want. His only caution with the HRT is it is not meant long term and my understanding is that is what they are all going on right now. I asked for and got a prescription for Fosomax (which I haven't used). It's ridiculous.

btw Promethium is FDA approved...


http://www.bioidenticalhormones101.com/NewsWeek_Attacks_Oprah.

good lick & thank you!

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Dr. John Lee always said that oral progesterone was not well absorbed and that's why he urged people to use the cream, which is NOT expensive. I get a 4 oz. tube of Pro-Gest from Nutrition Geeks for about $22. It lasts 3-4 months.

I believe Dr. Jonathan Wright, who has also written a book on this subject, recommends the cream also. And it does not require a prescription. http://www.amazon.com/Natural-Hormone-Replacement-Women-Over/dp/0962741809

Dr. Lee said progesterone PROTECTS AGAINST breast cancer.

He was always against using "unopposed estrogen." He said that progesterone "balances" estrogen. He was fine with using progesterone by itself.

He also reversed osteoporosis in some of his elderly patients using ONLY progesterone cream and no estrogen.

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Hi Karan
I've read several articles referring to....170 mg improving fracture rates though not increasing BMD as much as higher doses. I think this fact may be lost due to the need most of us feel to increase BMD. Here's 3 articles referring to this:
A. R. Gaby Strontium for osteoporosis: to dose or to megadose?
Focus - 'The Strange Case of Strontium'
Dr.Keith Mumby @ www.healthiertalk.com/bone-disease-kills-more-women-breast-cancer-3924

Hope this helps.

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Karan - Didn't they say the same thing about Bisphosphonates and fracture rates. Reduction of fracture rates is always the reply doctors give when 'selling' bisphosphonates to patients. Now we find you are more like to fracture than not after 5 years on drugs like fosamax.

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I am skeptical too for the same reasons several people here are (too much is unknown, particularly long term effects). I did start taking Strontium last year (340 mg first, now 227 mg) and I am perfectly willing/ready to take a lower dose if it becomes available or ... to stop taking if negative information surfaces.

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