Strontium Citrate for osteoporosis

[Karana81]

Does anyone have experience with bone density improvement after taking Strontium Citrate?

[Met00]

I'm replying in the hope of bumping this up for you. I can't share from personal experience, though might have an answer for you in a couple of years' time as I've just started taking a lowish dose of strontium citrate. But I have read of people who have improved their bone density, and, more important, stopped fracturing with strontium citrate. It's controversial because the strontium itself ends up in your bones, which skews your DEXA results, so any improvement can be misleading; but the science so far has shown that it also attracts more calcium into your bones, and it's suggested that if you reduce any improvement in scores by about 50%, that's likely to give a better picture of how much things have changed. A word of warning though, it can increase blood pressure and isn't recommended for anyone with heart or kidney problems as it can make existing issues worse.

[Mark_ABH]

Hi Karana81, I hope you'll read American Bone Health's publication on strontium; we reviewed and revised it just a few months ago: americanbonehealth.org/medi...

It's important to distinguish between strontium ranelate, which at one time was approved to treat osteoporosis in the EU but is no longer recommended because of evidence of harmful side effects, and other molecules, like strontium citrate that have no evidence of being safe or effective.

Calcium with vitamin D is still your best bet.

[Mark_ABH]

One more thing to add: Met00 is correct that strontium might increase your DXA scores but that can be misleading because it doesn't necessarily mean your bones have gotten stronger. Bone density is only one component of fracture risk, so it's important also to focus on exercise, proper nutrition (calcium and vitamin D plus magnesium and other bone-friendly minerals), etc.

[Karana81 in reply to Mark_ABH]

Thank you! I have read that DEXA results after taking strontium citrate might be inflated, which makes me question its effectiveness.

[Met00 in reply to Mark_ABH]

Strontium is very likely to increase your t-scores, but only part of the increase is due to the strontium. There's a formula which professionals can use to adjust the results, but for lay people it's recommended to assume that about 50% of any increase is due to the strontium, the rest due to additional calcium that's attracted to the bones as a result of strontium. I'd be please with any increase, even if I could only allow 10% of it, as usually our bone density declines with age.

[Karana81 in reply to Met00]

Great info - thanks!

[Met00 in reply to Mark_ABH]

I'm sorry to contradict you Mark, but strontium ranelate IS still approved for osteoporosis treatment in the EU. I live in the UK and it's available on prescription here. It was stopped temporarily due to supply issues. There are some limitations though, as it isn't suitable for anyone with existing heart or kidney problems, although the evidence is only that it can worsen existing issues, not that it can actually cause them.

[Mark_ABH in reply to Met00]

Hi met00,

The article doesn't say it's not available in the EU, just that regulators recommended against it, pending further research (ema.europa.eu/en/news/prac-.... And that the main supplier stopped distributing it. The article does say that it's still available in the UK.

Sorry if I confused; we are focused on a U.S. audience, and there are obviously some differences in the regulatory scene. Strontium ranelate has never been approved in the U.S., and the OP was asking about strontium *citrate* ...

From the article:

On October 1, 2014 the European Medicines Agency’s Pharmacovigilance Risk Assessment Committee (PRAC) recommended that strontium ranelate (Protelos/Osseor, Servier) no longer be used to treat osteoporosis because of data demonstrating serious negative side effects.

“The PRAC weighed the benefits of the medicine against the known risks and concluded that the balance was no longer favourable and recommended Protelos/Osseor be suspended until there are new data showing a favourable balance in a defined patient group.”[1]

Les Laboratoires Servier ceased the distribution of Protelos/Osseor® in August 2017.

A generic, non-branded version of strontium ranelate, from Aristo Pharma Ltd., is still available in the U.K.[2] with a number of special warnings and precautions for its use.

[Met00 in reply to Mark_ABH]

Servier stopped supplying strontium ranelate for commercial reasons (sps.nhs.uk/articles/discont..., but it became available again from a new supplier early last year (incidentally the 2014 press release was 10th January, not 1st October - we write the month and day the opposite way to America!). It's recognised that it can cause serious heart and kidney problems for those who already have issues, but is considered safe otherwise (gov.uk/drug-safety-update/s.... There's information from the UK Royal Osteoporosis Society about strontium ranelate here, with more details if you click on the link to the factsheet.: theros.org.uk/information-a.... I hope you don't mind me clarifying this, but quite a lot of misinformation about strontium ranelate is circulated by American sources, and I regularly see people claiming that it's banned in Europe! There's also a fair bit of evidence that strontium citrate works in the same manner as strontium ranelate (it's the strontium that's relevant, not what it's bound to).

[Mark_ABH in reply to Met00]

thanks for the update on availability in UK; I'll see if we can update that.

[Arcadia10]

Hi Karana81 - I had some success with strontium citrate shortly after being diagnosed with osteoporosis in 2012. I took it for 3 years and intend to go back onto it after I've managed to get off Prolia safely, hopefully next year. I got scared into having Prolia injections which I've had to discontinue due to side effects, and now have to take Actonel (bisphosphonate) to get off the Prolia safely! I'll reproduce part of my reply to someone else in another thread below:

I started taking SC when I was first diagnosed in 2012 as I didn't want to take bisphosphonates. My then-GP certainly didn't push me in the bisphosphonate direction as she had warned me about the possibility of developing osteonecrosis of the jaw, and I really didn't want to risk it. So I read Lara Pizzorno's book: "Your Bones" and decided to try SC and some other supplements to strengthen my bones naturally. In the 12 months from when I was first diagnosed to 2013, my spine increased by 3.9% from -2.2 to -1.9 although my total hip decreased by 4% from -3.1 to -3.3. In 2014 and 2015, my spine remained stable at -1.9 although the BMD lost a little bit. In 2014, my total hip increased by 1.8% to -3.2 and in 2015, my total hip increased to -2.8. In this time, I was taking SC plus magnesium, vitamin K2, boron, zinc, calcium citrate, vitamin C and B complex - no other drugs. In 2016, I had a change in personal circumstances and became a bit slack in taking SC and I think at the same time the brand I was using (Doctors Best, ordered from the US) was discontinued and it wasn't so easy to source SC in Australia, so I just forgot about it, meaning to get back to it. I eventually ordered some Life Extension SC, but never took them. A year later, my bone density had fallen to -2.3 in my spine although my total hip remained stable.

Hope this helps.

[Met00]

I've made the comparison and they're the same. I have no digestive issues with the citrate form.

[Met00]

680mg per serving, same as prescription strontium ranelate.

[Karana81]

Thank you for sharing this Arcadia. I don't think I ever replied! I have a bottle of Strontium Citrate in the drawer, but I just can't bring myself to take it - mostly due to the limitations of when to take it (can't have certain foods within a few hours), the lack of any really good studies and the size of the pill! Except for one small study, all I have is anecdotal info from a couple of friends who have had positive results. I have decided to confer with our university hospital experts before I do anything different, but that has been put off due to covid and I don't know when I will be able to do that. Meanwhile, I take my vitamins and consistently do my PT exercises and cardio. I appreciate your input. Good luck to getting back to building bone!

[Met00]

I take strontium citrate when I get up in the night as it's meant to be taken several hours away from food, and from drinks with milk in them (3 or 4 hours I think). There have been few studies done on strontium citrate, but some encouraging ones on strontium ranelate. It's generally considered that it's the strontium that's effective, not the form it's in. It isn't suitable for anyone with existing heart or kidney problems, and you should keep an eye on your blood pressure while taking it as it can raise it (so far hasn't affected mine).

[Karana81]

Thank you Met00. My daughter is an academic librarian in the sciences at a research university and I asked her to search for studies in respected peer reviewed journals about the benefits of strontium citrate and she could only find one very small study that was promising. I would really like to think this could work, but I also want to be cautious, so hopefully soon I will be able to talk to a cutting edge doctor at our medical school hospital. Thanks again!

[Met00]

Yes, that's the strontium content. I've read that strontium can account for up to half any improvement in bone density, but it does also attract more calcium into the bones, so long as you have several hours between strontium and calcium ingestion. Studies have also shown a reduction in fracture rate when taking strontium, which ultimately is more relevant than bone density.