Per Servier, the manufacturer of Protelos (strontium ranelate), their product increases BMD and decreases the risk of vertebral fracture. They also state on their website at www.servier.com, that doctors do not need to adjust BMD measurements in individual patients:
How much does Protelos increase BMD?
"The increase in BMD with Protelos is superior to that of other treatments. It is proven that Protelos is effective against vertebral and hip fractures, and a correlation up to 74% has been established between the increase in BMD with Protelos and vertebral fracture risk reduction, therefore it is not necessary to adjust BMD for each patient. This serves as a tool to measure compliance (allowing you to confirm that your patient is taking treatment) and a marker of clinical efficacy (for motivating them to continue taking treatment)."
In practice do I have to adjust BMD measurements in individual patients?
"No, it is not necessary to adjust BMD for each patient because each increase in BMD is highly correlated (up to 74%) with the decrease in the risk of sustaining a vertebral fracture. In other words with Protelos, the more the increase of BMD in your patient, the more your patient is protected from fracture. Moreover, BMD is a useful monitoring tool to confirm the compliance of your patient."
Skeleton Pirate
Artist: LindaB
WELCOME TO STRONTIUM FOR BONES BLOG
Have you experienced negative, and even dangerous, side effects from Fosamax (alendronate), Boniva (ibandronate), Actonel (risedronate), Reclast (zoledronic acid), Prolia (denosumab), Forteo (teriparatide), Tymlos (abaloparatide), or other drugs prescribed for osteoporosis? If you have, then rest assured there is a safe, effective treatment for this condition. Strontium, primarily in the form of strontium citrate, is taken orally once a day.
Visitors to my blog can leave comments or ask questions and can remain anonymous, if they wish. Their comments are relayed to my g-mail inbox. Below each post, the number of comments for that post is cited and underlined because it is a link. By clicking on that link below any post, a window opens so that a visitor can leave a comment. Ideally, visitors leave comments on posts most relevant to their comments. All comments to my posts are moderated by me.
Browse the posts and visit the link library of references.
Visitors to my blog can leave comments or ask questions and can remain anonymous, if they wish. Their comments are relayed to my g-mail inbox. Below each post, the number of comments for that post is cited and underlined because it is a link. By clicking on that link below any post, a window opens so that a visitor can leave a comment. Ideally, visitors leave comments on posts most relevant to their comments. All comments to my posts are moderated by me.
Browse the posts and visit the link library of references.
Friday, March 6, 2009
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Wandering Skeleton
Artist: Joel Hoekstra
Osteoporotic Bone
Source: www.mayoclinic.com
How Strontium Builds Bones
Strontium is a mineral that tends to accumulate in bone. Studies have shown that oral doses of strontium are a safe and effective way to prevent and reverse osteoporosis. Doses of 680 mg per day appear to be optimal. See my "For More Information About Strontium" links section.
Osteoporosis is caused by changes in bone production. In healthy young bones there is a constant cycle of new bone growth and bone removal. With age, more bone is removed and less new bone is produced. The bones become less dense and thus more fragile.
Scientists believe that strontium works in two ways. It may stimulate the replication of pre-osteoblasts, leading to an increase in osteoblasts (cells that build bone). Strontium also directly inhibits the activity of osteoclasts (cells that break down bone). The result is stronger bones.
When taking strontium, be sure to take 1200 mg calcium, 1000 IU vitamin D3, and 500 mg magnesium daily. It is best to take strontium late at night on an empty stomach. Calcium and strontium may compete with each other for absorption if taken together.
Osteoporosis is caused by changes in bone production. In healthy young bones there is a constant cycle of new bone growth and bone removal. With age, more bone is removed and less new bone is produced. The bones become less dense and thus more fragile.
Scientists believe that strontium works in two ways. It may stimulate the replication of pre-osteoblasts, leading to an increase in osteoblasts (cells that build bone). Strontium also directly inhibits the activity of osteoclasts (cells that break down bone). The result is stronger bones.
When taking strontium, be sure to take 1200 mg calcium, 1000 IU vitamin D3, and 500 mg magnesium daily. It is best to take strontium late at night on an empty stomach. Calcium and strontium may compete with each other for absorption if taken together.
For More Information about Strontium
- A Dose-response Study With Strontium Malonate
- A Review of the latest insights into the mechanism of action of strontium in bone
- Antifracture Efficacy Over 10 Years With Strontium Ranelate
- Combination of Micronutrients for Bone (COMB) Study: Bone Density after Micronutrient Intervention
- Echolight REMS Scan of Young, Normal Female
- Effect of bone strontium on BMD measurements
- Effect of Lumbar Scoliosis on DXA Results
- Effects of SrR on Calcium Metabolism
- Effects of strontium ions on growth and dissolution of hydroxyapatite and on bone mineral detection
- Influence of strontium on bone mineral density and bone mineral content measurements by dual X-ray absorptiometry
- Interpretation of BMD Scans in Patients Stopping Strontium
- Melatonin-micronutrients Osteopenia Treatment Study (MOTS)
- National Osteoporosis Foundation
- Osteoporosis And Bone Physiology
- Post-Marketing Assessment of the Safety of Strontium Ranelate
- PubMed Abstract On The SOTI Study
- PubMed Abstract On The TROPOS Study
- Strontium ranelate Aristo
- Strontium Ranelate For Spinal Osteoarthritis
- Strontium: Breakthrough Against Osteoporosis
- Summary Safety Review - Strontium
- The Influence of Strontium on Bone Tissue Metabolism and Its Application in Osteoporosis Treatment
- Thirteen Key Diagnostic Tests
5 comments:
Dear BoneLady, thanks so much for this information, and really all of your work. I find your site to be an excellent and information rich resource.
I am so excited about this news in particular, that I am jumping for joy! It removes a worry that many folks had, myself included, about how to interpret DXA's when taking strontium. I'm not worried anymore, and that's a big load off my shoulders. I hope others visiting your site will be as thrilled as I am.
J
Would it be safe after using strontium for some time to add a prolia or reclast drug. I just had a dexa and my dr. Said that its in the osteopenia range . He says that because of family history father at 93 fell and broke or fractured his hip that i have a 15% risk in the next 10 years and that even a 3% risk they are recommending treatment.
Dear Di,
I do not recommend taking strontium along with an antiresorptive drug, such as Prolia or Reclast, because they could work against each other. It is not known for certain if strontium and antiresorptives are synergistic or antagonistic, but some research shows they could be antagonistic. You can stop taking strontium and then take one of these drugs.
You said your recent dxa scan is in the osteopenia range, but you did not say if this scan was better or worse than the previous scan. Have your scores improved with strontium, and have you had any fractures since you began taking strontium? These are questions to ask yourself before deciding to switch to a prescription drug.
Your doctor must have used the Fracture Risk Assessment Tool (FRAX) to assess your 10-year fracture risk. One of the questions on the tool is whether you had a parent who fractured a hip. The doctor answered "yes." You can fill out the FRAX form yourself and see if you agree with the doctor's FRAX score. Since your father was 93, and the hip fracture was the result of a fall, you could answer "no," especially if the fall was from a significant height and/or onto a hard surface, and see how that change affects your score. https://www.sheffield.ac.uk/FRAX/tool.aspx?country=9
The following is from the website listed above:
"Consider FDA-approved medical therapies in postmenopausal women and men aged 50 years and older, based on the following:
A hip or vertebral (clinical or morphometric) fracture
T-score ≤ -2.5 at the femoral neck or spine after appropriate evaluation to exclude secondary causes
Low bone mass (T-score between -1.0 and -2.5 at the femoral neck or spine) and a 10-year probability of a hip fracture ≥ 3% or a 10-year probability of a major osteoporosis-related fracture ≥ 20% based on the US-adapted WHO algorithm
Clinicians judgment and/or patient preferences may indicate treatment for people with 10-year fracture probabilities above or below these levels."
Dear BoneLady,
Thanks for your response. Would you recall where you came up with the research regarding strontium and antiresorptives being synergistic or antagonistic. You say I could stop the strontium and then do one of the drugs. I would wonder though because I think (not sure) that the strontium stays in the bones for how long I have no idea. I am not sure if my score improved with my recent Dexa, my Dr. Is mailing me the report. Hew did say it was in the osteopenia range which some past tests called it osteoporosis. I agree about the Frax score that was the reason he is recommending meds. I feel also that my father was 93 when he fell not from a height and I,m not sure if it was a hard surface or not? I will let you know when I receive the report what it says.
Again thanks for your kind response.
Dear Di,
On 11 August 2015, I posted results of a study on sequential therapy with bisphosphonates and strontium ranelate (SR). The study was published in "Osteoporosis: Diagnosis and Management," Dale W. Stovall (ed.), Wiley (Jul 15, 2013), 288 pages, Chapter 13, pages 202-203. Women who took SR after having taken bisphosphonates did not gain as much BMD as those who were given SR without having taken a bisphosphonate. "The most likely mechanism to explain these effects is that bisphosphonates inhibit the uptake of strontium into bone because of suppression of bone turnover and the consequent reduction in newly formed bone," the authors speculated. http://strontiumforbones.blogspot.com/2015/08/sequential-therapy-with-bisphosphonates.html
The strontium stays in the bones for a long time, but,if you stop taking it, your BMD declines. The rate of decline is different for different people. http://strontiumforbones.blogspot.com/2018/02/bmd-increases-by-varying-amounts-with.html
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