Skeleton Pirate

Skeleton Pirate
Artist: LindaB


Have you experienced, or read about, negative, and even dangerous, side effects from Fosamax (alendronate), Boniva (ibandronate), Actonel (risedronate), and other bisphosphonates 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.

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Thursday, February 9, 2012

Combination of Micronutrients for Bone (COMB) Study

After 12 months of consecutive supplemental micronutrient therapy,repeat bone densitometry was performed. The results were analyzed in a group of compliant patients and demonstrate improved BMD in patients classified with normal, osteopenic and osteoporotic bone density.

Combination of Micronutrients (COMB) Protocol for Bone Health

1. Docosahexanoic acid or DHA (from Purified Fish Oil): 250 mg/day
2. Vitamin D3: 2000 IU/day
3. Vitamin K2 (non-synthetic MK7 form): 100 ug/day
4. Strontium citrate: 680 mg/day
5. Elemental magnesium: 25 mg/day
6. Dietary sources of calcium recommended
7. Daily impact exercising encouraged

After one year of therapy with the COMB protocol compared to published results for strontium ranelate and bisphosphonate medications, the percent changes in bone mineral density (z values) were as follows:

Femoral neck: 4% increase for the group on the COMB protocol vs. 2% for strontium ranelate, alendronate, and risedronate

Total hip: 3% increase for the COMB protocol vs. 3-4% for strontium ranelate, 2% for alendronate, and not calculated for risedronate

Total spine: 6% increase for COMB protocol vs. 5-6% for strontium ranelate, 4% for both alendronate and risedronate

This combined micronutrient supplementation regimen appears to be at least as effective as bisphosphonates or strontium ranelate in raising BMD levels in hip, spine, and femoral neck sites. No fractures occurred in the group taking the micronutrient protocol. This micronutrient regimen also appears to show efficacy in individuals for whom bisphosphonate therapy was previously unsuccessful in maintaining or raising BMD. Prospective clinical trials are required to confirm efficacy.

This study by Stephen J. Genuis and Thomas P. Bouchard was published in the Journal of Environmental and Public Health, Volume 2012 (2012), Article ID 354151,doi:10.1155/2012/354151 COMB Protocol


Anonymous said...

Very interesting to read. I was diagnosed with osteoporosis a couple of years ago. Took 8000 of Vit D a day per my doctor - but somewhat sporadically and calcium a bit sporadically too. On my last scan in August my scores had worsened significantly. Since then I have been quite religious with 8000 of D3, only 600 of calcium from Bone Up and 680 of Strontium. I went to an osteoporosis specialist and they did a blood test- guess my serum calcium was way up! So he said stop all supplements and drink 2 - 3 quarts of water for a week.Tomorrow I will take another blood test. Apparently too much Vit D can cause this. I have had none of the negative symptoms I see on the web about high serum calcium. Luckily I had a blood test in August and all was fine. So I think it must be something I am taking (!) Anyway an interesting journey. I am trying to eat a lot more vegetables to work on alkalinizing my diet. I hope I can reintroduce the strontium later. I have seen nothing on the web about it increasing serum calcium levels - only the opposite if taken with too little calcium.

Love your site- thanks for all the info!

BoneLady said...

To Anonymous of 2/11/2012:

If your doctor prescribed 8000 IU vitamin D daily (a high dosage), I assume your 25-OH-vitamin D test had been low. Because vitamin D helps your body absorb calcium, a large excess of stored vitamin D can cause too much calcium in the blood (hypercalcemia). Blood chemistry is a delicate balancing act that must be monitored on a regular basis, especially if you are taking high dosages of certain supplements, such as vitamin D.

Products that contain calcium may prevent your body from absorbing your strontium. That is why strontium and calcium-containing foods and supplements are to be taken at least two hours apart.

You should be able to reintroduce your strontium if you do not start taking an osteoporosis drug. Good luck to you. Keep in touch on your progress.

Anonymous said...

Hi BoneLady
I just started on retinol 150 mg once a month (first tablet last week no side effects as yet)and i take 680mg of strontium a day.
in the last paragraph of your last reply you wrote "you should be able to reintroduce your strontium if you do not start taking an osteoporosis drug" i was wondering about that, thanks Matt

BoneLady said...


I have read about people taking a bisphosphonate or Evista or other osteoporosis drug prescribed by their doctors and taking strontium citrate at the same time. Some tell their doctors; others do not. I discourage taking both a prescription drug for osteoporosis and strontium citrate. The DXA scan results will be impossible to interpret. What worked? Was it the drug or the supplement? Even more importantly, there are no clinical trials to tell us if such combinations are synergistic or antagonistic. That is what I meant when I wrote that you should be able to reintroduce strontium if you do not start taking an osteoporosis drug.

Anonymous said...

Hello - I am the previous Anonymous person who was taking 8000 of Vit D. Well I had my blood test and stopping all supplements and drinking lots of water helped! Apparently my serum calcium was 19 (!) Guess it should be between 8 and 10 something . The doctor had never seen one so high and asked an internist at the hospital. The internist apparently said is this person alive? Well after a week it went down to 13. I was supposed to go this week for another test but got a job so haven't. Have continued with lots of water. Will go next Monday and see if it has now become normal.

Thank you very much for your comments. I read everything I could and have not seen anything about Strontium causing this. I imagined it was the D too.
My doctor wants me to stop the Strontium for good.
I am living in a country where I think it is actually illegal to prescribe it. Although the doctor did say that he heard this was what was predominantly prescribed in Korea now for osteoporosis.Interesting if true.

I will have a bone scan here next week. I imagine that he will then ask me to take a drug which I will refuse. Hope that he will agree to continue to monitor me. And I will also check with my doctor in the States who originally suggested the higher does of D.

Always a journey!

Thank you for your support- great blog.

Anonymous of 2/11/2012

BoneLady said...

To Anonymous of 2/11/12 & 2/22/12:

Good luck on your follow-up tests.
Your high serum calcium levels could be due to excess vitamin D and/or excess calcium intake. There are other possible causes; strontium intake is not one of them.

The most common cause of high blood calcium is hyperparathyroidism. A parathyroid hormone (PTH) blood test measures the level of parathyroid hormone in the blood. This test is used to help identify hyperparathyroidism or to find the cause of abnormal calcium levels. PTH controls calcium and phosphorus levels in the blood. PTH levels that are too high or too low can cause problems with the kidneys and bones and cause changes in calcium and vitamin D levels.

Please have your doctor order a PTH test if your serum calcium does not return to normal.

Anonymous said...

Anonymous with high Calcium again !
Thank you for your informative Comments.
I went back for my third test and it is now down to 11 something so heading in the right direction. I will have another test in 2 weeks. Hope it is back to normal then.
My doctor seems to think Strontium was the problem but again don't think he knows much about it- or the relationship with Vitamin D either. Having a bone scan in two days so he can assess where I am now.
Will stay in touch!

BoneLady said...

To Anonymous With High Calcium,

I am glad your serum calcium level is going down. If your doctor does not understand the relationship between vitamin D and calcium, you need another doctor because that is basic physiology. The amount of vitamin D (8000 IU per day) you were taking was a high dosage.

As I mentioned before, you should also have a PTH level done to make sure you do not have a problem with your parathyroid glands. If you have hyperparathyroidism, only surgery will correct it.

Strontium can cause a false elevation in blood and urine calcium if the laboratory doing the analysis uses a colorimetric procedure. I don't know what country you are in or what procedure was used by your lab. Your doctor could be correct about strontium contributing to your elevated calcium levels, depending on how the calcium was analyzed. Bare in mind that strontium does not raise the level of calcium in your blood or urine, but it can cause false readings of serum and urine calcium if a colorimetric procedure is used. You should ask for an ionized calcium test and a serum calcium by inductively coupled plasma atomic emission spectrometry or atomic absorption spectrometry methods. Below is one of my earlier posts on this subject:

Blood and Urine Calcium
Strontium interferes with colorimetric methods for the determination of blood and urinary calcium concentrations. Therefore, in medical practice, inductively coupled plasma atomic emission spectrometry or atomic absorption spectrometry methods should be used to ensure an accurate assessment of blood and urinary calcium concentrations. These guidelines are included in the electronic Medicines Compendium (eMC), which contains information about UK licensed medicines:

Anonymous said...

High Calcium Anonymous again!

Bonelady thank you so much for your fascinating information. I will see if I can find out what sort of test they used. I did think it was interesting that I had none of the symptoms I could find about hypercalcemia except perhaps fatigue?? Forget exactly - think that was one but I have had that on and off before I ever took strontium. I will probably run your ideas by my
doctor in the States who originally prescribed the Vitamin D.

I am in Asia with a rather young doctor at a hospital with a very strong reputation. He did say that he had heard they prescribe Strontium in Korea which I found interesting. Also on a totally different subject I will say that my co-pay on my DEXA scan was about $17 !!! I paid $240 for one in the States I think with no insurance. Amazing.

Will check back with any significant news.

Many thanks again!

High Calcium Anonymous- my new name :)

Wandering Skeleton

Wandering Skeleton
Artist: Joel Hoekstra

Osteoporotic Bone

Osteoporotic Bone

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.