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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Tuesday, April 22, 2014

Dr. Hoffman’s Comments on Strontium and Vitamin D

In Dr. Ronald Hoffman’s recent podcast, he answered the following questions pertaining to strontium and vitamin D:

Are there dangers to using strontium?

He says there is an increased risk of blood clots with strontium ranelate, but he believes it is due to the ranelate, not the strontium. He says he has not seen this problem with strontium citrate.

My take: An increased risk of blood clots is only one of several adverse events attributed to strontium ranelate. I believe most of the negative side effects of strontium ranelate may be due to ranelic acid and/or aspartame, although no one knows for sure. I have not read of anyone who got a blood clot that could be attributed to strontium citrate. The most common adverse events associated with strontium citrate are constipation, other gastrointestinal disorders, and nausea. I have been using strontium citrate for six and a half years with no problems except minor constipation.   

Can strontium falsely elevate DEXA bone density scans?

He says there is a false elevation and the improvement is actually about half of what we see on the bone density test. He says you can take your percent increase and divide it by two.

My take: It is a fact that there is a false elevation of BMD with strontium. Servier, the manufacturer of strontium ranelate, says the BMD can be falsely elevated by as much as 50% after three years of strontium use. This 50% figure is an estimate. It depends on how long you have been taking strontium, how well you absorb it into your bones, and the type of DEXA equipment used. The exact correction will vary for each individual. If you have been taking strontium for three years or longer, you can use the 50% correction as a general rule.

Can you use an osteoporosis medication and strontium together?

This was not posed as a question in the podcast. Dr. Hoffman stated that he had one patient with very low bone density and that he prescribed a medication (not specified) and natural support (strontium, I assume, since the discussion was about strontium) together.

My take: If he prescribed a bisphosphonate and strontium together, it was probably not a good idea. The two may be antagonistic. A recent study provides evidence that prior bisphosphonate therapy results in blunting and delay of the BMD response to strontium ranelate. This study was on sequential use of a bisphosphonate followed by strontium ranelate. See my April 2, 2014 blog post, “Sequential Therapy with Bisphosphonates and Strontium” for more information on this study. We do not know if taking a bisphosphonate and strontium simultaneously would also result in blunting and delay of the BMD response.

Which vitamin D should you take, D2 or D3?

He says to avoid vitamin D2 because it cancels the effect of D3 to some extent. He says D3 is more bioavailable and more bioactive than D2.

My take: I use vitamin D3. I believe D3 is more bioavailable than D2 and will do a better job of raising your vitamin D blood level.  

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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.