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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Wednesday, December 17, 2014

Strontium Citrate and Strontium Ranelate

Strontium ranelate is prescribed for postmenopausal osteoporosis in the United Kingdom, Australia, much of Europe and Asia, and Mexico. Due to an increased risk of thrombosis and cardiovascular events in patients with a history of cardiovascular problems, some doctors are discouraging their patients from taking strontium ranelate or refusing to prescribe it.

Strontium ranelate is not available in the United States or Canada. However, strontium citrate can be purchased as a supplement from health food stores and online distributors. Is strontium citrate safe and effective?

In 2012, Canadian researchers published the Combination of Micronutrients for Bone (COMB) Study. Here is the abstract:

“Along with other investigations, patients presenting to an environmental health clinic with various chronic conditions were assessed for bone health status. Individuals with compromised bone strength were educated about skeletal health issues and provided with therapeutic options for potential amelioration of their bone health. Patients who declined pharmacotherapy or who previously experienced failure of drug treatment were offered other options including supplemental micronutrients identified in the medical literature as sometimes having a positive impact on bone mineral density (BMD). After 12 months of consecutive supplemental micronutrient therapy with a combination that included vitamin D3, vitamin K2, strontium, magnesium and docosahexaenoic acid (DHA), 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. According to the results, 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 where bisphosphonate therapy was previously unsuccessful in maintaining or raising BMD. Prospective clinical trials are required to confirm efficacy.”

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

The following two paragraphs are quotes from the paper:
“Studies to date have predominantly focused on strontium ranelate rather than the readily available strontium citrate supplement as used in this study. The results of this study, however, demonstrate that the micronutrient combination including strontium citrate is at least as effective in BMD change as strontium ranelate with suggestion of preferred efficacy of the former therapy at improving femoral neck outcomes. Furthermore, the ranelic acid salt is a purely synthetic molecular compound, while citrate is naturally occurring. It appears to be the strontium portion of the molecules which exerts most or all of the positive effect on bone. When consuming the strontium ranelate, for example, the compound splits into two strontium ions and one molecule of ranelic acid, with each absorbed separately. There is little evidence that the ranelic acid portion of the strontium ranelate compound contributes to the effect of strontium on skeletal tissue, and of the small amount of ranelic acid that is absorbed into the body, almost all is excreted within a week without ever being metabolized. All forms of strontium have bioavailabilities in the 25–30% range, but gastric tolerance appears to be better with the ranelate and citrate forms.”

“With the mounting concern about the safety profile of some standard medical interventions for bone compromise, strontium is very well tolerated and has shown remarkably little in the way of side effects or long-term adverse sequelae. An increased risk of thrombosis has been noted with strontium ranelate, an effect not reported (to our knowledge) with strontium citrate [16].”

16. S. J. Genuis and G. K. Schwalfenberg, “Picking a bone with contemporary osteoporosis management: nutrient strategies to enhance skeletal integrity,” Clinical Nutrition, vol. 26, no. 2, pp. 193–207, 2007.
The abstract to reference 16:
The entire article (reference 16) in PDF form:

The entire COMB Study article can be read here:


Anonymous said...

I have just been diagnosed with osteoporosis. Do not like the idea of Bisphosphonates.

Strontium Citrate looks like it is the only Strontium that I can get my hands on - I had a stroke 30years ago [aged 38] and the doctors will not prescribe Strontium [ranelate -live in UK].

Here we can get Strontium Citrate from Amazon, at 750mg a day from Life Extension. I am just hoping that this will be OK for me!

BoneLady said...

To: Anonymous of 02/02/2015,

As you read in the article, blood clots, which can lead to strokes and heart attacks, have not been associated with strontium citrate (SC). Of course, as a supplement, SC has not undergone the rigorous clinical trials required of prescription medications.

At an osteoporosis support group,,I met a member, Char42, who has a genetic blood clotting disorder and has had clots, including a pulmonary embolism. She had one of the clots while taking a bisphosphonate. She has been taking SC for 4 years with no problems. She took 680 mg for the first two years and then reduced the dosage to 340 mg. Her bone mineral density scores were some of the worst I have seen when she started taking SC. Her scores have steadily improved.

I have never had a clot or stroke. However, my father had a deep vein thrombosis and required surgery after the clot was eliminated with Coumadin. My mother died of a massive myocardial infarction. I take a statin drug because I could not lower my cholesterol and triglycerides with diet alone. Despite my family history, I have been taking SC (680 mg strontium) successfully for 7 years. I take Doctor's Best Strontium Bone Maker, which is also available from Amazon, but I buy it from

If you decide to take SC, be sure to also get adequate amounts of calcium, magnesium,& vitamin D. Vitamin K2 may help bones and prevent calcium from building up in arteries and other soft tissues. Try to get all or most of your calcium from food.

I wish you the very best.

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.