Strontium and Heart Health

I started taking strontium citrate on January 21, 2008. I had had a bad experience with Fosamax once weekly. When I say bad, I mean very bad. I was dizzy and had vertigo to the point I could barely walk a few steps to the bathroom and could not do floor exercises because the minute my head hit the floor, I felt I was falling off a cliff. I was worried about my osteoporosis diagnosis and was desperate to find something that would work for me without causing more harm than good. I began doing internet searches, but there was little information about strontium of any kind. After I had been on SC for a short time, I came across Sara DeHart's first case study, which had been posted on July 7, 2008. That study gave me much hope for SC. I decided to monitor my progress and post my results on my own blog. 

I also began following any news or articles I found about strontium, including strontium ranelate, because there were extensive clinical trials of SR. I posted articles about the SOTI and TROPOS clinical trials. 

It was not until 2013 that news about SR and increased risk of heart problems began appearing. In April 2013, the use of Protelos/Osseor (strontium ranelate) was restricted to those with severe osteoporosis at high risk of fracture. In 2014, the European Medicines Agency (EMA) recommended further restrictions. SR was to be prescribed only to patients with severe osteoporosis and unable to tolerate other medications. All patients were to be evaluated for heart risks before prescribing or continuing to prescribe SR. In 2017, Servier, the manufacturer of SR, pulled the product from the EU because it was not making enough money. 

I see myself as a reporter. I write about all the news--both good and bad. In 2013, I had already been on SC for five years. I felt great. I had had no side effects and no fractures. The only reports about SC were Sara DeHart's three case studies and the COMB study (2012)--all great news! So, for me, the information about SR and heart issues was interesting but only mildly disturbing. I may have inadvertently scared some people, who may have stopped taking SC solely on the basis of bad news about SR. 

On October 22, 2015, Health Canada published its "Summary Safety Review--Strontium--Risk of Heart and Circulatory Side Effects." Health Canada's review did not find information available on cardiovascular risk with the strontium ranelate form at doses less than 680 mg strontium per day, or with other non-ranelate forms of strontium at any dose. While uncertainties remain, Health Canada is taking a precautionary approach and recommending updates to the labels of products containing strontium, including informing consumers not to use these products if they have pre-existing heart or circulatory problems, such as heart attack, stroke or blood clot.

I have not had a heart attack, stroke, or blood clot, although I have close relatives who have had all three (not all three for the same person). I have mixed hyperlipidemia, for which I take a statin drug. I have occasional heart palpitations, but my recent EKG was normal, and I control the palpitations with CBD oil. I will continue to take SC and to report on my health and on any news about any form of strontium. 

Would I Do Anything Differently for My Bones? Would you?

Someone asked me recently if, knowing what I know today, I would do anything differently for my bones.

Knowing what I know today (16 years after my osteoporosis diagnosis), I would never have taken Fosamax, 70 mg, once weekly. I suffered from dizziness and vertigo and had to stop taking it after six months. 

I would still take strontium citrate because taking it has been a positive experience. I am still taking it 15 years later at the full dosage of 680 mg/day.

I will not take any of the osteoporosis drugs. The anabolic drugs are, therapeutically, a big step forward over the antiresorptive ones, but all the bone drugs come with many potential side effects.

The only other bone therapy I find acceptable is vitamin K2 (MK4) at 45 mg/day (15 mg taken three times per day). MK4 at this dosage is given by prescription in Japan and other Asian countries for osteoporosis. It is also said to be heart healthy. The only problem is it is hard in Western nations to find reliable information about how this therapy is working out. I do not know any Americans who have used this therapy over a protracted period of time. Anyway, it is my Plan B, in case I ever want to switch from SC. Another, more likely, possibility for my future is to reduce my SC dosage by one-third or one-half and add MK4 at 15 mg or 30 mg/day.

You may have noticed that I did not mention vitamin K2 (MK7). That is because I would never take it based on the reports of many people who say they experience nervousness, insomnia, and/or heart palpitations with even small doses of MK7. Also, I feel there is more evidence for the efficacy of MK4 than MK7 because MK4 has been used in Japan for osteoporosis for more than 20 years. 

What, if anything, would you do differently for your bones?