Strontium For Bones

Spinal BMD And Scoliosis

2012-01-06T12:13:00.000-05:00

On June 15, 2006, Ioannis P. Pappou, MD et al published a retrospective study entitled “Discordantly High Spinal Bone Mineral Density Values in Patients With Adult Lumbar Scoliosis.” The purposes of this study were: 1) to investigate the validity of bone mineral density measurements with DEXA in patients with adult lumbar scoliosis and 2) to investigate the association between osteoporosis and adult lumbar scoliosis.The study concluded the following:Cobb’s angle measurements on DEXA scans are reliable and comparable to conventional radiographs. Spinal BMD values are less valuable for monitoring osteoporosis than hip values in scoliotic patients; an increasing discrepancy with age was noted. Scoliotic patients exhibited discordantly high spinal BMD values, despite significant hip osteoporosis. The discrepancy correlated with aging and curve magnitude.Scoliosis was common among the osteoporotic population (9.47%). Lumbar scoliosis is a useful clinical marker for osteoporosis, irrespective of scoliosis history and magnitude. Viable alternatives for osteoporosis evaluation of adult patients with lumbar scoliosis are hip DEXA values, in conjunction with other BMD measurements.http://journals.lww.com/spinejournal/Abstract/2006/06150/Discordantly_High_Spinal_Bone_Mineral_Density.19.aspx

Effects of Strontium Ranelate on Spinal Osteoarthritis Progression

2011-12-23T12:03:00.000-05:00

In “Effects of strontium ranelate on spinal osteoarthritis progression,” published in Ann Rheum Dis 2008;67:335-339, O Bruyere et al aimed to determine whether a three-year treatment with strontium ranelate could delay the progression of spinal osteoarthritis (OA). This study was a post-hoc analysis of pooled data from the Spinal Osteoporosis Therapeutic Intervention (SOTI) and TReatment Of Peripheral OSteoporosis (TROPOS) trials performed on 1,105 women with osteoporosis and concomitant radiological spinal OA at baseline, and for whom lumbar x-rays were available at baseline and over the three-year treatment period. The presence and severity of osteophytes, disc space narrowing and sclerosis in the lumbar intervertebral spaces was graded, and an overall OA score was calculated for each intervertebral space. Back pain (measured on a five-point Likert scale only in SOTI) and health-related quality of life (SF-36 questionnaire) were assessed at baseline and after three years. Patients who suffered an incident or progressive vertebral fracture during the study were excluded from the analysis. The proportion of patients with worsening overall spinal OA score was reduced by 42% in the strontium ranelate group, compared with placebo. Significantly more patients in the strontium ranelate group experienced an improvement in back pain after three years, compared with placebo, while no significant difference was observed in terms of health-related quality of life between these patient groups. The researchers concluded that strontium ranelate could reduce the progression of the radiographic features of spinal osteoarthritis (OA) and back pain in women with osteoporosis and prevalent spinal OA. http://ard.bmj.com/content/67/3/335.abstract.

Supplements For Bone Health

2011-09-30T11:33:00.003-04:00

On August 5, 2010, I posted “My Daily Supplements,” a list of the many supplements I take. You can access it at http://strontiumforbones.blogspot.com/search?updated-max=2010-08-21T15%3A28%3A00-04%3A00&max-results=6. Here are the three supplements I take specifically for osteoporosis and to which I attribute my significant gain in bone mineral density. The multivitamin is for general health, but, with 1000 IU vitamin D3, 200 mg calcium, 100 mg magnesium and 80 mcg vitamin K, it is an important part of my bone-building strategy. This list may help you get started on your own supplement program.

Because each one of us is unique, each will have to individually tailor his/her own program. Some people, for example, will need much more vitamin D3 than the 1000 IU I take. If your blood calcium level is low and/or your 25-hyroxy vitamin D test is low, and/or you live in a northern climate or an area of high smog density where your sun exposure is limited, you may have to take much higher vitamin D dosages. Corticosteroids, diuretics, anticonvulsants, and some heartburn medications may interfere with vitamin D. If you take any of these medicines, you may need to increase your vitamin D intake. I spend considerable time outdoors in a southern climate and my blood calcium levels tend to run high normal; therefore, 1000 IU vitamin D3 is plenty for me.

Doctor’s Best Strontium Bone Maker, 2194 mg strontium citrate, 680 mg elemental strontium in two capsules. I buy this at www.iherb.com.

Nature Made Multi For Her 50+ (contains 22 key nutrients, including 1000 IU vitamin D3, 200 mg calcium, 100 mg magnesium, 80 mcg vitamin K, 2500 IU vitamin A with 60% as beta carotene, 25 mcg vitamin B12, 180 mg vitamin C, 60 IU vitamin E, 15 mg zinc, 70 mcg selenium). I buy this at www.walgreens.com when they have two-for-one specials. Walgreens drugstores have the same specials.

Kal Extra-Strength Calcium Magnesium (I take one tablet, which contains 500 mg calcium and 250 mg magnesium.) The multivitamin listed above contains 200 mg calcium and 100 mg magnesium. I get approximately 500 mg calcium from food to total the 1200 mg recommended for a woman over 50 years old. I do eat dairy products. I am currently buying this supplement at www.vitaminshoppe.com.

New BONIVA Advertisement Features Correction

2011-09-27T12:04:00.002-04:00

Have you seen the latest BONIVA ad? Apparently, the Food and Drug Administration (FDA) has forced Roche Therapeutics Inc. to recant a previous unsubstantiated claim about their product, which contains ibandronate sodium, a bisphosphonate. I saw this ad in the September 25, 2011, Parade magazine, which is included with my Sunday newspaper. The title and first two paragraphs of the advertisement concern the correction:

“An important correction from BONIVA for women with postmenopausal osteoporosis”

“You may have seen an ad about BONIVA for the treatment and prevention of postmenopausal osteoporosis that may have given you the wrong impression. Our ads stated that ‘After one year on BONIVA, 9 out of 10 women stopped and reversed their bone loss.’ The FDA has found that there is not enough evidence to support this statement and wants us to clear up any misunderstanding you may have had about these ads and make sure you have the correct information about BONIVA.”

“BONIVA has not been proven to stop and reverse bone loss in 9 out of 10 women and is not a cure for postmenopausal osteoporosis. BONIVA has been shown to help increase bone mass and help reduce the chance of having a spinal fracture (break). We encourage all patients to discuss their treatment with their healthcare provider. Only your doctor can determine if BONIVA is right for you.”

Antiresorptive, Anabolic, And Dual-Action Osteoporosis Drugs

2011-09-13T12:01:00.011-04:00

Osteoporosis drugs can be divided into three categories: antiresorptive drugs that slow bone breakdown (resorption), anabolic drugs that build new bone, and dual-action drugs that both slow bone resorption and build new bone. Most approved osteoporosis drugs are antiresorptive. These slow bone loss and help fill in the remodeling spaces. All antiresorptive agents reduce the risk of vertebral (spinal) fractures and reduce markers of bone turnover. These markers are substances in the blood and urine that reflect the activity of the bone cells involved in breakdown and formation.

Antiresorptive medications include bisphosphonates, selective estrogen receptor modulators (SERMs), hormone replacement therapy (HRT), and calcitonin. Bisphosphonates include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast). The only approved SERM is raloxifene (Evista). HRT includes several agents: Premarin, Prempro, Estrace, Estraderm, and Climara. Calcitonin is a polypeptide hormone secreted by the parafollicular cells of the thyroid gland in mammals and by the ultimobranchial gland of birds and fish. Miacalcin® (calcitonin-salmon) Nasal Spray is a synthetic polypeptide of 32 amino acids in the same linear sequence that is found in calcitonin of salmon origin. Miacalcin is also available as an injection.

The newest drug in the antiresorptive category is denosumab (Prolia), an injection administered subcutaneously once every six months. Prolia binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption. Prolia prevents RANKL from activating its receptor, RANK, on the surface of osteoclasts and their precursors. Prevention of the RANKL/RANK interaction inhibits osteoclast formation, function, and survival, thereby decreasing bone resorption and increasing bone mass and strength in both cortical and trabecular bone.

In clinical trials in women with postmenopausal osteoporosis, treatment with Prolia resulted in significant suppression of bone remodeling as evidenced by markers of bone turnover and bone histomorphometry. The significance of these findings and the effect of long-term treatment with Prolia are unknown. The long-term consequences of the degree of suppression of bone remodeling observed with Prolia may contribute to adverse outcomes such as osteonecrosis of the jaw, atypical fractures, and delayed fracture healing.

Antiresorptives do not build bone beyond what is produced to help fill the remodeling spaces. Bone-building (anabolic) drugs, on the other hand, stimulate bone formation by increasing the activity of the cells known as osteoblasts. The only such medication approved in the U.S.A. for treating osteoporosis is teriparatide (Forteo), a form of human parathyroid hormone (PTH). The drug comes as a daily injection, which can be self-administered. PTH produces larger increases in BMD than antiresorptives do. It also improves bone microarchitecture. However, it is prescribed for no more than about two years because its long-term safety and efficacy are unknown. Most experts recommend that antiresorptive drugs be stopped during PTH therapy and restarted after the course of PTH is complete.

Strontium ranelate is a compound that incorporates the element strontium, which is found in trace amounts throughout the skeleton. Results from Phase III trials conducted by French researchers suggest that strontium ranelate may reduce vertebral fractures about as well as bisphosphonates. The drug is believed to work by decreasing bone breakdown and increasing bone buildup. This prescription drug is not available in the U.S.A., but strontium citrate can be purchased as a supplement.

My opinion is that the antiresorptive drugs are flawed models as osteoporosis drugs. If we keep slowing bone breakdown without building new bone, we eventually end up with very old, weak bones. Long-term suppression of bone remodeling by Fosamax and other bisphosphonates has led to osteonecrosis of the jaw and atypical femur fractures in some patients. Better models are bone-building (anabolic) drugs (i.e. Forteo) and dual-action agents (i.e. strontium ranelate, strontium citrate) that decrease bone breakdown and increase bone buildup.

http://www.health.harvard.edu/newsweek/Update_on_osteoporosis_drugs.htm
http://www.rxlist.com/miacalcin-drug.htm
http://www.rxlist.com/prolia-drug.htm

Bone Remodeling

2011-08-12T12:29:00.001-04:00

Bone remodeling is the replacement of old bone tissue by new bone tissue. This process, which mainly occurs in the adult skeleton to maintain bone mass, involves the coupling of bone formation and bone resorption and consists of five phases:

1. Activation: preosteoclasts are stimulated and differentiate under the influence of cytokines and growth factors into mature active osteoclasts

2. Resorption: osteoclasts digest mineral matrix (old bone)

3. Reversal: end of resorption

4. Formation: osteoblasts synthesize new bone matrix

5. Quiescence: osteoblasts become resting bone lining cells on the newly formed bone surface

http://www.iofbonehealth.org/health-professionals/about-osteoporosis/basic-bone-biology.html

Strontium Ranelate And Risk Of Vertebral Fractures In Frail Osteoporotic Women

2011-07-22T12:28:00.004-04:00

Data were obtained from the SOTI (Spinal Osteoporosis Therapeutic Intervention) and TROPOS (Treatment Of Peripheral Osteoporosis) studies which randomized participants to receive either strontium ranelate or placebo over three years. The study identified 2346 robust, 2472 intermediate and 264 frail women. At three years, the risk for vertebral fractures was reduced by 30% in the robust, by 45% in the intermediate, and by 58% in the frail patients compared to those assigned to placebo. Risk of vertebral fracture was reduced within one year in all three groups.
This study was published by Rolland Y, Van Kan GA, Gillette-Guyonnet S, Roux C, Boonen S, and Vellas B in Bone 2011;48:332-8.

The Effect Of Bone Strontium On BMD Differs For Different DXA Equipment

2011-07-19T12:32:00.006-04:00

Osteoporotic patients treated with strontium ranelate show relatively large increases in bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) due to the replacement of some of the calcium atoms in bone by strontium. A study by Pors Nielsen and colleagues reported that replacement of 1% of calcium atoms by strontium causes a 10% increase in BMD. The ratio of the percentage increase in BMD to the molar percentage of strontium in bone is referred to as the strontium ratio. Theoretically it is expected that the strontium ratio should vary between different manufacturers' DXA equipment depending on the effective photon energy of the device.

In this study the researchers reported theoretical estimates of the strontium ratio for two axial DXA systems and two peripheral DXA devices based on their broad spectrum X-ray emission. The theoretical figures were verified in an experimental study in which the strontium ratio for each device was measured using phantoms containing mixtures of hydroxyapatite and strontium hydrogen-phosphate. The theoretical values of the strontium ratio were 11.0 for the Hologic Discovery, 9.9 for the GE-Lunar Prodigy, 9.1 for the Demetech Calscan, and 8.5 for the Osteometer Dexacare G4. Experimental results were 11.2 for the Discovery, 9.9 for the Prodigy, 8.6 for the Calscan and 6.3 for the Dexacare G4. The results confirm that the effect of bone strontium on BMD measurements is different for different DXA systems. In the future it might be possible to exploit this effect to make a non-invasive estimate of average bone strontium content in groups of patients receiving strontium medication for osteoporosis.

Liao J, Blake GM, McGregor AH, Patel R. Bone. 2010 Nov; 47(5):882-7. Epub 2010 Aug 10

http://www.ncbi.nlm.nih.gov/pubmed/20699129

Dietary Calcium Intake And Risk Of Fracture And Osteoporosis

2011-06-23T11:57:00.002-04:00

The optimal level of calcium intake to compensate for skeletal calcium losses and to prevent osteoporosis and fractures remains unclear. This is reflected by the wide range of daily calcium recommendations for individuals older than 50 years: at present 700 mg in the UK, 800 mg in Scandinavia, 1200 mg in the United States, and 1300 mg in Australia and New Zealand.

The findings of a large Swedish study recently published in the British Medical Journal show an association between a low habitual dietary calcium intake (below 751 mg per day for women) and an increased risk of fractures and of osteoporosis. Above this base level, only minor differences in risk were observed. The highest reported calcium intake (>1137 mg) did not further reduce the risk of fractures of any type, or of osteoporosis, but was associated with a higher rate of hip fracture.

Eva Warensjö, et al. BMJ. 2011; 342: d1473.
Published online 2011 May 24. doi: 10.1136/bmj.d1473.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101331/

Drugs Associated With Increased Bone Loss And Fracture Risk

2011-04-21T11:49:00.005-04:00

"Certain drugs (e.g., glucocorticoids, carbamazepine, phenytoin, valproic acid, lithium, depot medroxyprogesterone, chemotherapeutic agents, and long-term heparin therapy) are known to be associated with increases in bone loss or fracture rate. Thiazolidinediones are the newest addition to this list, as recent clinical trials have reported increased fracture rates in patients receiving these drugs for the treatment of type 2 diabetes mellitus."

"Pioglitazone and rosiglitazone, the two currently available thiazolidinediones, accounted for nearly one quarter of the antidiabetic drugs prescribed in the United States in 2004 and 2005. In 2008, both pioglitazone (8th) and rosiglitazone (98th) ranked within the top 100 prescription drug sales in the United States. This widespread use has exposed many postapproval adverse effects, including bone changes and fractures."

The entire article can be read at:

http://www.medscape.com/viewarticle/725156
Bone Loss and Fracture Risk Associated with Thiazolidinedione Therapy
Daniel M. Riche, Pharm.D.; S. Travis King, Pharm.D.
Posted: 10/05/2010; Pharmacotherapy

Systematic Treatment After Successful Surgical Treatment for Primary Hyperparathyroidism With Strontium Ranelate

2011-02-28T12:17:00.009-05:00

Patients with primary hyperparathyroidism (pHPT) with osteopenia or osteoporosis are treated with strontium ranelate/Ca+Vitamin-D or placebo/Ca+Vitamin D after successful surgical treatment of pHPT. This clinical trial is currently recruiting participants. ClinicalTrials.gov processed this record on February 27, 2011.

The chronic excessive hypersecretion of parathyroid hormone (PTH) has significant impact on bone remodeling. In primary hyperparathyroidism (pHPT) bone turnover is increased, resulting in a higher resorption of bone and thus loss of bone density.

After successful surgical treatment of pHPT, bone metabolism switches from catabolic state to anabolic state again. However, studies show that postmenopausal women in particular regain significantly less BMD and often suffer from osteopenia or osteoporosis. The hypothesis is that strontium ranelate/Ca + Vitamin-D helps to regain bone mass in patients with osteopenia or osteoporosis after successful parathyroidectomy for pHPT and results in higher gain of BMD than placebo-treated patients.

Eligibility Requirements: 18 Years and older, either gender, biochemically proven pHPT and PTX planned, osteopenia (t-score < -1 and > -2.5) or osteoporosis (t-score ≤ -2.5) according to WHO Criteria

Medical University Vienna, General Hospital Vienna, Vienna, Austria, 1090
Contact: Bruno Niederle, Prof., MD. at chir-endokrin@meduniwien.ac.at

Contact: Christian Scheuba, Prof., MD at christian.scheuba@meduniwien.ac.at

There is a long list of exclusion criteria and more information at:

http://www.clinicaltrials.gov/ct2/show/NCT01222026?term=strontium+AND+osteoporosis&rank=1

Strontium Citrate Clinical Trial Results By Year End

2010-11-05T10:19:00.003-04:00

Data from the three-month strontium citrate clinical trial known as the Scope Study are currently (as of November 4, 2010) being evaluated at the UC Davis Medical Center. Some results should be available by the end of the year. Stay tuned for the latest word from the Scope Team.

Strontium Ranelate Available In Mexico As Protos

2010-09-23T11:15:00.004-04:00

I had been asked if strontium ranelate is available in Mexico. I knew the drug was available in different countries (not the U.S.) under various brand names. A spokesperson from Servier International just replied to my question: "Is Protelos available in Mexico? If it is available, what brand name is it sold under?" Here is the reply:

"Thank you for your interest for strontium ranelate/Protelos. In response to your question below, please be advised that strontium ranelate is available in Mexico under the brand name of Protos, however, please note that strontium ranelate has not been submitted to the FDA and, thus, is not approved for use in the USA."
Sincerely, M. Rebuffe-Scrive
Servier International

The Osteoporosis Patient With Renal Insufficiency

2010-09-18T16:28:00.006-04:00

A German paper by G. Lehmann, G. Hein, and G. Wolf addresses the osteoporosis patient with renal insufficiency and what has to be taken into account in the selection and administration of medications for osteoporosis. Because the incidence of osteoporosis and renal insufficiency increases with age, the use of antiosteoporotic drugs approved for long-term administration in patients with inadequate renal function is a cause for concern. In the dose approved for the treatment of osteoporosis, oral bisphosphonates and i.v. ibandronate (3 mg every 12 weeks) are considered safe in patients with glomerular filtration rate (GFR) > 30 ml/min. Treatment with strontium ranelate and the osteoanabolic substance teriparatide is not altered by impaired renal function until GFR falls below 30 ml/min. Efficiency of the selective estrogen receptor modulator (SERM) raloxifene is not altered by renal function.
http://www.ncbi.nlm.nih.gov/pubmed/16924452

Picking a Bone With Contemporary Osteoporosis Management

2010-08-21T15:28:00.004-04:00

I recently came across an abstract of a research article critical of contemporary osteoporosis management and recommending strontium, calcium, vitamins D and K, and essential fatty acids. The article was published in Clin Nutr. Apr. 2007;26(2):193-207 and Epub. Oct. 13, 2006, by S.J. Genuis and G.K. Schwalfenberg of the University of Alberta, Alberta, Canada. Here is the abstract of the paper entitled, "Picking a Bone with Contemporary Osteoporosis Management: Nutrient Strategies to Enhance Skeletal Integrity."

"Epidemic rates of osteoporosis in the western world have yielded intense efforts to develop management approaches to combat this potentially devastating disorder; recent research has unveiled innovative strategies which hold considerable promise for prevention of skeletal compromise and amelioration of suboptimal bone health. According to many algorithms and practice directives, the contemporary assessment and management of osteoporosis focuses heavily on determination of fracture risk and pharmaceutical intervention for those patients deemed to be at high risk. While routine recommendations for calcium and vitamin D have been incorporated into most regimens, disproportionately little attention has been given to recent research elucidating improved bone health and diminution in fracture rates experienced by patients receiving specific nutrients. In mainstream medical practice, clinical analysis and management of nutritional or dietary issues is sometimes perceived as unconventional, primitive or unsophisticated health care. Recent evidence-based research, however, supports intervention with adequate amounts of specific nutrients, including vitamin D, strontium, vitamin K, and essential fatty acids, in the prevention and primary management of osteoporosis."

http://www.ncbi.nlm.nih.gov/pubmed/17046114

Development Plan for Strontium Malonate in U.S.

2010-08-20T11:42:00.004-04:00

On August 16, 2010, Osteologix, Inc., filed its quarterly Q-10, a required financial statement. Part of the report is quoted here: "We believe that our available existing resources will provide liquidity to fund our planned operations, excluding any clinical trials, into the second quarter of 2011. Because the business of developing pharmaceutical products is time-consuming and expensive, and NB S101 (strontium malonate), our most advanced investigational drug, still must complete pivotal human clinical trials before it can be marketed, we will require additional financial resources to carry out our business strategy. The development plan for NB S101 will require a larger phase 2 and/or phase 3 clinical trial that we estimate will take at least two years to complete. After or possibly concurrent with our next clinical trial, either one or two similar or potentially larger phase 3 trials will be required. We are seeking a third party development partner with substantially more resources than us for further clinical development in the United States, and we do not expect to proceed with further U.S. clinical development until we enter into a development agreement with such a partner Off-Balance Sheet Arrangements."

Strontium Malonate Licensing Agreement

2010-08-16T11:55:00.006-04:00

On August 2, 2010, Osteologix and Servier announced an ex-U.S. licensing agreement for NB S101 (strontium malonate). Osteologix has granted Servier an exclusive royalty-bearing license to develop and commercialize NB S101 to treat postmenopausal osteoporosis, other bone and joint disorders and dental indications worldwide, except in the United States. Under the terms of the agreement, Osteologix will receive up to €12 million in upfront and milestone payments. Additionally, Osteologix is eligible to receive up to €30 million in minimum royalty payments creditable against mid to low single digit royalties on sales. Osteologix will also be eligible to receive milestone payments and royalties on product development and sales in Japan. Servier will be responsible for all costs outside of the U.S. associated with development, regulatory approval and commercialization of NB S101. Osteologix will continue to own intellectual property rights for development in the U.S. This information is from a press release issued by Osteologix at http://www.osteologix.com/wb0005.php?oid=12.

Another Strontium Citrate Success

2010-08-10T12:16:00.006-04:00

Most of my posts are about my own experience with strontium citrate and about research on the various strontium salts. This post is about Sara S. DeHart's strontium success story, which she wrote about herself in two articles, the most recent one published online just a few days ago. In 2006, she was taking Actonel and developed a fracture at T-9. Later, that same year, she switched to strontium citrate (750 mg strontium/day) and has had no further vertebral fractures. Here are her T-scores from 2006 to the present:

Left Hip Lumbar Spine

2006 -1.2 -1.4
2008 -0.6 -0.2
2010 -0.5 +0.2

Here is the original article: http://onlinejournal.com/artman/publish/printer_6185.shtml

My Daily Supplements

2010-08-05T12:07:00.002-04:00

One of my readers asked me to add more information about supplements. I’ve decided to list all the ones I currently take. This list may provide a start for your own research. Each person’s needs will vary depending on age, sex, diet, and health.

Doctor’s Best Strontium Bone Maker, 2194 mg strontium citrate, 680 mg elemental strontium in two capsules
Nature Made Multi For Her 50+ (contains 22 key nutrients, including 1000 IU vitamin D3, 200 mg calcium, 100 mg magnesium, 80 mcg vitamin K, 2500 IU vitamin A with 60% as beta carotene, 25 mcg vitamin B12, 180 mg vitamin C, 60 IU vitamin E, 15 mg zinc, 70 mcg selenium)
Nature Made Vitamin C, 500 mg
Nature Made Vitamin E, 100 % Natural, 400 IU
Kal Extra-Strength Calcium Magnesium (I take one tablet, which contains 500 mg calcium and 250 mg magnesium.)
Kal Bioflavonoids 1000
Finest Natural Zinc, 50 mg
Finest Natural Selenium, 200 mcg
Nature’s Bounty Lutein, 20 mg
Nature’s Bounty Sublingual Vitamin B12, 2500 mcg (I take one tablet Monday, Wednesday, and Friday.)
Bluebonnet Lecithin, 1365 mg (I take three capsules daily.)
Nature’s Way Primadophilus bifidus

Also look up my previous posts:
03/30/2010 “How Much Calcium Are You Getting?” (Includes IOF’s Calcium Calculator)
03/29/2010 “Strontium With Insufficient Calcium and Magnesium, A Case Study”
03/22/2010 “Strontium And Calcium”

Preniva For Osteoporosis

2010-06-11T12:41:00.009-04:00

Recently, Saturday Night Live (SNL) did a skit about Preniva, a drug women don't need for osteoporosis but are scared into taking for our weak bones. Many of you have seen the Sally Field commercials for Boniva and will recognize the pun. Health Freedom Alliance posted the video with an introduction by Drew Kaplan. The Alliance, SNL, and I want people to be wary of tactics used by the big pharmaceutical companies to scare us into taking their sometimes useless and dangerous drugs. They often use celebrities, who may or may not take the drugs themselves, to make us believe they take them and love them. They imply that not taking their drugs could have dire consequences for our health. Follow this link for a real treat:

http://healthfreedoms.org/2010/05/24/snl-gets-it-right/

Proton Pump Inhibitors May Increase Fracture Risk

2010-05-28T12:10:00.007-04:00

On May 25, 2010, the U.S. Food and Drug Administration (FDA) announced that it would add safety information about the possible increased risk for hip, wrist, and spine fractures to the prescription and over-the-counter (OTC) labels for Proton Pump Inhibitors (PPIs), which include esomeprazole (Nexium), omeprazole (Prilosec, Zegerid), and lansoprazole (Prevacid).

PPIs treat conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. Ironically, PPIs are commonly prescribed to treat side effects, such as dyspepsia or heartburn, commonly associated with bisphosphonates.

Dr. Amar R. Deshpande, an assistant professor of gastroenterology at the University of Miami Miller School of Medicine, said PPIs may disrupt the body's ability to absorb calcium, which, in turn, can increase the risk for fractures. He also believes this class of drugs is overused and often taken for too long.

The FDA is advising consumers to not stop taking PPIs until they have consulted with their doctors. However, patients should be aware of the increased risk for fractures. The highest risk was seen in people taking higher doses of PPIs, or among those who took them for a year or more. For people taking OTC proton pump inhibitors, the FDA said they should only be taken for 14 days to help ease frequent heartburn. If heartburn continues, people should see their doctor. Under no circumstances should over-the-counter PPIs be taken for more than three 14-day periods in a year, the agency said.

Strontium Ranelate Reduces Fracture Risk In The Elderly

2010-05-26T11:32:00.006-04:00

According to a study by Ego Seeman et al., strontium ranelate produces an early and sustained reduction of both vertebral and nonvertebral fractures in women 80 years of age and older. More than 30% of all fragility fractures and 60% of hip fractures occur in women aged 80 and older, because of the high prevalence of osteoporosis and high incidence of falls. The aim of this study was to determine whether strontium ranelate, an agent that reduces the risk of vertebral and nonvertebral fractures in postmenopausal women >50 years of age, also reduces fractures in the elderly.

An analysis based on pooled data from two international, phase III, randomized, placebo-controlled, double-blind studies (the Spinal Osteoporosis Therapeutic Intervention [SOTI] and TReatment Of Peripheral OSteoporosis [TROPOS]) included 1488 women between 80 and 100 years of age followed for three years. Yearly spinal X-rays were performed in 895 patients. Only radiographically confirmed nonvertebral fractures were included.

The risk of vertebral, nonvertebral, and clinical (symptomatic vertebral and nonvertebral) fractures was reduced within one year by 59% (p = 0.002), 41% (p = 0.027), and 37% (p = 0.012), respectively. At the end of three years, vertebral, nonvertebral, and clinical fracture risks were reduced by 32% (p = 0.013), 31% (p =0.011), and 22% (p = 0.040), respectively. The medication was well tolerated, and the safety profile was similar to that in younger patients.

The authors concluded that treatment with strontium ranelate safely reduces the risk of vertebral and nonvertebral fractures in women with osteoporosis aged 80 and older. Even in the oldest old, it is not too late to reduce fracture risk.

J Bone Miner Res 2006;21:1113–1120. Published online on May 8, 2006; doi: 10.1359/JBMR.060404

How Much Calcium Are You Getting?

2010-03-30T10:49:00.004-04:00

To determine how much calcium to supplement, first figure out how much calcium you are already getting. The International Osteoporosis Foundation (IOF) has a calcium calculator to find out if you are getting enough calcium in your diet each day. Remember, women ages 19 to 50 need at least 1,000 mg of calcium daily. Women over 50 need at least 1,200 mg. Here is the link to the calculator:

http://www.iofbonehealth.org/patients-public/calcium-calculator.html

Strontium With Insufficient Calcium and Magnesium , A Case Study

2010-03-29T11:07:00.004-04:00

In 2008, Sara S. DeHart, MSN, Ph.D, published "Strontium and Osteoporosis: A Treatment Not Offered to American Women." The article presents her own case study of how she was treated for osteopenia by traditional medicine while continuing to fracture until she learned to treat herself with strontium citrate. I want to emphasize what she wrote about the importance of taking adequate levels of calcium and magnesium, along with the optimum levels of strontium citrate, and what happened to her before she realized this relationship.

"By that time (2006), I’d been investigating alternative therapies and added Strontium Bone Maker (1000 mg strontium citrate, 340 mg elemental strontium per day). I later increased the dosage to 2000 mg daily (680 mg elemental strontium), which is the dosage used in the strontium ranelate clinical trials (Meunier, Roux, Seeman, et al. 2004). The larger dosage led to a drop in my serum calcium level that was sufficient to cause muscle tetany in both hands. (Note I discontinued Actonel in 2007 and the muscle pain decreased significantly.) The larger dosage of strontium with insufficient calcium and magnesium caused the serum calcium level to drop. I increased my calcium + magnesium dosage and the serum calcium and ionized calcium levels returned to normal."

"Currently I am taking Osteo-MINS AM from the Tahoma Clinic in Renton, Washington, (700 mg per 3 capsules), though I have also used Strontium Support (AOR) from a Canadian firm. The Osteo-MINS AM appears to be the better formulation for my highly sensitive muscles. I take strontium two hours before breakfast so that it has cleared my digestive track prior to taking food or any calcium/magnesium. This is an important part of my supplementation program because without it my serum calcium level will drop and that has an effect on muscles throughout the body."

To read the entire article, see http://onlinejournal.com/artman/publish/article_3458.shtml

Strontium And Calcium

2010-03-22T11:51:00.009-04:00

For patients taking any strontium salt (e.g., strontium ranelate, strontium citrate) for osteoporosis, it is recommended that you obtain an adequate calcium intake as part of a well balanced diet. If you have difficulties obtaining adequate calcium from your diet, a calcium supplement may also be required. (All patients participating in the strontium ranelate research trials had an adequate calcium intake.) Take your calcium supplement or calcium-rich food at least two hours before or two hours after you have taken the strontium because calcium will prevent the absorption of strontium.

There is an upper limit to the amount of calcium that can be taken safely. It is recommended that you do not exceed 2000 - 2500 mg of calcium per day included in your food, drink and supplements. Consistently exceeding the upper limit may increase your risk of medical problems, including a high level of calcium in the blood (milk alkali syndrome), and may interfere with the absorption of other minerals such as iron. If you have a history of kidney stones, consuming a diet rich in calcium will not increase your risk of further stone formation. Most renal doctors do not restrict calcium intake for their patients these days.

Splitting your calcium intake into 500-mg doses is advisable, as the gut would not be able to absorb 1000 mg all at once. To maximize the absorption of your calcium tablet, take it at meal times with or after food. If you take iron tablets for other health reasons, avoid taking calcium at the same time by staggering the tablets throughout the day. This will ensure that both minerals are fully absorbed.

This information is from the National Osteoporosis Society, located in the United Kingdom, where strontium ranelate (Protelos) is an approved prescription drug for the treatment of postmenopausal osteoporosis. To obtain NOS publications and Information Sheets, go to www.nos.org.uk.

FDA Safety Announcement About Bisphosphonates

2010-03-11T11:13:00.002-05:00

Most readers who visit my blog have either already stopped taking bisphosphonates for osteoporosis or are seriously contemplating doing so and switching to strontium or something else. ABC News has recently reported on femur fractures occurring in some patients following several years on bisphosphonates. In response to those news reports and the outcry from viewers, on 03/10/2010, the FDA issued a Drug Safety Communication on bisphosphonates and femur fractures. Here is part of that announcement:

"Patients and healthcare professionals may have questions about oral bisphosphonate medications and atypical subtrochanteric femur fractures – fractures in the bone just below the hip joint. Oral bisphosphonates are commonly prescribed to prevent or treat osteoporosis in postmenopausal women. Common brand names of medications in this class include Fosamax, Actonel, Boniva, and Reclast."

"Recent news reports have raised the question about whether there is an increased risk of this type of fracture in patients with osteoporosis using these medications. At this point, the data that FDA has reviewed have not shown a clear connection between bisphosphonate use and a risk of atypical subtrochanteric femur fractures. FDA is working closely with outside experts, including members of the recently convened American Society of Bone and Mineral Research Subtrochanteric Femoral Fracture Task Force, to gather additional information that may provide more insight into this issue." See the entire FDA announcement at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm203891.htm

Report any adverse events with the use of oral bisphosphonates to FDA's MedWatch program:

1-800-332-1088
1-800-FDA-0178 Fax
MedWatch Online2
Regular Mail: Use postage-paid FDA Form 35003
Mail to: MedWatch 5600 Fishers Lane
Rockville, MD 20852-9787

Strontium Ranelate Reduces Vertebral Fracture Risk

2010-03-02T11:55:00.005-05:00

The primary goal of any osteoporosis treatment is prevention of stress fractures. The following abstract is from one of the most recent studies on strontium ranelate highlighted by the International Osteoporosis Foundation (IOF) at www.iofbonehealth.org/pio/latest-issue/volume-10-issue-4-2009/overview.html:

"Meunier et al report on 1649 osteoporotic women randomized to strontium ranelate (SrR) or placebo for four years followed by a one-year treatment-switch period for half of the patients. Over four years, risk of vertebral fracture was reduced by 33%. Among patients with two or more prevalent vertebral fractures, risk reduction was 36%. Lumbar BMD increased over five years in patients who continued with SrR, and decreased in patients who switched to placebo. Osteoporos Int 2009;20:1663-73"

Strontium Citrate Clinical Trial Still Recruiting

2010-01-22T12:23:00.004-05:00

"The researchers are seeking post-menopausal women who are at least one year but less than five years past their last menstrual period. Participation in the study will include a screening visit with blood draw at UC Davis Medical Center, followed by a blood draw and free DEXA scan at the Veterans Administration Northern California Health Care Center."

"Participants will be randomly assigned to one of two groups. One group will take strontium citrate plus calcium and vitamin D for three months, while the other group will take a placebo plus calcium and vitamin D for three months. During the three-month period, participants will visit UC Davis Medical Center three times for short questionnaires and blood draws. DEXA scans and test results can be provided to participants.For more information or to schedule a screening visit, contact Stephanie Burns, study coordinator, at (530) 754-7576 or (916) 734-5562 or scope@phs.ucdavis.edu."

Update On Strontium Citrate Clinical Trial

2010-01-20T12:52:00.004-05:00

Here is the latest update on the Strontium Citrate Clinical Trial known as the Scope Study and being conducted at the University of California at Davis (UCD). Per Stephanie Burns, study coordinator, "we are currently half-way through our recruitment period. We should have results in about a year’s time."

Osteologix To Market Strontium Malonate In EU By 2012

2009-12-29T12:12:00.004-05:00

On December 09, 2009, Osteologix Inc. (OLGX.OB) announced that it should be prepared to file a marketing application in 2011 in the European Union for its proprietary strontium therapy, NB S101 (strontium malonate). If successful, this will be Osteologix' first marketing approval of NB S101 for the treatment of postmenopausal osteoporosis. Following the successful completion of the company's initial Phase 2 study comparing NB S101 (strontium malonate) to Protelos (strontium ranelate), which is marketed by Les Laboratoires Servier (Servier), Osteologix sought feedback on its development program from various regulatory authorities. Osteologix has determined that the company will be positioned to pursue a European Marketing Application for NB S101 as a treatment for post-menopausal osteoporosis. The company expects that it can complete the additional development work in 2010 and will be prepared to file a marketing application during the first half of 2011. This pathway is in keeping with the Company's overall strategy of developing its once-daily strontium tablet for the osteoporosis market. Osteologix has initiated discussion with potential regional and global partners and believes that the selected partner(s) will be able to begin marketing the product by 2012, providing them with at least 12 years of patent protection in the European Union.

This is an abbreviated version of a press release by Osteologix. See the original at www.osteologix.com.

Strontium Ranelate Reduces Fracture Risk

2009-11-06T12:19:00.003-05:00

The TROPOS study of strontium ranelate (Protelos) reached the following conclusions about fracture risk reduction:

The number of patients experiencing a hip fracture was reduced by 36% (P=0.046) over 3 years of treatment in postmenopausal women over 74 years of age.

Protelos also reduced the relative risk of nonvertebral fracture by 16% (P=0.04) over 3 years compared with placebo.

Protelos reduced the risk of major fragility fractures (fracture of the hip, wrist, pelvis and sacrum, ribs and sternum, clavicle, humerus) by 19% (P=0.031) over 3 years compared with placebo.

In patients without prevalent vertebral fracture at baseline, Protelos reduced their risk of experiencing a first fracture by 45% (P<0.001).

BMD Improvements With Strontium

2009-11-05T12:24:00.007-05:00

Research indicates that over three years, strontium can improve bone mineral density by 8-14%, depending on the site. These findings come from three studies on strontium ranelate (STRATOS, SOTI, and TROPOS). One study on strontium malonate (Strong study) showed a 2.66% increase in BMD at the lumbar spine after just three months. The University of California at Davis (UCD) is conducting a three-month clinical trial on strontium citrate, but the results may not be available before May, 2010.

The STRATOS trial (2002) of strontium ranelate determined that 680 mg strontium was the optimum dose. It was followed by a much larger study (SOTI study, 2004) of 1,649 osteoporotic postmenopausal women over a three-year period. Participants that received 680 mg of strontium daily, along with calcium and vitamin D supplements, increased lumbar bone mineral density by an average of 14.4% and femoral neck BMD an average of 8.3%.

The TROPOS study in 2005 focused on non-vertebral fractures in 5,091 postmenopausal women with osteoporosis. After five years, this double-blind, placebo-controlled study found an 8.2% improvement in the femoral neck and a 9.8% improvement in the total hip bone density.

In 2007, Osteologix, Inc. announced the results of its phase II clinical trial (Strong study) involving 289 postmenopausal women with low bone mineral density. The company reported that after three months, a 680 mg dose of strontium malonate increased lumbar spine BMD by 2.66%.

Strontium Ranelate Safety

2009-09-23T12:28:00.007-04:00

_ 3,790 patients were exposed to strontium ranelate during phase II and III trials. The overall incidence rates of adverse effects did not differ significantly from placebo. Adverse effects seen were generally mild and transient. The most common were:

_ headache (3.0% v 2.4%), nausea (6.6% v 4.3%), diarrhea (6.5% v 4.6%), loose stools (1.1% v 0.2%) dermatitis (2.1% v 1.6%) and eczema (1.5% v 1.2%)

_ In phase III studies, the annual incidence of venous thromboembolism (VTE) observed over 4 years was approximately 0.7%, with a relative risk of 1.42 (CI 1.02; 1.98, p=0.036) in strontium ranelate treated patients as compared to placebo treated patients. The cause of this finding is unknown. Strontium ranelate should be used with caution in patients at increased risk of VTE, including patients with a past history of VTE. The risk for strontium ranelate appears to be less than that seen with Selective Estrogen Receptor Modulator (SERM) or hormone replacement therapy (HRT).

_ Disturbances in consciousness, memory loss and seizures were all reported with higher frequency in the strontium ranelate group.

http://www.haad.ae/HAADDeps/Portals/7/Drug%20Monograph/strontium.ran%20final.pdf

Improvement Of Bone Microarchitecture By Strontium Ranelate

2009-09-23T11:08:00.006-04:00

The analysis of transiliac bone biopsy samples from phase 2 and 3 clinical trials of strontium ranelate has provided further evidence of the good bone safety of strontium ranelate in the treatment of postmenopausal osteoporosis. Strontium ranelate improves both trabecular and cortical bone.

At the trabecular level, strontium ranelate significantly increases trabecular number by 14% and decreases trabecular separation by 16%, shifting trabeculae from rod-like structures to plate-like patterns. At the cortical level, strontium ranelate enlarges cortical bone dimensions by increasing cortical thickness by 18%.

Strontium ranelate is the first oral treatment to improve both trabecular and cortical bone in postmenopausal osteoporotic women. The change in 3D trabecular and cortical microarchitecture may improve bone biomechanical competence and explain the decreased fracture rate after strontium use.

http://www.servier.com/pro/osteoporosis/Osteoscoop/pdf/Osteoscoop_Issue61.pdf

Measuring Risk Of Fracture

2009-09-14T10:38:00.008-04:00

An individual's risk of fracture over a given period of years can be predicted using one of two models. Both are simple to use by individuals with no medical training. A patient simply answers a few questions.

The FRAX tool was developed by the World Health Organization (WHO) and gives the 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (spine, forearm, hip or shoulder fracture). It includes height, weight, personal history of fracture, family history of fracture, smoking, alcohol consumption, use of corticosteroids, rheumatoid arthritis and secondary osteoporosis. This model ignores falls. It is the most commonly used fracture-risk algorithm worldwide. To access it, follow this link, click on "Calculation Tool," and select your location and race/ethnicity:

http://www.shef.ac.uk/FRAX/

A second model is used in Australia to determine whether Pharmaceutical Benefits Scheme reimbursements for osteoporosis therapy apply. It was developed by the Garvan Institute of Medical Research in Sydney. The Garvan fracture risk calculator is based on gender, bone mineral density, age, history of personal fracture, and history of falls over the last 12 months. It is incredibly simple but is believed to incorporate the most critical risk factors. It provides five and 10 year risk assessments for hip fracture and for any osteoporosis/fragility fracture. The T-score and BMD in g/cm2 used in this tool refer to the values at the femoral neck, which will read Hip (neck) on most DXA scan reports. To access this calculator:

http://www.garvan.org.au/promotions/bone-fracture-risk/

Comparison of Strontium Malonate to Strontium Ranelate

2009-08-19T12:53:00.005-04:00

Currently, Osteologix’s primary goal is to obtain approval for NB S101 (strontium malonate) for the treatment and prevention of osteoporosis. Their phase I study of the pharmacokinetic, or PK, properties of NB S101 revealed that a one gram tablet dose of NB S101 resulted in approximately the same level of strontium in human serum as a European company's approved product containing two grams of strontium ranelate in sachet formulation, which must be mixed with water before ingestion. Thus, at a significantly lower dose, their tablet formulation of strontium has shown bioequivalent levels of strontium to a marketed sachet product that has been proven safe and effective in osteoporotic patients in Europe.

More importantly, the recent results of their phase II study demonstrated that NB S101 decreased an established biomarker of bone resorption, CTX-1, in a dose-dependent manner by an amount statistically equivalent to or superior to the product approved in Europe. The phase II results also showed that NB S101 significantly increased bone mineral density at the lumbar spine and hip with only 12 weeks of treatment, and no significant side effects were noted in the trial.

Improved T-Scores After Treatment

2009-07-11T15:40:00.006-04:00

My first DEXA scan on 05/08/07 diagnosed me with osteoporosis. My second scan was done 07/06/09 after the following treatment: Fosamax 70 mg weekly from 06/18/07 to 12/24/07, two capsules Doctor's Best Strontium Bone Maker daily from 01/21/08 to 07/06/09. Here are my BMD results in g/cm2 and my T-scores for my second scan:

Spine (L1-L4): BMD 0.749, T-Score -2.7

Lt. Hip (neck): BMD 0.563, T-Score -2.6

Lt. Hip (total): BMD 0.739, T-Score -1.7

Despite my best efforts, my scores were not corrected for strontium intake by the radiologist. My first and second scans were not on the same DEXA machine, but they were both on DXA Hologic scanners. Even so, I am very happy with my results. My T-scores improved 10.0% at the spine, 7.1% at the left hip (neck), and 22.7% at the left hip (total). I plan to continue taking strontium citrate.

Study Shows Protelos Builds Better Bone Than Fosamax

2009-06-22T12:08:00.004-04:00

A two-year double-blind study included 88 women over age 50 with postmenopausal osteoporosis who were treated with either Protelos (strontium ranelate) 2 g. daily or Fosamax (alendronate) 70 mg. weekly. The study, which used high-resolution computerized tomography, showed that Protelos increased cortical bone thickness, bone volume and trabecular bone density to a significantly greater extent than Fosamax over a one-year period.

The one-year interim results on bone microstucture, a determinant of bone strength, showed a +5.3% increase in cortical thickness and a +2.0% increase in bone volume in the Protelos-treated group. There was no change in the Fosamax-treated group.

For more information and references, see www.medicalnewstoday.com/printerfriendlynews.php?newsid=132149

Update On Strontium Malonate For Osteoporosis

2009-05-28T11:55:00.005-04:00

Osteologix, Inc. has received a key U.S. Patent Allowance for its osteoporosis drug, NB S101 (strontium malonate). This brings the company closer to its goal of manufacturing and marketing a prescription strontium drug in the U.S.

The Notice of Allowance from the U.S. Patent and Trademark Office is for U.S. Patent Application Number 11/269,289 titled "Water-Soluble Strontium Salts for Use in Treatment of Cartilage and/or Bone Conditions." It allows claims covering the treatment of osteoporosis and related bone conditions using NB S101 (strontium malonate). The patent will most likely issue in the second half of 2009 and expire in 2024.

The company has a number of other pending patent applications covering various aspects of the NB S101 drug program, including composition, manufacturing and method of use patent applications. "Based on the Notice of Allowance and the claims allowed by the USPTO, we believe the intellectual property protections established by this US patent allowance, coupled with our recently upheld European equivalent, will significantly enhance our ability to finalize strong development collaborations with potential partners to complete the Phase III development of NB S101 in osteoporosis," stated Philip J. Young, President and Chief Executive Officer of Osteologix. This is from the company's website at http://www.osteologix.com/.

Update on Strontium Citrate Clinical Trial

2009-05-28T11:05:00.004-04:00

BoneLady's Question, May 18, 2009:
What is the latest news on the strontium citrate for osteoporosis clinical trial? I went to the UCD site and found no update since February. I also visited www.clinicaltrials.gov/ and did not find this study listed. Is the medical center still recruiting? If so, what is the projected start date for the trial?

SCOPE Study Coordinator's Reply, May 27, 2009:
At this time, we are recruiting and enrolling participants and will most likely be doing so through the end of the year. No results will be available until at least this time next year.

Strontium and Antibiotics

2009-05-11T11:10:00.001-04:00

Strontium may reduce the absorption of tetracycline antibiotics (e.g., tetracycline, minocycline, doxycycline) and quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, nalidixic acid) from the gut and could make them less effective.

If you are prescribed a course of one of these types of antibiotics you should stop taking strontium during the course of antibiotics.This information is from www.netdoctor.co.uk/medicines/100000762.html

Poll Results On T-Scores After Strontium Citrate

2009-05-04T11:28:00.004-04:00

Here are the results of my latest poll: Did your DEXA scan T-scores improve after taking strontium citrate?

12 (75%) YES
4 (25%) NO

Strontium Safety

2009-04-17T11:25:00.006-04:00

Strontium is safe for most people, but there are certain individuals who should not take it. These include those with any of the following disorders:

- Decreased kidney function.

- History of blood clots in the veins (venous thromboembolism, e.g., deep vein thrombosis or pulmonary embolism).

- Blood disorders that increase the risk of blood clots in the veins, e.g. antiphospholipid syndrome, factor V Leiden.

There is some evidence that strontium could slightly increase the incidence of blood clots. The tests were performed on strontium ranelate.

Strontium should also not be taken by children nor by pregnant or lactating women.

A Dose-Response Study With Strontium Malonate

2009-04-08T12:26:00.003-04:00

Osteologix, Inc. is conducting a Phase II clinical trial with strontium malonate in postmenopausal women. The study's primary objective is to compare dose-response effect of three levels of strontium malonate to placebo on bone resorption quantified by S-CTX-1 following 12 weeks of treatment. The four parallel groups in this trial will take 750 mg strontium malonate, 1000 mg strontium malonate, 2000 mg strontium malonate, 2 grams Protelos (strontium ranelate), and placebo. For more details, visit http://clinicaltrials.gov/ct2/show/NCT00409032

FDA Bisphosphonate Alert

2009-04-07T11:52:00.003-04:00

Information on Bisphosphonates (marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa)

FDA ALERT [1/7/2008] - FDA is highlighting the possibility of severe and sometimes incapacitating bone, joint, and/or muscle (musculoskeletal) pain in patients taking bisphosphonates. Although severe musculoskeletal pain is included in the prescribing information for all bisphosphonates, the association between bisphosphonates and severe musculoskeletal pain may be overlooked by healthcare professionals, delaying diagnosis, prolonging pain and/or impairment, and necessitating the use of analgesics.

The severe musculoskeletal pain may occur within days, months, or years after starting a bisphosphonate. Some patients have reported complete relief of symptoms after discontinuing the bisphosphonate, whereas others have reported slow or incomplete resolution. The risk factors for and incidence of severe musculoskeletal pain associated with bisphosphonates are unknown.

This severe musculoskeletal pain is in contrast to the acute phase response characterized by fever, chills, bone pain, myalgias, and arthralgias that sometimes accompanies initial administration of intravenous bisphosphonates and may occur with initial exposure to once-weekly or once-monthly doses of oral bisphosphonates. The symptoms related to the acute phase response tend to resolve within several days with continued drug use.

Healthcare professionals should consider whether bisphosphonate use might be responsible for severe musculoskeletal pain in patients who present with these symptoms and consider temporary or permanent discontinuation of the drug.
This information reflects FDA's current analysis of data available to FDA concerning this drug. FDA intends to update this when additional information or analyses become available.

Dieters Risk Bone Loss

2009-03-31T12:04:00.002-04:00

"What happens to bones during weight loss?" " It depends on how you lose the weight. A study conducted at the Washington University School of Medicine in St. Louis monitored two groups of people who lost a little more than one pound per month for a year. Half of them lost the weight by eating fewer calories, and the other half lost by increasing their physical activity. Despite the gradual rate of weight loss, the dieters lost bone mineral density from their spines and hips. The exercisers lost weight but not bone mass." For more on this subject, see http://archives.starbulletin.com/2008/03/08/features/health.html.

Not All Strontium Supplements Are The Same

2009-03-31T11:25:00.005-04:00

Be careful about the strontium supplement you choose. They are not all the same. The optimum dose is 680 mg elemental strontium daily. One study found that three out of five products tested contained significantly less strontium than their labels indicated. The two properly labeled products were AOR Strontium Support and Strontium Bone Maker. The information from the study came from
http://www.starbulletin.com/specialprojects/09/yah/20090326_supplement_helps_bones_grow_stronger.html

Blood and Urine Calcium

2009-03-06T12:54:00.007-05:00

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:
http://emc.medicines.org.uk/document.aspx?documentID=15410

Adjustments To BMD Unnecessary With Strontium Therapy

2009-03-06T11:56:00.005-05:00

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."

Strontium Citrate Clinical Trial

2009-03-02T09:11:00.006-05:00

UC Davis Study to Prevent Osteoporosis with Dietary Supplement Begins Recruitment
http://www.ucdmc.ucdavis.edu/newsroom/newsdetail.html?key=1985

February 26, 2009(SACRAMENTO, Calif.) — Osteoporosis affects many women and can cause painful, disabling and even life-threatening fractures. Researchers from the UC Davis Department of Internal Medicine are seeking a simple, inexpensive way to prevent the disease.

Strontium citrate is a widely available, over-the-counter dietary supplement promoted to “improve bone health.” Strontium is a natural element found in bone in all people. Strontium citrate is another form of strontium ranelate, a proven medication prescribed across Europe and Australia to treat and prevent osteoporosis and related fractures. Unlike pharmaceuticals, strontium citrate is not a prescribed medication and is inexpensive.

The UC Davis researchers are trying to demonstrate that a nutraceutical, which women can buy without seeing a doctor or paying a drug company, can be used to improve bone health.
The researchers are seeking post-menopausal women who are at least one year but less than five years past their last menstrual period. Participation in the study will include a screening visit with blood draw at UC Davis Medical Center, followed by a blood draw and free DEXA scan at the Veterans Administration Northern California Health Care Center.

Participants will be randomly assigned to one of two groups. One group will take strontium citrate plus calcium and vitamin D for three months, while the other group will take a placebo plus calcium and vitamin D for three months.

During the three-month period, participants will visit UC Davis Medical Center three times for short questionnaires and blood draws. DEXA scans and test results can be provided to participants.For more information or to schedule a screening visit, contact Stephanie Burns, study coordinator, at (530) 754-7576 or (916) 734-5562 or scope@phs.ucdavis.edu.

Strontium and Osteoporosis

2009-02-27T12:57:00.004-05:00

On July 7, 2008, Sara S. DeHart, MSN, Ph.D., Online Journal Contributing Writer, wrote Strontium and Osteoporosis: A Treatment Not Offered to American Women. "The purpose of this article is to provide a summary of current published research on the mineral strontium and its purported function in preventing osteoporotic fractures in postmenopausal women. This mineral is available through regular medical sources in Europe and is approved for use in 21 European countries." For comparative purposes of what happens to postmenopausal women in the United States, she included a case study of her own "journey through this morass of data and treatment options." Because Dr. DeHart's stated purpose in writing the article so closely correlates with my purpose in maintaining this blog, I have added a link to her article. http://onlinejournal.com/artman/publish/article_3458.shtml

Poll Results

2009-01-30T11:53:00.003-05:00

Here are the results of my previous poll, with 104 responses: Are you currently taking strontium for bone problems?

Yes 80 (76%)
No 24 (23%)

Please take part in the current poll on DEXA scan results after strontium therapy.

Bone Quality

2008-12-18T11:50:00.006-05:00

Bone strength is determined by several properties, especially bone mass, which is measured using ionizing radiation (DEXA scan). Another technique used to evaluate bone strength uses ultrasound waves to describe two other properties of bone that are also related to bone strength: elasticity and structure. As the ultrasound wave passes through the heel bone (os calcis), the wave is altered. The way in which the ultrasound wave is altered describes the elasticity and structure of the bone. These two properties are combined into the term “Stiffness Index”. Studies have shown that Stiffness Index is related to bone density, making it a good indicator of bone strength.

U.S. National Library of Medicine (NLM)

2008-12-16T12:33:00.011-05:00

I have asked the U.S. National Library of Medicine (NLM) to add strontium citrate to their list of alternative therapies for osteoporosis. To contact the agency, use http://www.nlm.nih.gov/medlineplus/osteoporosis.html.

Heel Ultrasound Predicts Osteoporosis Risk

2008-12-16T12:00:00.007-05:00

News from the RSNA Journal Radiology
June 24, 2008
Simple Ultrasound Exam May Predict Osteoporosis Risk At A Glance

An ultrasound exam of the heel may be able to predict if a woman is at heightened risk for fractures due to osteoporosis, according to a new multicenter study being published in the July issue of the journal Radiology. Along with certain risk factors, including age or recent fall, radiation-free ultrasound of the heel may be used to better select women who need further bone density testing, such as a dual-energy x-ray absorptiometry (DXA) exam.

In the three-year multicenter study, 6,174 women age 70 to 85 with no previous formal diagnosis of osteoporosis were screened with heel-bone quantitative ultrasound (QUS), a diagnostic test used to assess bone density. QUS was used to calculate the stiffness index, which is an indicator of bone strength, at the heel. Researchers added in risk factors such as age, history of fractures or a recent fall to the results of the heel-bone ultrasound to develop a predictive rule to estimate the risk of fractures.

In the group of higher risk women, 290 (6.1 percent) developed fractures whereas only 27 (1.8 percent) of the women in the lower risk group developed fractures. Among the 66 women who developed a hip fracture, 60 (90 percent) were in the higher risk group.

The results show that heel QUS is not only effective at identifying high-risk patients who should receive further testing, but also may be helpful in identifying patients for whom further testing can be avoided.

RSS Feeder Added

2008-12-03T13:37:00.002-05:00

I have added a RSS feeder at the top right of my blog so that you may subscribe to posts and comments. Just click on either posts or comments or both and select your RSS reader.

Petition FDA To Add Strontium Citrate

2008-11-24T13:12:00.003-05:00

I have just asked the FDA to consider adding strontium citrate to their Medline supplement index, which is a list of approved supplements. If you would like to email the FDA, click here: http://vm.cfsan.fda.gov/~dms/qa-top.html

Effect Of Strontium on DEXA Scan

2008-11-04T11:44:00.003-05:00

The presence of strontium in bone influences bone mineral density (BMD) and bone mineral content (BMC) measurements by dual-energy X-ray absorptiometry (DEXA). DEXA scans are usually read based on calcium as the main component of bone. Since strontium is heavier than calcium, its presence in bone will change the results of the scan.

When you go for your next DEXA scan, be sure to inform the radiologist, in writing, about your daily dose of strontium and how long you have been taking it. He can make a correction, or at least note on your results, that you have been taking strontium. Without an adjustment in the interpretation, BMD can be read as artificially high. You might be wise to give the clinician a copy of "Strontium DEXA Scan Effect," which you can print out at www.osteopenia3.com/Strontium-dexa-scan.html.

Strontium Malonate

2008-09-01T12:24:00.004-04:00

Osteologix, Inc., a specialty biopharmaceutical company headquartered in San Francisco, CA, announced in May, 2008, that the FDA has accepted its investigational new drug (IND) application for NB S101 (strontium malonate) to treat and prevent osteoporosis. See links to three articles on this topic at the end of this blog.

Men And Young Women With Osteoporosis

2008-08-11T10:19:00.012-04:00

Mention osteoporosis to most people and they automatically think of women, especially older women, but men and young women can also have brittle bones. According to Dr. Isadore Rosenfeld's article in Parade (May 18, 2008, page 8), two million men is the U.S.A. have the disease, and 12 million more are at risk. I haven't found statistics for young women, but I have read blog posts from several women in their 20's and 30's with osteoporosis.

Causes include:

Steroids taken to treat asthma or arthritis

Long-term use of antacids containing aluminum

Low levels of sex hormones (Hysterectemies in women can cause this.)

Too much thyroid hormone

Smoking

Excessive alcohol consumption

Lack of exercise

Inadequate dietary calcium

Heredity

Lactation (Nursing mothers lose calcium.)

Why I No Longer Take Fosamax

2008-06-19T12:26:00.006-04:00

I took Fosamax 70 mg once weekly for seven months before getting off due to intolerable side effects beginning after four months. The worst problems were vertigo and dizziness, which came on suddenly. I woke up one morning and when I tried to get out of bed, I felt like I was falling. I had to call my husband to assist me to the bathroom. Although these symptoms became less severe, I never regained my equilibrium while on Fosamax and was unable to exercise on the floor due to vertigo when I lay flat. I also experienced heart palpitations,extreme coldness, and general malaise about two hours after taking my weekly dose. I now wonder if I was having atrial fibrillation, another serious side effect of Fosamax. I am so glad I got off it!

I gave my body a month to clear out the drug and then I began taking strontium citrate 680 mg once daily. I feel well again and began this blog to relate my progress and get comments from others.

Availability Of Protelos In U.S.

2008-05-21T12:48:00.004-04:00

Is your company seeking approval of Protelos (strontium ranelate)for osteoporosis in the United States of America? If so, at what stage in the process is it?

BoneLady

Thank you for your interest for Protelos. Protelos is registered in 84 countries worldwide but has not yet been filed to the FDA and thus, for the time being, it is not possible to give you any indication on availability date in the USA.

Sincerely,

M. Rebuffé-Scrive
Scientific Director Servier International Canada, USA, Northern, Central & Eastern Europe

Alternative Medicine For Osteoporosis

2008-05-20T11:16:00.003-04:00

Strontium citrate is an excellent alternative medicine for osteoporosis treatment. Instead of poisoning your body with drugs such as Fosamax, take strontium, a naturally occurring mineral present in water, food, and the human skeleton in trace amounts. Studies show that strontium promotes bone formation and decreases bone resorption (loss), leading to higher bone density.

Strontium And Arthritis

2008-05-02T12:50:00.004-04:00

Did you know that there is some evidence that strontium may improve cartilage metabolism in osteoarthritis? An in vitro study performed by the Bone and Cartilage Metabolism Research Unit, University Hospital, Liege, Belgium, suggests strontium promotes cartilage growth. Clinical testing is needed in this area. For more information on this subject, go to Strontium For Osteoporosis and Arthritis in my links section.

Comments And Suggestions

2008-04-22T11:25:00.000-04:00

If you have any comments or suggestions about my blog, please reply here.

Strontium For Osteoporosis

2008-04-22T11:08:00.002-04:00

I took Fosamax 70 mg once weekly for seven months until I could no longer tolerate the side effects. I waited a month before starting a regimen of strontium citrate 680 mg once daily. Please comment with your experiences taking strontium or if you would like more information about it.