Update on Strontium, Osteoarthritis, and Reduced Dose of Strontium Citrate

For almost a year and a half (3/5/2023 through 8/17/2024), I reduced my daily dosage of strontium citrate from 682 mg of strontium per day to 341 mg (half dose) 4X per week and 682 mg (full dose) 3X per week. That averages out to 487 mg/day, which is 37 mg more than the MOTS study dosage of 450 mg for osteopenia. 

Reducing my dosage was an experiment. I was not having any adverse events. On 8/18/2024, I resumed the full dose of strontium. During the year and a half at a reduced dose, I developed a myxoid cyst (digital mucous cyst) on my left thumb. Mucous cysts are frequently observed in individuals with osteoarthritis, especially in the distal interphalangeal (DIP) joint, which is the joint at the tip of the finger. Later, I developed a bump on the finger next to that thumb. It is likely a Bouchard's node. Bouchard's nodes are bony enlargements that develop on the middle joints (proximal interphalangeal joints) of the fingers. They are a common sign of osteoarthritis. 

So, my main reason for resuming my full dose was worsening osteoarthritis. I had never had bumps on my fingers before, and any other osteoarthritic signs, such as stiffness or joint pain, had always been, and still are, minimal. I want to keep it that way. 

I had a DXA scan with TBS on November 18, 2024. My left femoral neck BMD was slightly worse than my previous scan of 18 August 2022. It was 0.728 g/cm2 with T-score of -1.1 (osteopenia) in 2024, compared to 0.741 g/cm2 with T-score of -1.0 (normal density) in 2022. I had resumed my full dosage of strontium three months prior to the 2024 scan. My TBS showed normal bone microarchitecture! If I had not already resumed my full strontium dose, I probably would have done so after this scan due to the femoral neck results.

I caused my temporomendibular joint disorder (TMD) by clenching my jaws at night. I was unaware of doing that except that I would wake up with pain in my right jaw and right ear. Now, I wear Plackers Grind No More dental guards at night. They worked like a charm, and I have no more pain. Apparently, my TMD was not caused by osteoarthritis, which can affect the temporomendibular joint (TMJ), leading to TMJ disorder, also known as TMD. I had dental X-rays in January 2025, and my jaws and teeth looked fine. 

Juggling Medications and Supplements

It is a juggling act with medications and supplements.

I take my levothyroxine in the early morning hours (usually 1-3 a.m.) when I wake up to use the bathroom. This hormone stopped my hair from falling out! 

I take my first dose of CBD and a probiotic with breakfast. 

I take most of my vitamins and minerals and my second dose of CBD with supper, my largest meal. These include my calcium/magnesium/vitamin D3 supplement, multivitamin, zinc, selenium, citrus bioflavonoids, vitamin C, vitamin D3, natural vitamin E, lutein with zeaxanthin and others. 

I take my SrC and simvastatin a couple of hours before bedtime and about 30 minutes apart. 

I get magnesium in my Ca/Mg/D supplement. I had been taking a magnesium glycinate capsule at lunch time for a while, but I stopped taking it due to multiple bowel movements. I still give it to my husband. It is best to take magnesium at bedtime, but lunch seems to fit in better for us.

I take sublingual methylcobalamin (Vitamin B12), 5000 mcg, one tablet per week. My husband takes this high dose every day around 3:00 p.m. to keep his canker sores from returning.  

Credentials of Technologists Performing REMS Echolight Scans

You should always ask about the education and training of the technician performing your REMS Echolight scan. I recently had an online chat with a bot at Precision Bone Imaging, which performs scans at OsteoStrong facilities and other locations in Arizona, California, and Colorado.

I asked: 

What are the credentials of techs performing REMS scans?

The bot answered: 

Our technicians who administer REMS scans at our locations are trained ultrasound technicians. They not only have a background in ultrasound technology but also receive specialized training specific to REMS scanning. This additional training ensures they can perform accurate scans and guide patients smoothly through the process. 

Precision Bone Imaging, 3301 E Indian School Rd, Suite 101, Phoenix, AZ 85018, 

phone (888) 415-7377

https://www.precisionboneimaging.com/

https://app.acuityscheduling.com/schedule.php?owner=32710610

To become an ultrasound technician, you'll need to:

Complete high school

• You'll need a high school diploma or GED to enroll in a college or university program. 

  
  

  Earn an associate's or bachelor's degree
• You can earn an associate's degree in Diagnostic Medical Sonography from an accredited college or university. You can also earn a bachelor's degree in sonography. 

  
  

  Complete a certificate program
• You can complete a one-year certificate program in sonography at a college or hospital. 

  
  

  Complete clinical education
• You'll need to complete clinical education, where you'll apply your formal education in a hands-on setting. 

  
  

  Pass licensing exams
• You'll need to pass the proper licensing exams to become a licensed ultrasound technician.

  
  

  Become certified
• You can become certified through the American Registry for Diagnostic Medical Sonographers (ARDMS) or the American Registry of Radiologic Technologists (ARRT).

  
  

  Some courses you might take in an ultrasound technician program include:

Anatomy and physiology, Medical terminology, Applied sciences, General physics, Pharmacology, and Echocardiography pathology.

Many employers also require candidates to complete basic life support training. 

Echolight & NASA

 News release from Echolight Medical:

NASA NOW EQUIPPED WITH ECHOLIGHT DEVICES FOR BONE HEALTH MONITORING IN SPACEFLIGHT SIMULATIONS

 

HOUSTON, Oct. 21, 2024 /PRNewswire/ — Echolight, a global innovator in bone densitometry, announced that NASA is using its proprietary REMS (Radiofrequency Echographic Multi Spectrometry) technology to monitor bone changes in a human bedrest study and to assess the effects of unloading on bone mass given the paramount importance of Bone Health in space too.

Through a simple ultrasound scan of axial anatomical sites such as the spine and femur, the REMS innovative technology measures bone density and microarchitecture without using the radiation of traditional x-ray scans. This radiation-free technology allows scientists to perform repeated scans for monitoring bone health over time. In addition, the ability to automatically exclude artifacts commonly present with other densitometry procedures yields a highly reliable diagnostic assessment.

“Echolight is pleased with this additional milestone in the US adoption of REMS devices, where the diagnostic system for the unique, personalized and patient-centered assessment of bone health has registered a very high interest among the US medical community sharing the intent to reduce fragility fractures,” explained Sergio Casciaro, Echolight S.p.A. CEO and founder.

Prof. Aenor Sawyer, director of UCSF Skeletal Health Service and of UC Space Health, reported “Echolight technology provides a number of potential benefits for possible use during spaceflight missions including its portability (the unit is the size of a small suitcase), fast scan time of under 10 minutes, edge analytics, and the ability to scan frequently with no harmful radiation effects. NASA is currently unable to assess the bone loss of each astronaut occurring in spaceflight and make real-intime adjustments to their countermeasures. This will be increasingly important on longer missions such as those to the Moon and Mars, and REMS could potentially provide this critical in-mission information.”

Echolight was established in Italy with head office in Lecce, and in 2020 opened its offices in the United States. Since then, its sales network has grown to more than 40 distributors and several hundreds of satisfied customers across the world who have adopted the innovative R.E.M.S. technology for assessing the bone condition of their patients.

Created as a spin-off of the Italian National Research Council, Echolight is at the forefront of medical innovation, introducing new cutting-edge solutions to contribute to human wellbeing. It has been awarded all the standard certificates: UNI CEI EN ISO 13485: 2016, Quality Management System UNI EN ISO 9001: 2015, CE mark, FDA clearance, and other major certificates worldwide for innovative solutions considered as the best practice in bone health for personalized medicine.

Dexa Bone Density Axial Skeleton with TBS on 18 November 2024

Below are the results of my latest DXA scan and my first TBS. I am so excited about my TBS showing normal bone microarchitecture! 

The only value that was slightly worse than my previous scan of 18 August 2022, was my left femoral neck BMD of 0.728 g/cm2 and a T-score of -1.1 (osteopenia) in 2024, compared to left femoral neck BMD of 0.741 g/cm2 and a T-score of -1.0 (normal density) in 2022. 

For almost a year and a half (3/5/2023 through 8/17/2024), I reduced my daily dosage of strontium citrate from 682 mg of strontium per day to 341 mg 4X per week and 682 mg 3X per week. I resumed the full dosage on 8/18/2024. 

Impression

Based on BMD criteria, the patient has osteopenia. 

Based on the lumbar spine TBS data, the patient has a normal bone microarchitecture compared to the reference population. 

The patient's associated BMD and TBS values suggest a moderate resilience to fracture. 

Follow up with DEXA and TBS: 2 years 

WHO CRITERIA FOR T-SCORES: 

< or = -2.5 = osteoporosis 

< -1.0 and -2.5 = osteopenia

> or = -1.0 = normal density 

TBS scores: 

>1.31: normal bone microarchitecture

<1.31 and >1.23: partially degraded microarchitecture 

<1.23: degraded microarchitecture 

Narrative

EXAM: DXA AXIAL 

INDICATION: Postmenopausal. Risk factors for osteoporosis include [advanced age 

COMPARISON: 8/18/2022 

FINDINGS: 

Spine: Total BMD of the spine L1-4 is 1.129 g/cm2, with a T-score of 0.7 and a Z-score of 3.2. The lumbar spine trabecular bone score (TBS) is 1.521.

Left Femoral Neck: BMD is 0.728 g/cm2, with a T-score of -1.1 and a Z-score of 1.1. 

Left Total Hip: BMD is 0.842 g/cm2, with a T-score of -0.8 and a Z-score of 1.1. 

Right Femoral Neck: BMD is 0.754 g/cm2, with a T-score of -0.9 and a Z-score of 1.3. 

Right Total Hip: BMD is 0.900 g/cm2, with a T-score of -0.3 and a Z-score of 1.5. 

Diffuse increased 10% in the lumbar spine 

FRAX (adjusted for TBS if available) evaluation calculates 10-year probability of fracture: 

Major Osteoporotic: 8.7% 

Hip: 1.7%

Strontium, Osteoarthritis, and Reduced Dose of Strontium Citrate

Some research has suggested that strontium may boost the formation of collagen and cartilage in joints. In clinical studies, strontium ranelate seemed to reduce the progression of osteoarthritis (OA).

A year and a half ago, I reduced my daily dosage of strontium citrate from 682 mg strontium to 341 mg 4X per week and 682 mg 3X per week. Since then, I have developed the following:

1. A myxoid cyst, or digital mucus cyst, on my left thumb: A mucus cyst is a small, noncancerous bump usually found near a joint at the end of a finger. Such cysts are often found on the fingers of people with OA. Hot compresses may help shrink these cysts. 

2. Temporomendibular joint disorder (TMD): I have had a few, mild, temporary flare-ups of TMD in years past, but this flare-up is quite painful and not easing up after a couple of weeks. I may have brought it on by eating dry papaya slices, which were tough and chewy. I may be clenching my jaws at night due to stress. The pain is worse just after I wake up in the morning. Most likely, my TMJ disorder is due to progressing OA. 

Because of these two physical changes, I am resuming strontium citrate (SrC) at the full dose of 682 mg elemental strontium per day. Also, there was no reason to cut back the dosage in the first place because I was not having any adverse events from the strontium, and osteoporosis is a chronic condition--as is osteoarthritis. I didn't realize I have OA until I reduced my SrC, which was probably keeping the disease in check. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040865/

https://academic.oup.com/mr/article-abstract/24/6/881/6302017?redirectedFrom=fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791090/