In Dr. Ronald Hoffman’s
recent podcast, he answered the following questions pertaining to strontium and
vitamin D:
Are there dangers to
using strontium?
He says there is an
increased risk of blood clots with strontium ranelate, but he believes it is
due to the ranelate, not the strontium. He says he has not seen this problem
with strontium citrate.
My take: An increased
risk of blood clots is only one of several adverse events attributed to
strontium ranelate. I believe most of the negative side
effects of strontium ranelate may be due to ranelic acid and/or aspartame, although no one knows
for sure. I have not read of anyone who got a blood clot that could be
attributed to strontium citrate. The most common adverse events associated with
strontium citrate are constipation, other gastrointestinal disorders, and
nausea. I have been using strontium citrate for six and a half years with no
problems except minor constipation.
Can strontium falsely
elevate DEXA bone density scans?
He says there is a
false elevation and the improvement is actually about half of what we see on
the bone density test. He says you can take your percent increase and divide it
by two.
My take: It is a fact
that there is a false elevation of BMD with strontium. Servier, the
manufacturer of strontium ranelate, says the BMD can be falsely elevated by as
much as 50% after three years of strontium use. This 50% figure is an estimate.
It depends on how long you have been taking strontium, how well you absorb it
into your bones, and the type of DEXA equipment used. The exact correction will
vary for each individual. If you have been taking strontium for three years or
longer, you can use the 50% correction as a general rule.
Can you use an
osteoporosis medication and strontium together?
This was not posed as a question in the podcast. Dr. Hoffman stated that he had one patient with very low bone density and that he prescribed a medication (not specified) and natural support (strontium, I assume, since the discussion was about strontium) together.
My take: If he
prescribed a bisphosphonate and strontium together, it was probably not a good
idea. The two may be antagonistic. A recent study provides evidence that prior
bisphosphonate therapy results in blunting and delay of the BMD response to
strontium ranelate. This study was on sequential use of a bisphosphonate
followed by strontium ranelate. See my April 2, 2014 blog post, “Sequential
Therapy with Bisphosphonates and Strontium” for more information on this study.
We do not know if taking a bisphosphonate and strontium simultaneously would
also result in blunting and delay of the BMD response.
Which vitamin D
should you take, D2 or D3?
He says to avoid
vitamin D2 because it cancels the effect of D3 to some extent. He says D3 is
more bioavailable and more bioactive than D2.
My take: I use
vitamin D3. I believe D3 is more bioavailable than D2 and will do a better job
of raising your vitamin D blood level.
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