Strontium ranelate is prescribed for postmenopausal
osteoporosis in the United Kingdom, Australia, much of Europe and Asia, and Mexico.
Due to an increased risk of thrombosis and cardiovascular events in patients
with a history of cardiovascular problems, some doctors are discouraging their
patients from taking strontium ranelate or refusing to prescribe it.
Strontium ranelate is not available in the United States or
Canada. However, strontium citrate can be purchased as a supplement from health
food stores and online distributors. Is
strontium citrate safe and effective?
In 2012, Canadian researchers published the Combination of
Micronutrients for Bone (COMB) Study. Here is the abstract:
“Along with other investigations, patients presenting to an
environmental health clinic with various chronic conditions were assessed for
bone health status. Individuals with compromised bone strength were educated
about skeletal health issues and provided with therapeutic options for
potential amelioration of their bone health. Patients who declined
pharmacotherapy or who previously experienced failure of drug treatment were
offered other options including supplemental micronutrients identified in the
medical literature as sometimes having a positive impact on bone mineral
density (BMD). After 12 months of consecutive supplemental micronutrient
therapy with a combination that included vitamin D3, vitamin K2, strontium,
magnesium and docosahexaenoic acid (DHA), repeat bone densitometry was
performed. The results were analyzed in a group of compliant patients and
demonstrate improved BMD in patients classified with normal, osteopenic and
osteoporotic bone density. According to the results, this combined
micronutrient supplementation regimen appears to be at least as effective as
bisphosphonates or strontium ranelate in raising BMD levels in hip, spine, and
femoral neck sites. No fractures occurred in the group taking the micronutrient
protocol. This micronutrient regimen also appears to show efficacy in
individuals where bisphosphonate therapy was previously unsuccessful in
maintaining or raising BMD. Prospective clinical trials are required to confirm
efficacy.”
Here is the COMB protocol for bone health:
(1) Docosahexaenoic acid or DHA (from Purified Fish Oil): 250 mg/day
(2) Vitamin D3: 2000 IU/day
(3) Vitamin K2 (non-synthetic MK7 form): 100 ug/day
(4) Strontium citrate: 680 mg/day (strontium)
(5) Elemental magnesium: 25 mg/day
(6) Dietary sources of calcium recommended
(7) Daily impact exercising encouraged
The following two paragraphs are quotes from the paper:
“Studies to date have predominantly focused on strontium
ranelate rather than the readily available strontium citrate supplement as used
in this study. The results of this study, however, demonstrate that the
micronutrient combination including strontium citrate is at least as effective
in BMD change as strontium ranelate with suggestion of preferred efficacy of
the former therapy at improving femoral neck outcomes. Furthermore, the ranelic
acid salt is a purely synthetic molecular compound, while citrate is naturally
occurring. It appears to be the strontium portion of the molecules which exerts
most or all of the positive effect on bone. When consuming the strontium
ranelate, for example, the compound splits into two strontium ions and one
molecule of ranelic acid, with each absorbed separately. There is little
evidence that the ranelic acid portion of the strontium ranelate compound
contributes to the effect of strontium on skeletal tissue, and of the small
amount of ranelic acid that is absorbed into the body, almost all is excreted
within a week without ever being metabolized. All forms of strontium have
bioavailabilities in the 25–30% range, but gastric tolerance appears to be
better with the ranelate and citrate forms.”
“With the mounting concern about the safety profile of some
standard medical interventions for bone compromise, strontium is very well
tolerated and has shown remarkably little in the way of side effects or
long-term adverse sequelae. An increased
risk of thrombosis has been noted with strontium ranelate, an effect not
reported (to our knowledge) with strontium citrate [16].”
16. S. J. Genuis and G. K. Schwalfenberg, “Picking a bone
with contemporary osteoporosis management: nutrient strategies to enhance
skeletal integrity,” Clinical Nutrition, vol. 26, no. 2, pp. 193–207, 2007.
The abstract to reference 16:
http://www.clinicalnutritionjournal.com/article/S0261-5614%2806%2900151-8/abstract
The entire article (reference 16) in PDF form:
http://www.uio.no/studier/emner/medisin/nutri/ERN3120/v12/ERN3120-Unit3-Student/02%20Osteoporosis%20and%20Ostaomalacia/Osteoporose-ern%C3%A6ring-03.pdf
The abstract to reference 16:
http://www.clinicalnutritionjournal.com/article/S0261-5614%2806%2900151-8/abstract
The entire article (reference 16) in PDF form:
http://www.uio.no/studier/emner/medisin/nutri/ERN3120/v12/ERN3120-Unit3-Student/02%20Osteoporosis%20and%20Ostaomalacia/Osteoporose-ern%C3%A6ring-03.pdf
The entire COMB Study article can be read here:
2 comments:
I have just been diagnosed with osteoporosis. Do not like the idea of Bisphosphonates.
Strontium Citrate looks like it is the only Strontium that I can get my hands on - I had a stroke 30years ago [aged 38] and the doctors will not prescribe Strontium [ranelate -live in UK].
Here we can get Strontium Citrate from Amazon, at 750mg a day from Life Extension. I am just hoping that this will be OK for me!
To: Anonymous of 02/02/2015,
As you read in the article, blood clots, which can lead to strokes and heart attacks, have not been associated with strontium citrate (SC). Of course, as a supplement, SC has not undergone the rigorous clinical trials required of prescription medications.
At an osteoporosis support group, www.inspire.com,I met a member, Char42, who has a genetic blood clotting disorder and has had clots, including a pulmonary embolism. She had one of the clots while taking a bisphosphonate. She has been taking SC for 4 years with no problems. She took 680 mg for the first two years and then reduced the dosage to 340 mg. Her bone mineral density scores were some of the worst I have seen when she started taking SC. Her scores have steadily improved.
I have never had a clot or stroke. However, my father had a deep vein thrombosis and required surgery after the clot was eliminated with Coumadin. My mother died of a massive myocardial infarction. I take a statin drug because I could not lower my cholesterol and triglycerides with diet alone. Despite my family history, I have been taking SC (680 mg strontium) successfully for 7 years. I take Doctor's Best Strontium Bone Maker, which is also available from Amazon, but I buy it from www.iherb.com.
If you decide to take SC, be sure to also get adequate amounts of calcium, magnesium,& vitamin D. Vitamin K2 may help bones and prevent calcium from building up in arteries and other soft tissues. Try to get all or most of your calcium from food.
I wish you the very best.
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