Strontium Interaction with Calcium and Food and Antacids

Most of us taking strontium know that for maximum absorption strontium must be taken at least two hours away from calcium supplements and dairy foods. Actually, strontium is best absorbed on an empty stomach, defined as at least two hours after eating. Food, milk and derivative products, and medicinal products containing calcium may reduce the bioavailability of strontium by about 60-70%.

Many are unaware that antacids should be taken at least two hours AFTER strontium. A study has shown that taking antacids containing magnesium hydroxide or aluminum hydroxide either together with strontium or two hours before strontium causes a 20-25% decrease in strontium absorption.

Here is a direct quote from Servier’s Summary of Product Characteristics (SPC) for Protelos (strontium ranelate):

“An in vivo clinical interaction study showed that the administration of aluminium and magnesium hydroxides either two hours before or together with strontium ranelate caused a slight decrease in the absorption of strontium ranelate (20-25% AUC decrease), while absorption was almost unaffected when the antacid was given two hours after strontium ranelate. It is therefore preferable to take antacids at least two hours after Protelos. However, when this dosing regimen is impractical due to the recommended administration of Protelos at bedtime, concomitant intake remains acceptable.”

http://www.servier.com/sites/default/files/SmPCProtelos062014.pdf

Strontium for Knee Osteoarthritis

“Preliminary research suggests that strontium may also benefit arthritic joints by stimulating cartilage formation, among other possible mechanisms. In a large study in the Annals of the Rheumatic Diseases in 2013, people with knee osteoarthritis took strontium ranelate (1 or 2 grams a day) or a placebo for three years. Both strontium groups showed less joint space narrowing on X-rays (indicating slower disease progression) than the placebo group. The higher-dose group also had improvements in knee pain and physical functioning.”

Below is an edited abstract:

Background Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomized, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis.

Methods Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) 2.5–5 mm) were randomly allocated to strontium ranelate 1 g/day (n=558), 2 g/day (n=566) or placebo (n=559). The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment) over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee pain. The trial is registered (ISRCTN41323372).

Results The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: −0.23 mm; 2 g/day: −0.27 mm; placebo: −0.37 mm); treatment-placebo differences were 0.14 for 1 g/day and 0.10 for 2 g/day. Fewer radiological progressors were observed with strontium ranelate for 1 and 2 g/day. There were greater reductions in total WOMAC score, pain subscore, physical function subscore and knee pain with strontium ranelate 2 g/day. Strontium ranelate was well tolerated.

Conclusions Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day.

http://www.berkeleywellness.com/supplements/minerals/article/new-supplement-old-bones