Strontium Citrate Protocols

If you decide to take strontium citrate, you need to ensure you are also getting adequate calcium, magnesium, vitamin D, other vitamins and minerals, and protein. You can get these nutrients from a combination of diet and supplements. Choosing a supplement plan, or protocol, that is right for you can be as simple as choosing one of the three protocols described in this post or by modifying one of them with your own choice of supplements. 

Protocols for Osteoporosis:

 COMB                                                                                 BoneLady 

Strontium citrate                   680 mg                                                  680 mg

Vitamin K2 (MK7)               100 mcg                                                none

Vitamin D3                         2000 IU                                                 1000 IU

Docosahexanoic acid (DHA)250 mg                                                 none

Magnesium                             25 mg                                                  250 mg*

Calcium                       Dietary sources                                    500 mg*  

*BoneLady takes a supplement tablet that contains 250 mg Mg and 500 mg Ca. In addition, she gets about 700 mg Ca from food for a total of about 1200 mg Ca per day.  

Protocol for Osteopenia:

MOTS 

Strontium citrate     450 mg

Vitamin K2 (MK7)     60 mcg

Vitamin D3            2000 IU*

Melatonin                    5 mg

DHA                             none

Magnesium                  none    

Calcium                          * 

*In addition to study medication, participants in the MOTS study were allowed to take less than 1000 IU of vitamin D3 and less than 1000 mg of calcium daily. 

http://strontiumforbones.blogspot.com/2017/02/mots-and-comb-study-comparison.html

http://strontiumforbones.blogspot.com/2012/02/combination-of-micronutrients-for-bone.html

https://s3-us-west-1.amazonaws.com/paperchase-aging/pdf/vmFJfarchkyMAtwWn.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310667/

https://clinicaltrials.gov/ct2/show/NCT01870115?term=strontium+citrate&rank=1

Axial DXA 8 January 2019

The report of my axial DXA scan taken on 8 January 2019 appears below. I have been on 2 grams strontium citrate/day for 11 years. I also take a calcium/magnesium tablet (500 mg Ca/250 mg Mg), a multivitamin with 1000 IU vitamin D3, and several other supplements. I get plenty of protein in my diet. I exercise daily.

As you can see, my DXA results were excellent, except for my left femoral neck, which showed no change from the previous scan.

I am happy with my results, although I know the comparison of this year's results to those of 2.5 years ago contains some built-in error because two different brands of DXA machines were used. My 2016 scan was on a Hologic and the 2019 scan was on a GE Lunar Prodigy.

Changing testing sites, and, therefore, machines, was not my choice. I had been getting my scans in the outpatient radiology department of a large hospital medical center, but the provider is now pushing patients into its freestanding imaging centers. I was told my insurance would not pay for a DXA unless it was done at a freestanding center, but my insurance denied that assertion.

The risk factor for secondary osteoporosis mentioned, but not specified, in the report is early menopause.

INDICATION: Postmenopausal. Follow-up of osteopenia on prior DXA.
Patient reports risk factors for secondary osteoporosis.

COMPARISON: 8/4/2016

FINDINGS:

Spine: Total BMD of the spine (L1-4) is 1.108 g/cm2, with a T-score of
-0.7 and a Z-score of 1.0.

Left Femoral Neck: BMD is 0.883 g/cm2, with a T-score of -1.1 and a
Z-score of 0.6.

Left Total Hip: BMD is 0.928 g/cm2, with a T-score of -0.6 and a Z-score
of 0.9.

Right Femoral Neck: BMD is 0.919 g/cm2, with a T-score of -0.9 and a
Z-score of 0.9.

Right Total Hip: BMD is 0.963 g/cm2, with a T-score of -0.4 and a Z-score
of 1.1.

Compared to the prior study, there has been 9% increase in spine density, 6% increase in left total hip density, but no change in left femoral neck density.

FRAX evaluation calculates 10-year probability of fracture:

Major Osteoporotic: 7.8%

Hip: 1.0%

IMPRESSION:

Based on BMD, diagnosis is consistent with osteopenia.

FOLLOWUP: In 2 years is recommended.

In Memory of Sara Shackleford DeHart

December 18, 1931 - November 8, 2017

Sara was born December 18, 1931 and passed away at her Lynnwood, WA home on November 8, 2017.
 

Arrangements under the direction of Purdy & Walters at Floral Hills, Lynnwood, WA.

Published in The Herald (Everett) on Nov. 22, 2017

Read obituary at Herald, The (Everett).

http://obits.dignitymemorial.com/dignity-memorial/obituary.aspx?n=Sara-DeHart&lc=4171&pid=187298167&mid=7633682&Affiliate=heraldnet&PersonID=187298167&FHID=11419

Sara DeHart was an inspiration to me and others. Ten years ago, when I started looking for alternatives to Fosamax, there was little information about strontium citrate (SC). Strontium ranelate was registered in Europe in 2004 for postmenopausal osteoporosis. I started using SC on January 21, 2008, and Sara's first article about strontium and osteoporosis was posted July 7, 2008.

Sara DeHart wrote three case studies about her struggle with osteopenia and fragility fractures while taking osteoporosis drugs. Only after taking strontium citrate with sufficient vitamin D3, calcium, and magnesium did the fractures cease. She later added vitamin K2 as well. I wrote a post about each of her articles on strontium.

Sara underwent radiation for inoperable throat cancer in 2000 and again for ductal carcinoma in situ in 2016. Of course, she wrote about those experiences and how to minimize the risk of radiation skin burns. She was a medical professional, professor, and writer until the end. She died November 8, 2017, three weeks short of her 86^th birthday.

http://strontiumforbones.blogspot.com/2009/02/strontium-and-osteoporosis.html

http://strontiumforbones.blogspot.com/2010/08/another-strontium-citrate-success.html

http://strontiumforbones.blogspot.com/2012/10/case-study-on-strontium-citrate-for.html

http://www.intrepidreport.com/archives/2608

http://www.intrepidreport.com/archives/2612

http://www.intrepidreport.com/archives/7529

 

MOTS and COMB Study Comparison

A one-year study on strontium citrate combined with melatonin and other supplements and named the Melatonin-micronutrients Osteopenia Treatment Study (MOTS) was recently published (January 26, 2017). I’d like to compare it to the Combination of Micronutrients for Bone (COMB) Study published in 2012. See the following chart:

        
    COMB Study                                                               MOTS

Study size                        114                                                                                  20

Baseline BMD status      osteoporosis                                                                   osteopenia

Strontium (citrate)               680 mg                                                                          450 mg

Vitamin K2 (MK7)               100 mcg                                                                         60 mcg

Melatonin                              none                                                                                5 mg                        

Vitamin D3                         2000 IU                                                                          2000 IU

Docosahexanoic acid (DHA)   250 mg                                                                      none

Magnesium                             25 mg                                                                          none

Lumbar spine BMD             6% increase                                                             4.3% increase

Femoral neck BMD             4% increase                                                             2.2% increase

Total hip BMD               3% increase                                                             No sign. diff., pos. trend

I could have predicted the results on BMD. How? Well, it had previously been shown, from studies on strontium ranelate, that strontium increased BMD at all dosages studied, but the optimum increases were gained with 680 mg strontium. Also, melatonin has been used for years as a sleep aid, but there is little evidence for it as a bone supplement. The authors of MOTS named two studies on melatonin listed below.         

“Limitations to this study include low number of subjects, lack of a diverse cohort and lack of different micronutrient combinations on primary and secondary endpoints in MOTS clinical trial.”

Despite the limitations of MOTS, there is valuable information to be gained from it:

MOTS increased awareness of the importance of preventative care in patients with osteopenia. “Over half of all women in the U.S. above age 50 have osteopenia with a prevalence of approximately 3.4 times more than osteoporosis. Consequently, twice the number of fractures arises from women with osteopenia as they represent almost 50% of the total population at risk.”

“The 10-year vertebral fracture risk probability decreased by 6.48% in response to MSDK (melatonin, strontium, vitamins D and K) therapy compared to 10.8% increase in placebo.”

“MSDK reduced bone marker turnover primarily by increasing the bone formation marker P1NP and maintaining healthy bone turnover.”

“MSDK demonstrated positive effects on inflammatory status and improved quality of life especially related to sleep.”

MOTS confirmed that dosages lower than 680 mg strontium will increase BMD by lower percentages.

                       

http://strontiumforbones.blogspot.com/2012/02/combination-of-micronutrients-for-bone.html

https://s3-us-west-1.amazonaws.com/paperchase-aging/pdf/vmFJfarchkyMAtwWn.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310667/

https://clinicaltrials.gov/ct2/show/NCT01870115?term=strontium+citrate&rank=1

Kotlarczyk MP, Lassila HC, O’Neil CK, D’Amico F, Enderby LT, Witt‐Enderby PA, Balk JL. Melatonin osteoporosis prevention study (MOPS): a randomized, double‐blind, placebo‐controlled study examining the effects of melatonin on bone health and quality of life in perimenopausal women. J Pineal Res. 2012; 52:414–26. doi: 10.1111/j.1600‐079X.2011.00956.x

Amstrup AK, Sikjaer T, Heickendorff L, Mosekilde L, Rejnmark L. Melatonin improves bone mineral density at the femoral neck in postmenopausal women with osteopenia: a randomized controlled trial. J Pineal Res. 2015; 59:221–29. doi:10.1111/jpi.12252

My DXA Scan on August 4, 2016

My scores improved, but I am still in the osteopenia range. Therefore, I will keep taking 680 mg strontium per day from strontium citrate, along with my other supplements. Here are my results:

Spine: Total BMD of the spine (L1-4) is 0.897 g/cm2, with a T-score of -1.4.

Left Femoral Neck: BMD is 0.729 g/cm2, with a T-score of -1.1.

Left Total Hip: BMD is 0.812 g/cm2, with a T-score of -1.1.

Compared to the prior study (August 21, 2013), there was a 3% increase in BMD of the lumbar spine and a 5% increase in BMD of the left total hip.

My lumbar spine T-scores have always been worse than my left total hip T-scores.

 

My lumbar spine T-scores went from -3.0 (osteoporosis) in May 2007 to -2.7 (still osteoporosis but better) in July 2009 to -1.6 (osteopenia) in August 2013 to -1.4 (osteopenia) in August 2016.

My Progress with Strontium Citrate

I’ve been taking Doctor’s Best Strontium Bone Maker (680 mg strontium) once daily since January 2008. That’s eight years of taking strontium continuously. My back is stronger than it’s been in years. This morning I did yard work—pulling up oak seedlings and weeds and burying a cable that keeps being uncovered by the rain. I bent over numerous times with no pain. I should have taken a work bench and not bent over, but, sometimes I forget to avoid forward bending because I feel well. I’ve had no fractures, although I keep getting older. My BMD has continued to improve. I love strontium citrate!

My lumbar spine T-scores went from -3.0 (osteoporosis) in May 2007 to -2.7 (still osteoporosis but better) in July 2009 to -1.6 (osteopenia) in August 2013. I documented my scores on this blog:

http://strontiumforbones.blogspot.com/

https://www.blogger.com/profile/10034636499792659801

http://strontiumforbones.blogspot.com/2009/07/improved-t-scores-after-treatment.html

http://strontiumforbones.blogspot.com/2013/09/from-osteoporosis-to-osteopenia-with.html

I have orders for another DXA scan this year (2016). I haven’t made an appointment yet. I’m hoping for normal (-1.0 and above) T-scores this time. I’ll keep you posted.