@citsu62 it has not been shown or proven that the ranelate causes the cardiovascular risks. I just looked it up and there is caution about strontium citrate as well. It is a very weak anti-resorptive so if DEXA's show serious bone loss, maybe go to a medication vs strontium.
https://urbannutritioncentermdr.com/the-potential-risks-examining-strontium-supplement-side-effects-and-safety-measures
Some potential side effects of taking strontium supplements include gastrointestinal issues such as upset stomach, diarrhea, and constipation. It may also cause headaches, nausea, vomiting, and skin rashes. In rare cases, strontium supplements have been associated with more serious side effects like blood clots or thrombosis.

Also: Use with caution of kidneys are a concern
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/strontium-citrate-side-effects-x1oyv4/
That said, I would consider it for maintenance after treatment with medications. Maybe at a lower dose. It will affect my DEXA scores though.