Strontium citrate (Algaecal) and fractures

Posted by pami @pami, Apr 15 7:54am

I am looking to see if there are any studies done that show a reduced chance of fracture from using Strontium citrate (Algaecal) as opposed to calcium. Everything I have read only mentions increase of density using it. Does anyone have doctor input or a study showing an decrease in bone fractures?

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@gravity3

I agree....leave no stone unturned. I have stopped wishing that the medical community would do more to help women but that has not produced results and I have accepted that I will have to continue doing my own research and advocacy. Exhausting.....thank so much to Mayo connect and all who share their experiences.

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Yes, "exhausted" is the word because there is so much to learn in order to make sure and to know what works for each person.

The supplements, exercises and medications, ALL of that is what I am researching because it requires piecing together so one gets the whole idea.

As far as exercise, I am adding a modified heel drop where I don't tip toe so much.

I was doing a a foot stomp based on Cleveland Clinic and another source. I may still do that but if you try both, at least for me I notice the heel drop impact seems to translate more impactfully to my hip

And the stomp, while somewhat the same impact, I feel a little more in my knee.

I just hope we can all benefit somehow and I am so grateful for everyone here sharing and researching together.

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Therapeutic dose of strontium citrate, I was told, is 680mg once daily taken away from calcium.

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@healthmatters

This paper tells you all about strontium ranelate and includes that it should NOT be taken with osteoporosis medications such as bisphosphonates, e.g. alendronate (Alendro, Fosamax, Fosamax Plus), risedronate (Actonel, Actonel CombiActonel Combi D) and zolendronate (Aclasta); or denosumab (Prolia), raloxifene (Evista) or teriparatide (Forteo). Source: https://drlisacarroll.com.au/wp-content/uploads/2018/08/strontium_2016.pdf

This video makes a comment about strontium ranelate versus strontium citrate:
Go to minute 16:30 on this video https://www.youtube.com/watch?v=L9gw8wB5Loo

A study comparing three strontium formulations and their effect on bone density:
The three types of strontium salts studied are, strontium ranelate (SrR), strontium citrate (SrC), and strontium chloride (SrCl)

The administration of strontium salts led to a significant increase in trabecular and cortical tissue mineral density (TMD) in all experimental groups.

Among the studies, the SrC (strontium citrate) group exhibited the smallest increase in TMD.

These results may indicate that the administration of strontium significantly increases the mineral density of bone tissue, which is independent of bone mass, as it is converted into surface area.

Although some other studies have shown that Sr is more strongly incorporated into the trabecular bone compared to cortical bone, in our study, TMD increased similarly in both the cortical and trabecular bones.

Specifically, in the trabeculae, TMD increased by 36.9%, 16.5%, and 44.0% in the SrR, SrC, SrCl groups, respectively.

In the case of compact bones, TMD increased by 35.6%, 22.6%, and 40.0%, respectively.

These results are consistent with the findings of other researchers.

Our results revealed a positive correlation between the content of strontium in bone and TMD in both trabecular and cortical tissue.

Additionally, a positive correlation was observed in old (not producing hormones anymore) hens supplemented with strontium for 11 months for bone mineral density and bone mineral content.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11012416/
Here is another source https://blog.algaecal.com/strontium-ranelate-vs-strontium-citrate/

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@healthmatters That looks like a very technical study that would take me a lot of work to understand. That's not a criticism, just saying. I do not see in your comment that it is a small mouse study (small in number of mice - not that they chose tiny mice). It's definitely something to keep in mind when talking about increases in TMD (which btw is a term I am unfamiliar with).
When most human studies are talking about percentage increases in bone density they are talking about DXA scans in humans. That's how Evenity, Forteo etc are being evaluated. These percentages are in Ovariectomized mice using micro ct. Not saying this isn't good or important research, just saying it's important to remember that this is not apples to apples with the numbers commonly seen in this group when discussing increases in bone density.
Thanks for bringing this paper to our attention.

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@heatlh matters that study cites many contradictory results among similar studies. The lowest impact found was, unfortunately, strontium citrate, the from sold in the US as far as I know. It looks like impact on femur is low. TMD refers to mineral density. I am still unclear what the presence of more strontium (or calcium, phosphorus) means and if it is a good thing.

The conventional wisdom is that strontium is heavier/denser than calcium and competes with it. (The study showing increased calcium would seem to contradict this.) Since strontium is heavier/denser, and replaces calcium in bone (again this is what I have seen so often in readings) the DEXA is affected and makes bones look denser than they really are. I guess we could conclude that CT would be better to evaluate the effects of strontium versus a DEXA?

@awful truth "tiny mice" LOL

The study refers to micro CT. so I am picturing tiny mice inside a miniature CT machine!

Too many contradictory studies so far, and the real concern for many of us is cardiovascular. Is that risk equal among the different forms of strontium. There is this idea that strontium is "natural" but there is nothing natural about 680 mg and in Europe the ranelate form is considered a medication. Here it is in health food stores so is considered "natural" but it is not, and it is also not regulated.

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@healthmatters

This paper tells you all about strontium ranelate and includes that it should NOT be taken with osteoporosis medications such as bisphosphonates, e.g. alendronate (Alendro, Fosamax, Fosamax Plus), risedronate (Actonel, Actonel CombiActonel Combi D) and zolendronate (Aclasta); or denosumab (Prolia), raloxifene (Evista) or teriparatide (Forteo). Source: https://drlisacarroll.com.au/wp-content/uploads/2018/08/strontium_2016.pdf

This video makes a comment about strontium ranelate versus strontium citrate:
Go to minute 16:30 on this video https://www.youtube.com/watch?v=L9gw8wB5Loo

A study comparing three strontium formulations and their effect on bone density:
The three types of strontium salts studied are, strontium ranelate (SrR), strontium citrate (SrC), and strontium chloride (SrCl)

The administration of strontium salts led to a significant increase in trabecular and cortical tissue mineral density (TMD) in all experimental groups.

Among the studies, the SrC (strontium citrate) group exhibited the smallest increase in TMD.

These results may indicate that the administration of strontium significantly increases the mineral density of bone tissue, which is independent of bone mass, as it is converted into surface area.

Although some other studies have shown that Sr is more strongly incorporated into the trabecular bone compared to cortical bone, in our study, TMD increased similarly in both the cortical and trabecular bones.

Specifically, in the trabeculae, TMD increased by 36.9%, 16.5%, and 44.0% in the SrR, SrC, SrCl groups, respectively.

In the case of compact bones, TMD increased by 35.6%, 22.6%, and 40.0%, respectively.

These results are consistent with the findings of other researchers.

Our results revealed a positive correlation between the content of strontium in bone and TMD in both trabecular and cortical tissue.

Additionally, a positive correlation was observed in old (not producing hormones anymore) hens supplemented with strontium for 11 months for bone mineral density and bone mineral content.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11012416/
Here is another source https://blog.algaecal.com/strontium-ranelate-vs-strontium-citrate/

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My cardiologist also advised against taking strontium due to my blood thinner.

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@windyshores

@heatlh matters that study cites many contradictory results among similar studies. The lowest impact found was, unfortunately, strontium citrate, the from sold in the US as far as I know. It looks like impact on femur is low. TMD refers to mineral density. I am still unclear what the presence of more strontium (or calcium, phosphorus) means and if it is a good thing.

The conventional wisdom is that strontium is heavier/denser than calcium and competes with it. (The study showing increased calcium would seem to contradict this.) Since strontium is heavier/denser, and replaces calcium in bone (again this is what I have seen so often in readings) the DEXA is affected and makes bones look denser than they really are. I guess we could conclude that CT would be better to evaluate the effects of strontium versus a DEXA?

@awful truth "tiny mice" LOL

The study refers to micro CT. so I am picturing tiny mice inside a miniature CT machine!

Too many contradictory studies so far, and the real concern for many of us is cardiovascular. Is that risk equal among the different forms of strontium. There is this idea that strontium is "natural" but there is nothing natural about 680 mg and in Europe the ranelate form is considered a medication. Here it is in health food stores so is considered "natural" but it is not, and it is also not regulated.

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I am taking Forteo and have seen conflicting information on which minerals are ok to take with it. So far, no in depth information. I have heard warnings about Calcium to take and not to take. My vitamin D level was elevated to 99 & my Endo Dr told me to stop taking it until blood tests in 4 months.
I was taking Algae-Cal, however it has high levels of Vitamin D.
Calcium dilemma. To take or not to take?

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@elaussies

I am taking Forteo and have seen conflicting information on which minerals are ok to take with it. So far, no in depth information. I have heard warnings about Calcium to take and not to take. My vitamin D level was elevated to 99 & my Endo Dr told me to stop taking it until blood tests in 4 months.
I was taking Algae-Cal, however it has high levels of Vitamin D.
Calcium dilemma. To take or not to take?

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@elaussies I read that too high Vitamin D increases calcium. Is your doctor doing blood and/or urine calcium testing?

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@elaussies

I am taking Forteo and have seen conflicting information on which minerals are ok to take with it. So far, no in depth information. I have heard warnings about Calcium to take and not to take. My vitamin D level was elevated to 99 & my Endo Dr told me to stop taking it until blood tests in 4 months.
I was taking Algae-Cal, however it has high levels of Vitamin D.
Calcium dilemma. To take or not to take?

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@elaussies My suggestion is not to try to get calcium and Vitamin D in the same supplement. The level of Vitamin D in your blood may vary at different times and you need to be able to adjust your dose or in your case stop altogether for awhile. Adjusting your vitamin D should not determine whether you take calcium or not. Both calcium and D are cheap supplements even from good companies - just take two separate pills. I think the best evidence is that we need lots of calcium for bone health and that it does not have to all come from food. My guess the "dangers" of supplemental calcium are way way overblown. My doc suggested I get 1200mg a day from food and supplements combined (1200 is suggested for adults over 70). I cannot get anything like that with food due to food sensitivities so I take calcium supplements. I worry about plenty of stuff but I don't worry about that one.

BTW plenty of people on the bone forums that caution about calcium supplements are drinking milk substitutes and fortified foods that have calcium added to them. They think it's almond milk etc so it's calcium from food but in fact it's a supplemental calcium just mixed in their food. Go figure.

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@awfultruth

@elaussies My suggestion is not to try to get calcium and Vitamin D in the same supplement. The level of Vitamin D in your blood may vary at different times and you need to be able to adjust your dose or in your case stop altogether for awhile. Adjusting your vitamin D should not determine whether you take calcium or not. Both calcium and D are cheap supplements even from good companies - just take two separate pills. I think the best evidence is that we need lots of calcium for bone health and that it does not have to all come from food. My guess the "dangers" of supplemental calcium are way way overblown. My doc suggested I get 1200mg a day from food and supplements combined (1200 is suggested for adults over 70). I cannot get anything like that with food due to food sensitivities so I take calcium supplements. I worry about plenty of stuff but I don't worry about that one.

BTW plenty of people on the bone forums that caution about calcium supplements are drinking milk substitutes and fortified foods that have calcium added to them. They think it's almond milk etc so it's calcium from food but in fact it's a supplemental calcium just mixed in their food. Go figure.

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Thank you 😊

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In reply to @elaussies "Thank you 😊" + (show)
@elaussies

Thank you 😊

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@elaussies I hope you will talk to your doctor because high levels of Vitamin D can cause too much calcium, so supplements might not be harmful. This is complex and probably not a matter for this forum but instead for a doctor or nutritionist. See below:

"The main side effect of high levels of vitamin D (toxicity) is a buildup of calcium in your blood (hypercalcemia), which can cause nausea and vomiting, weakness, and frequent urination. It might also progress to bone pain and kidney calcium stones. Other possible side effects are decrease in appetite, constipation, dehydration, increased thirst (polydipsia), confusion, lethargy, and fatigue."
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108

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