The therapeutic dose for strontium that I have read and been told by integrative medicine is 680mg daily.

As you may know, in Europe it was withdrawn from the market for a time due to concerns about cardiovascular effects (the ranelate form). It is back on but being used there only for those who have no other option, I read.

The problem is that it distorts the DEXA so you won't be able to interpret Tymlos results. Strontium is denser than calcium and replaces it in bone so the bone density looks better on DEXA.

I also experienced fatigue on Tymlos. My DEXA was at 18 months and showed amazing gains. But at that point my bone markers didn't show continuing effectiveness. Both endos that I spoke with had me eontinue for two years but I could have stopped.

Bone markers (P1NP and CTX) are controversial but could give some clues, along with the DEXA, as to whether you can stop the Tymlos. I kind of miss it: I felt protected! But it did make me tired.