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?

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@nene78

I would like to thank you for the deep dive article. It gave me some insight as to whether I should continue to take the strontium from “organic algae” or not. Interestingly it actually exists in ocean and river water, hence the absorption into the algae. The dose is low-4 mg/dose/day do I will continue and if you come across any further info please post it.

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I agree if you are taking just the AlgaeCal with trace elemental minerals incorporated. This is like consuming naturally occurring strontium in our food.

However I remain concerned about the "Strontium Boost" supplement, which is 680 mg of Strontium Citrate; according to their website is sourced from elemental strontium from soil combined with citrate.

The daily dose is equivalent to twice the TOTAL amount of strontium that occurs naturally in our bones.

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@sueinmn

I agree if you are taking just the AlgaeCal with trace elemental minerals incorporated. This is like consuming naturally occurring strontium in our food.

However I remain concerned about the "Strontium Boost" supplement, which is 680 mg of Strontium Citrate; according to their website is sourced from elemental strontium from soil combined with citrate.

The daily dose is equivalent to twice the TOTAL amount of strontium that occurs naturally in our bones.

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@sueinmn from the article I believe the therapeutic dose of 680mg might be up to 200 times what we get from food. Side effects, especially cardiovascular, are a concern. I was however interested in the info in the article on possible benefits of low dose strontium (excerpt below). I still wonder if the 4mg or so that is typical in various supplements has any effect. We need more research!

"Researchers should investigate the possibility that the beneficial effects of high-dose strontium could be duplicated at least in part by much lower “nutritional” doses, such as 2-6 mg per day. The improvement in bone quality that results from the incorporation of strontium into hydroxyapatite crystals likely occurs with small doses of strontium, since strontium is present in the hydroxyapatite crystals of people who do not take strontium supplements. The possibility that low-dose strontium is beneficial is supported by the results of one study, in which the reduction in fracture incidence was nonsignificantly greater with 170 mg per day of strontium than with 340 or 680 mg per day. Whether doses less than 170 mg per day would influence bone mineral density or fracture risk has not been investigated."

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@awfultruth

@nene78 Hi there. I read the osteoporosis section just now and it is quite positive. And I do intend to keep researching strontium.

Your intake of 12mg is quite low and maybe not a level that would trigger alarms for the different potential problems with strontium?
Here's one of my favorite pieces on strontium from Dr Alan Gaby a nutritional oriented doctor who I greatly respect.
https://townsendletter.com/editorial-05-18-gaby-high-dose-strontium/

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Thank you for the informational article. I wish I could find info on strontium occurring in water, “organic algae” so I would know if I’m harming myself! I did have a suprising effect taking 5 mg/day-5% bone increase in dexa. My endocrinologist was really suprised. I would like to find an ongoing study to participate in. If you or anyone heard of one I’d appreciate hearing of it. Regards, Renee

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@nene78

Thank you for the informational article. I wish I could find info on strontium occurring in water, “organic algae” so I would know if I’m harming myself! I did have a suprising effect taking 5 mg/day-5% bone increase in dexa. My endocrinologist was really suprised. I would like to find an ongoing study to participate in. If you or anyone heard of one I’d appreciate hearing of it. Regards, Renee

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@nene78 the problem is that you cannot know for sure that that increase is real. I have read the DEXA should be adjusted by 10% for strontium but that may have been for the 680mg.

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Thank you for your reply. I actually called the vitamin company today and asked for the “studies” done on the strontium they are using in their vitamin. We will see if they reply to me! And you are right-no way of knowing!

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@nene78

Thank you for your reply. I actually called the vitamin company today and asked for the “studies” done on the strontium they are using in their vitamin. We will see if they reply to me! And you are right-no way of knowing!

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Here is one of the Algaecal studies:
https://pubmed.ncbi.nlm.nih.gov/21492428/
Any study on strontium will be a study on Algaecal strontium.

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@kathleen1314

Here is one of the Algaecal studies:
https://pubmed.ncbi.nlm.nih.gov/21492428/
Any study on strontium will be a study on Algaecal strontium.

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What are Algaecal 1 and 2? Are these Algaecal (no strontium) , Algaecal Plus (trace strontium) or Bone Builder pack with Strontium Boost (680mg strontium)?

I am certainly interested in this study but find the website fundamentally flawed by mentioning a promised increase in DEXA scores without explaining that the improvement may be illusory.

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@kathleen1314

Here is one of the Algaecal studies:
https://pubmed.ncbi.nlm.nih.gov/21492428/
Any study on strontium will be a study on Algaecal strontium.

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Thank you for your reply and information. My vitamin is called MyKind and is a plant based Cal, K2 Mag and Strontium vitamin. Not sure how it compares to Algaecal.

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@sueinmn

Since this question has repeatedly been discussed on the forum, and I have found no independent, scientific, peer reviewed study of Algaecal to give you as a reference, I went on a deep dive into the research of Strontium and its bone-building mechanism.
I found two very recent, apparently independent studies of how strontium is used by the body.

The first, "The Influence of Strontium on Bone Tissue Metabolism and Its Application in Osteoporosis Treatment" ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235140/ ) provided the following details:
"The recommended dose for treatment of osteoporosis is 2 g of strontium ranelate daily, taken as an oral suspension [40]. In clinical trials, the above dose was used for three years, and in follow-up studies, long-term results were noted after treatment lasting 5 to 10 years [41]. Strontium ranelate was, at one point, withdrawn from treatment due to reports of serious side effects. Information has emerged about the growth of cardiovascular risk and non-fatal myocardial infarctions. Recently, the EMA (European Medicines Agency) has issued an overview of how strontium ranelate can be used with many restrictions on its use..."

Later in the article they add: "Orally administered strontium ranelate does not significantly affect bone formation in vivo because it does not reach a sufficient concentration near this tissue, assuming a standard drug supply and a normal calcium-rich diet."

The conclusion by these scientists: "The mechanism of action of strontium is still not fully understood, which is a significant problem in modern science. However, the research that has been conducted to date has brought us closer to understanding the mechanism by which strontium ions work in the bone formation process. It seems that administering Sr locally can be very effective, with fewer side effects than systemic administration, and it can significantly improve the osseointegration of bone implants."
Later in the article they add: "Orally administered strontium ranelate does not significantly affect bone formation in vivo because it does not reach a sufficient concentration near this tissue, assuming a standard drug supply and a normal calcium-rich diet."

The takeaway - high doses of strontium, 2 grams per day in oral suspension, provided good benefits, but not without significant risks. Research continues...

A new article : https://www.sciencedirect.com/science/article/pii/S0167732224000151#s00600 - is a PRELIMINARY study of how to influence the uptake of strontium at the cellular level in humans

So, what about AlgaeCal & it's companion Strontium Boost? The basic AlgaeCal supplement contains Calcium from algae, magnesium, vitamin D3 and a trace of strontium along with a number of other trace minerals. (https://www.algaecal.com/products/algaecal-basic/) AlgaeCal Strontium Boost contains 680 mg of strontium in capsule form, to be taken once a day. That is one-third the amount in the study referenced above, and not a liquid suspension.

The bottom line -
There is developing evidence that the form of calcium in red algae (algas calcareas)and other forms are more "bio-available" than calcium carbonate and calcium citrate.
Strontium still offers big questions because consuming large amounts can have side effects.
Only you can decide whether the price tag on the AlgaeCal products are worthwhile for you - I think there company offers a money-back guarantee with certain limitations. Or whether you can find other less expensive algae-based supplements that have been tested for purity.

Sue

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Here is a posting of research and studies on strontium research which might be helpful to you in your deep dive into strontium research. Notice the bone biopsies and the 2020 review of strontium research etc.. https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/dd823b-strontium-a-compilation-of-research-and-information/
Also, notice the TBS research and newer Rems information.

In the research which you cited, but did not discuss, about the interaction amongst calcium, strontium, and citrate ions, notice that the addition of strontium was found to increase calcium bioaccessibility from calcium citrate suspensions at different temperatures. ( a partial quote from the research)
https://www.sciencedirect.com/science/article/pii/S0167732224000151#s00600
I see that you may have misread part of the 2021 research when you say that oral Strontium Ranelate does not affect bone formation. Notice that your provided quote is referring to bone defects not osteoporosis and is in the section discussing local use of strontium for bone defects not osteoporosis. This is not a quote about osteoporosis but about the need for strontium laced materials to be applied directly to the site of the bone defect.
Titled "Local Administration of Strontium Ions". The quoted portion which you provide contrasts the use of strontium used directly at the site of the defect as opposed to oral administration and then points out that strontium is needed directly at the site of the defect rather than orally. It is not negating the use of oral strontium for conditions such as osteoporosis. see acutal osteoporosis quotes from the article below
To reiterate
You say:
"Later in the article they add: "Orally administered strontium ranelate does not significantly affect bone formation in vivo because it does not reach a sufficient concentration near this tissue, assuming a standard drug supply and a normal calcium-rich diet.""
This is a statement about specific bone defects not osteoporosis. No one doubts that specific areas of bone damage need a more concentrated application of strontium. Multiple research upholds this as does current use.
Strontium laced products applied directly to the area of concern are being used in multiple ways for bone defects, jaw necrosis, cranial burr holes. see my first linking of a compilation of strontium research where there is a list of such applications
When osteoporosis is discussed in your 2021 linked research, rather than bone defects, the article says: "Strontium can also be incorporated into bone cells, which increases their density and reduces the risk of developing osteopenia and osteoporosis. "
Then this statement about osteoporosis, strontium and fractures is found:
"The SOTI (Spinal Osteoporosis Therapeutic Intervention) study found a reduction in the incidence of spine fractures in postmenopausal women after just one year of treatment. This decrease, compared to the placebo control group, amounted to 49%. A three-year double-blind study showed a 41% reduction in the incidence of new spine fractures, compared with a placebo group. TROPOS (treatment of peripheral osteoporosis) studies have shown the effective anti-fracture effect of ranelate on non-vertebral fractures within the first three years of use. These fractures were reduced by 16% [37,38,39]."
Plus, a long discussion of how strontium works with osteoblasts and osteoclasts to form bone.

Strontium citrate is easily obtained as a supplement in itself without the price tag of the AlgaeCal products. AOR and Vitacost are just two providers.

Part of a deep dive into strontium might be to research the newer bone tests such as REMS and Dexa with TBS. Both of these bone scans show that strontium users have good bone density and good bone quality. The research of Dexa with TBS shows that strontium users place within the top three of bone quality results. Page 7 of the research, https://www.panoramaortho.com/wp-content/uploads/2019/03/TBS-Review-JBMR-2014.pdf
see further research in the first provided posting of strontium research at the top

The discussion of strontium ranelate, its differences and its complicated history in the European medical community makes for a long and involved posting. It may be found in my first linked offering above.
Probably the quickest answer is that strontium ranelate is not available in the USA. Strontium citrate is available and strontium citrate has never been banned or limited in its use. I do think that further testing would be helpful, but the current testing and research has not found strontium citrate to be associated with any cardio vascular problems.

There is a tendency to "poo-Poo" strontium use in terms of osteoporosis results. This probably has to do with a back lash against the Naural vs Medical discussion. My use of strontium for my once osteoporosis now "normal" bones is based entirely on research and on my doctor's recommendations. There are not many osteoporosis treatments which have years of research, bone biopsies, plus good results from DEXA, REMS, and TBS and an almost non existent chance of side effects. Strontium is hard to believe, but a read of the actual research and studies at least says that this is a supplement which needs more study.
Thank you for the discussion.

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@windyshores

What are Algaecal 1 and 2? Are these Algaecal (no strontium) , Algaecal Plus (trace strontium) or Bone Builder pack with Strontium Boost (680mg strontium)?

I am certainly interested in this study but find the website fundamentally flawed by mentioning a promised increase in DEXA scores without explaining that the improvement may be illusory.

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My suggestion is to just use strontium citrate and not worry about all the different Algaecal.
But here is the explanation which Algaecal gives of the studies
https://blog.algaecal.com/lara-pizzorno-algaecal-plant-based-calcium-studies-say/
Algaecal 2 showed the most significant changes
" AlgaeCal 1 had a positive mean annualized percent change in increase in BMD of a gain of 1.15% and AlgaeCal 2 that is now sold as AlgaeCal Plus and Strontium Boost had a positive annualized net change of 2.79% that’s really significant."

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