Strontium citrate (Algaecal) and fractures

Posted by pami @pami, Apr 15, 2024

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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@windyshores

@kathleen1314 I guess what you missed is that you are kind of preaching to the choir. I used strontium when my bones were mildly osteoporotic. I had cancer and those meds caused severe bone loss and strontium was too slow and gentle for me after all those fractures. I wrote that I am open to considering strontium for maintenance. Not sure why you are writing so much on this to me.

I said "even" because McCormick is a chiropractor known for expertise in holistic approaches who is very open minded and individualizes treatment. His new book is "Great Bones>" I was surprised that he is not on board for strontium.

Last post on this topic for me. It isn't an emotional one for me as it seems to be for you.

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I am writing to you when you reply to me. It just seems courteous not to ignore your replies and the questions which you put to me.
I try very hard not to be emotional or to accuse others of preaching or being emotional. I think that you are doing your best in a difficult medical situation. You deserve to be shown the respect of a reply to your questions and concerns.
I hope that your bone plan works and that you do well on it.

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@kathleen1314

There is an Inspire poster that is fairly well known, PhoneyBoney. She was also fracturing on bisphosphonates etc.; I believe that she took various drugs.
She self reports that after taking strontium citrate that she stopped fracturing.
The links which I sent you has a 2020 compilation of strontium research; in that compilation the scientists say that one reason strontium has such a high success of preventing fractures is because it seems to make something called "sacrificial bonds" which allow the bone to sustain more injury.
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/dd823b-strontium-a-compilation-of-research-and-information/
I don't know if this sacrificial bond is what stopped PhoneBoney's bisphosphonate fracturing, but it is possible.
Strontium user stories:
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/strontium-users-stories-2-alternative-to-pharma-meds/

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Thanks for the additional info. I fractured 13 months ago and have not fractured since so I hope I am on the right path now. I stopped Fosamax 11 months ago, was off all meds for 3 months, then did 4 months of Tymlos followed by two months off and now on teriparatide.

Knowing what I know now, I would never have taken Fosamax for as long as I did.

That is very interesting info regarding the "sacrificial bonds". Looking forward to diving into the info after work today.

I was on the Inspire forum shortly after my fracture was diagnosed but dropped it when I was told (in very bold and insistent terms) that Tymlos would give me cancer.

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@kathleen1314

There is an Inspire poster that is fairly well known, PhoneyBoney. She was also fracturing on bisphosphonates etc.; I believe that she took various drugs.
She self reports that after taking strontium citrate that she stopped fracturing.
The links which I sent you has a 2020 compilation of strontium research; in that compilation the scientists say that one reason strontium has such a high success of preventing fractures is because it seems to make something called "sacrificial bonds" which allow the bone to sustain more injury.
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/dd823b-strontium-a-compilation-of-research-and-information/
I don't know if this sacrificial bond is what stopped PhoneBoney's bisphosphonate fracturing, but it is possible.
Strontium user stories:
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/strontium-users-stories-2-alternative-to-pharma-meds/

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I am interested in knowing how hard Strontium is on kidneys. I try to get all my calcium from milk, yogurt, cheese, leafy greens etc.

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@oopsiedaisy

Thanks for the additional info. I fractured 13 months ago and have not fractured since so I hope I am on the right path now. I stopped Fosamax 11 months ago, was off all meds for 3 months, then did 4 months of Tymlos followed by two months off and now on teriparatide.

Knowing what I know now, I would never have taken Fosamax for as long as I did.

That is very interesting info regarding the "sacrificial bonds". Looking forward to diving into the info after work today.

I was on the Inspire forum shortly after my fracture was diagnosed but dropped it when I was told (in very bold and insistent terms) that Tymlos would give me cancer.

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Yes, there were some studies with rats that showed a risk of bone cancer. I have not seen any research to back this up with humans. But the warning was on the Tymlos site, at least at one time.
https://tymlos.com/
Research:
" the initial phase 3 trials of the bone anabolic drug teriparatide were stopped because of a preclinical finding of osteosarcoma in rats treated with high doses of teriparatide for near lifetime. Even so, teriparatide was observed to reduce fracture risk in postmenopausal women with osteoporosis and showed efficacy and tolerability in the phase 3 program and in subsequent studies with a positive benefit to risk profile. Based on the phase 3 results, additional preclinical findings, and with risk mitigations, the agent was approved for use. Subsequent studies including in real‐world settings have not identified an increased risk of osteosarcoma in humans, and the label has been updated and adjusted, including removal of the boxed warning and a revision of the 2‐year lifetime limitation. Thus, observational studies with large sample sizes using real‐world data can be an important and efficient strategy for generating evidence in support of regulatory decision making and significant label updates."
https://pmc.ncbi.nlm.nih.gov/articles/PMC9465003/

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@kathleen1314

Yes, there were some studies with rats that showed a risk of bone cancer. I have not seen any research to back this up with humans. But the warning was on the Tymlos site, at least at one time.
https://tymlos.com/
Research:
" the initial phase 3 trials of the bone anabolic drug teriparatide were stopped because of a preclinical finding of osteosarcoma in rats treated with high doses of teriparatide for near lifetime. Even so, teriparatide was observed to reduce fracture risk in postmenopausal women with osteoporosis and showed efficacy and tolerability in the phase 3 program and in subsequent studies with a positive benefit to risk profile. Based on the phase 3 results, additional preclinical findings, and with risk mitigations, the agent was approved for use. Subsequent studies including in real‐world settings have not identified an increased risk of osteosarcoma in humans, and the label has been updated and adjusted, including removal of the boxed warning and a revision of the 2‐year lifetime limitation. Thus, observational studies with large sample sizes using real‐world data can be an important and efficient strategy for generating evidence in support of regulatory decision making and significant label updates."
https://pmc.ncbi.nlm.nih.gov/articles/PMC9465003/

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This illustrates the importance of reporting adverse reaction. If not reported, they do not get added to the "real-world data".

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@pami

I am interested in knowing how hard Strontium is on kidneys. I try to get all my calcium from milk, yogurt, cheese, leafy greens etc.

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With kidneys, the question seems to be, as it is with basically all drugs and supplements, "how healthy are the kidneys?".
Strontium, other supplements and drugs taken by mouth, are secreted by the kidneys. If the kidneys don't work, then drugs, supplements, and yes, strontium may build up.
As with any drug or supplement you need to be careful with accumulation if you have renal insufficiency .

The strontium ranelate site has this breakdn of use with kidney impairment:
"strontium ranelate is not recommended for patients with severe renal impairment (creatinine clearance below 30 ml/min).
No dose adjustment is required in patients with mild-to-moderate renal impairment (30-70 ml/min creatinine clearance)."
This might be a good base line for use of strontium citrate, just to be safe, but as with many supplements, no one has spent the money to check.
It is always best to ask your doctor.

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@windyshores

But @mcchesney the study that was cited above measured increase in DEXA, which may be a false increase. I would like to see a study on improvement in REMS and TBS if those are now available to more people.

The suggested therapeutic dose for strontium citrate is 680mg, the dose in Strontium Boost.

I am not at all critical of strontium use and tried it 18 years ago for a short time,. I would love good news given my sensitivities to most med options (which I am doing anyway in an adjusted fashion). But I need more than a study showing increase in DEXA on strontium since we know it is denser than calcium and throws the scan results off, I cannot afford to try a year and compare results done the second time with the first- bones can't afford that risk! In any case it may work too slowly for those of us with severe osteoporosis.

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I followed the Duquesne University study of strontium citrate with other micro nutrients. I only use 340 mg and reversed my osteoporosis to osteopenia in a year. The study was very involved in study of the bone cells.

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