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?

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

@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.

Jump to this post

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.

REPLY
@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/

Jump to this post

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.

REPLY
@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/

Jump to this post

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.

REPLY
@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.

Jump to this post

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/

REPLY
@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/

Jump to this post

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

REPLY
@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.

Jump to this post

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.

REPLY
@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.

Jump to this post

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.

REPLY
@sue417

Hi
Thanks don't think I will bother with it

Jump to this post

I have just bought it . So was thinking should I take it or not . Did you have any adverse effects after taking strontium? Did the strontium have positive effects for you ? Thank you

REPLY
@karenjaninaz

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.

Jump to this post

Congratulations on moving to osteopenia from osteoporosis! I am considering taking strontium citrate. Do you mind if I ask what your bone density score was before and after? And did you experience any side effects from it? Also what was the brand you took?

REPLY
@kathleen1314

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.

Jump to this post

@kathleen1314 , I am late coming to this discussion about strontium. I was told there were cardiovascular risks associated with its use, but now I am wondering whether the risks were solely associated with strontium ranelate or also with strontium citrate. Can you offer any clarification?

REPLY
Please sign in or register to post a reply.