Strontium citrate (Algaecal) and fractures

All strontium is the same strontium in terms of bone building ability.
What differs are the additives and the monitoring bodies. I have used AOr monitored by the Canadian government, similar to a drug and containing few additives; I have used vitacost brand which is at a good price point.
I try to use a product that is just strontium citrate with few additives.

@loplady different Dexa machines give different results

@loplady Would the problem of Strontium causing inaccurate DEXA results be eliminated if patient discontinued taking Strontium 24 hours, possibly longer, before their DEXA scan---like taking calcium or iron needs to be discontinued 24 hours before a DEXA?

Well, a lot of these old concerns do stem from the dexa skews for strontium. Skews of about 10% greater for strontium users depending on the machine, because of their denser bones and how the radiation penetrates strontium differently than a more largely calcium bone.
Plus, doctors are bound by FDA authorizations and frankly led by their pharma representatives. That is actually how I was introduced to strontium; my endocrinologist had heard about the strontium ranelate being sold by a large pharma co in Europe and mentioned it to me in an office visit. I researched and surprise there was strontium citrate. Still, there has been quite a bit of research about strontium over the years, and it seems to have been ignored by the medical community.
But dexa.....
Those old dexa skew concerns are now very dated and don't "hold water" because of the TBS and the REMs. Both TBS and REMS are not affected in the same way by the denser aspect of strontium. Because of the use of TBS and REMS, more and more strontium users are showing tests that show good bone density and good bone quality.
So I would ask those doctors if they still have the same concerns. I would expect at least a moderation based on the consistent results for REMS and TBS and strontium users, but it is difficult for anyone to say "I was wrong", especially a doctor that may have mislead many patients. I do know several medical providers on Inspire are starting to moderate their antistrontium screes, but no apologies have been issued.
With good bone density, good bone quality and bone biopsies showing good density and bone quality and research showing significant lessening of fracture risk and few side effects, it is now very very hard to be "against" strontium.
Indeed, as I have said in the past, my endocrinologist told me to change nothing, and I have never known a doctor to tell a strontium user, with good results, to stop using strontium. It would be a strange doctor who would tell a patient with good results and who is not fracturing with no side effects to stop strontium and take another pharma drug.
Contact some of them and ask, I would be interested. They will probably give you the standard reply that "it is early days, and they will be interested to see more research and studies".
Ok, I asked AI google and copied your exact question. This was its answer:
"Experts like Keith McCormick and Dr. John Neustadt are cautious about strontium due to concerns over inaccurate DEXA scan results, the lack of large-scale clinical trials for the supplement form, and potential cardiovascular risks associated with the prescription form. Dr. Doug Lucas's position is less clear, with some sources suggesting he is an advocate for the supplement form as part of a specific protocol."
So the dexa concern is shot down by rems and tbs results, and if you will read my previous reply about the cardio risks that cropped up in one flawed population study then you can put that concern into context. Plus, there are several osteoporosis drugs that have written cardio concerns in their literature, (Evenity, Forteo, Prolia), so I don't understand the demands for strontium citrate to prove no cardio concerns especially when it has never had a cardio concern listed in any of its studies. sigh
I would like more large scale clinical trials on strontium citrate also. Indeed, I, like many doctors, never think that we have enough research. ha

@sequoia Huh? This doesn't match the discussion about Strontium Citrate and why those doctors are against it. I know different machines can give a different result and never questioned that.

@loplady Dr say taking strontium skews Dexa numbers and my point was that different machines give differences too. So really strontium and a different machine, a person would not really know if numbers were improving. Sorry to have mentioned the machines.

@kathleen1314 I'd love to get the chance to ask the question directly. I agree on AI about Doug Lucas. I watched one video and he was against it but this last one in December, he was wishy washy. Also agree on Doctors having no problem with the side effects of the prescription meds or the black box warning on Evenity. My gynecologist does not want to prescribe HRT for me because of side effects she has seen with people over 60 yet she told me to just take the drugs that my endo has wanted to put me on - fosamax a couple of years ago and this year Evenity. Doesn't make sense to me her fear of one drug but not the others.

@loplady
I think the fears with HRT are probably 3 fold for your doctor; 1. her experience 2. the old WHi report that was not about BHRT but still strikes terror in the hearts of many who aren't aware of the old vs new HRT/BHRT, and 3. the need for her to be sure that you do not have health concerns that would cause a problem with any HRT and all the responsibility that goes with keeping you safe.
Ex: Many of the concerns about beginning any HRT, if the patient has not been on any hormones for 10 years or more, stems from concerns about plaque in the cardio system breaking loose. When you are in menopause for many years then the lack of hormones may cause cardio changes....stiffening of the cardio vessels and possible build up of plaque. When hormones are reintroduced then there is a chance that as the cardio system becomes more pliable that the old menopause plaque may loosen and cause problems.
Because of this, you need a doctor that is willing to do all the tests before and during your use of hormones; tests to keep you safe...plus, many doctors put their patients on vit k to help keep the calcium in your bones and remove it or prevent it from entering your cardio system.
A hormone expert familar with these concerns and who is going to test you regularly is imperative; also a gyn who will check your uterus one to two times a year with a uterine ultrasound is, I feel, also imperative.
Your gyn's fear of the old HRT and progestins is well founded. BHRT does not carry the same risks, but those HRT concerns are hard for drs to shake and to put into context. Plus, her fear of HRT is based on her knowledge of the old HRT and responsibility towards you.
If you take osteoporosis drugs then that responsiblity would be with another doctors, your endo, so that doctor will be responsible....so she is passing that responsiblity on to your endo; which she should do. Still, it explains her concerns for what is her responsibility and her passing of other concerns to an expert on osteoporosis drugs.

@loplady Would the problem of Strontium causing inaccurate DEXA results be eliminated if patient discontinued taking Strontium 24 hours, possibly longer, before their DEXA scan---like taking calcium or iron needs to be discontinued 24 hours before a DEXA?

@tonilynn I found this on-line: "Strontium can skew DEXA scans because it has a higher density than calcium, which can lead to an overestimation of bone mineral density. This means that while strontium may improve bone density, it can create misleading results in DEXA measurements for up to ten years after stopping supplementation."