BHRT vs PHRT

@squitirogloria
You ask "you are in normal bone territory. Is it just from the BHRT and strontium, or other things as well?"

Well, Bone health is a synergistic action. Lots of moving parts that make up how a healthy body makes bone and keeps it healthy. Pharma drugs try to put a stop or a push to parts of that synergistic action.
Supplements, exercise try to meet the needs of the bodies' synergistic bone actions. To basically up everything that the body needs or supply what the body is not getting and allow the body to react. BHRT especially works in this context to provide the hormones needed for an aging body to mimic a younger body and make bone.

Now....consider...

Strontium citrate is a mix of pulling all the levers of normal bone actions in full, not in part like pharma drugs do. It impacts both osteoclasts and osteoblasts using the bodies' own calcium receptors and something which science believes may be a strontium receptor. So taking strontium gives the body something for which it is already set up to receive.

But here is the difference, strontium citrate users take strontium at a therapeutic level, at a drug level. So although the body knows and uses the strontium similar to calcium, if you use strontium citrate you usually take it at a "drug" similar level.

And yes, BHRT plays a role. My endocrinologist explained it this way: "the estrogen drives the calcium and strontium into the bone". But I know from talking to hundreds of strontium users that strontium citrate can work without BHRT.
Whether strontium at a non therapeutic level combined with BHRT would work, I do not know; it would probably depend on the level of osteoporosis.

We need more research, but that is hard to finance for a supplement.

So yes, bone building using supplements which the body already recognizes involves many moving parts, but using strontium citrate at a therapeutic level seems to be able to act on its own to change bone density and fracture risk. (per all the research which I have seen)
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/2020-a-review-of-latest-insights-into-the-mechanism-of-action-by-strontium-/

@kathleen1314 So very helpful, Kathleen. Thank you for taking the time to educate me, and everyone else on this site.

It's weird. My doctor, whom I've known since my midwife days (1990s), just recently and unexpectedly passed. He would've been right on top of this situation, because he stayed abreast of the research, particularly, the unconventional means to an end, which is generally much healthier than pharmaceuticals.

But he's not here and I'm with a new integrative doctor who believes strontium is poison. He said the AlgeCal was okay for me to take. But it seems that you're saying that that is not a therapeutic dose.

I just signed up with Doug Lucas for 6 months and I'm hoping that he is as good in person as he is online. Otherwise, I will have to keep looking for local doctors who can guide me—not an easy task.

Thank you again for your wisdom.

@squitirogloria
680 mg is the therapeutic dose.
Algaecal makes so many products with varying amounts of strontium that I am not sure what amount you are taking...sorry.

Well, you might ask your integrative doctor how most of the world's ground water and food especially seafood has strontium in it with no problems for most of the world if it is a poison.

There was one report of a huge amount of strontium in ground water in Iraq or Iran ( I think) and the result was very thick bones....the "cure" was to take more calcium. In fact, that is the only caution that my endocrinologist gave me "to be sure to take enough calcium".

Plus, doctors are using strontium laced components in skull surgeries; jaw bone surgeries etc. and the original sensodyne was just strontium in a tooth paste format.

It is rare for doctors to suggest strontium, but I have never know a doctor with a patient whose osteoporosis was "cured" with strontium or whose fractures stopped after beginning strontium that ever told their patient to stop strontium.

We have a woman on Inspire whose husband is a doctor and gave her all the fear mongering about strontium. She told him that she had read the research and was going to try it. She is now in normal bone terrritory and her husband had to "eat" his words.

I think sometimes it helps if you have doctors in your family. Because frankly, you know that you are just as smart as they are. I have multiple medical doctors, phds and a couple of nuclear physicists in my immediate family. I can hold my own and out think most of them on day to day stuff or research. Now 40 years of nuclear physics knowledge is another thing; I bow to their knowledge. Indeed, 40 years of tests for all the conditions surrounding osteoporosis is also another thing and I bow to and use endocrinologists. 40 years of treating with osteoporosis drugs is also a great source of research for you in a doctor.
I am a big believer in testing and a great doctor can do all the tests, and they know which ones are appropriate.

Doctors can provide you with the information, discuss your options and then you with your very good brain can make the best decision for yourself.

In many ways I was lucky that I had such a bad reaction to an osteoporosis drug. It forced me to look and research and try something else. But frankly, there are better osteoporosis drugs now than there were when I was diagnosed and better hormones such as BHRT. We have lots of good options now.

@kathleen1314 As always, you bring a lot of comfort to the field of osteoporosis. Thank you.

Because I haven't had the testing done as yet (I'm caught in a hurry up and wait loop), I am taking half the recommended dose of strontium (680 mg) and 310 mg of calcium (AlgeCal brand).

I want some of those supplements in me, but without the testing, I'm afraid to go up to the therapeutic dose because I've read that if you have plaque in your veins, it could cause a stroke or heart attack. But maybe that isn't true?

I've also included other supplements and foods to get the other nutrients/minerals I need, like D/E/A/K, etc.

I'm sorry you had a bad reaction to a pharmaceutical drug, but I know I've benefited from your experience, so thank you for sharing it here.

I think you're brave to go against conventional wisdom, and I BOW to you for that.

And yes, it would be great to have a doctor in the family—lucky you! Although I wouldn't want to be them when they might have to debate you!

My doctor who just passed was like family to me, and it really does help to have that type of connection to Western Medicine. The connection being, a calm, loving conversation about various ailments and "cures."

@squitirogloria
No strontium is not associated with plaque breaking loose.

You may be confusing strontium with HRT; if one starts HRT after years of no hormones the stiffer cardio system, from a lack of hormones, then becomes more pliable and any existing plaque may break loose. Some doctors use vit K2 to keep calcium plaque in the bones and out of the cardio system. This problem may be controlled with good medical care, vit k2 and with a great doctor who can check you before and during HRT or preferably BHRT use.

BUT....
There was one population study on strontium ranelate that studied all the people, including those with known heart problems, taking strontium ranelate. Surprise, ha, the people with existing heart problems had heart problems.
Several studies tried to duplicate these results but weeding out obvious heart problems to see if strontium produced heart problems but no link was found. Indeed, Denmark ran a population study for a year to see if strontium ranelate was tied to cardio problems, none were found. Some sites report the original report linking strontium to heart problems as flawed.

Still, strontium ranelate is not available in the USA , and I would personally not take it because of the ranelate and the aspartame in strontium ranelate.

Strontium Citrate is available in the USA as a supplement.

No studies on strontium citrate have ever been associated with heart problems. Remember that much of the earth has strontium in its ground water and some areas have very large concentrations of strontium in their ground water. No pockets of cardio problems have been documented in those areas. The US army did note stronger teeth etc for troops with a background in strontium ground water areas.

Why I started on strontium citrate......

Well, I started with conventional medicine, had a bad reaction and no good results from the osteoporosis drugs, I remembered my doctor talking about a new drug with strontium in it for osteoporosis and then I researched, and as my friend says I won the bone lottery (in my belief).

Doctors in my family....

Well, they are family and I know all their weaknesses and poor grades so I approach them as just my nutty brother etc.who has had some life experiences from which I can learn.

My brother in law helped me greatly when I had bell's palsy and the early high-dose corticosteroids (prednisone) just didn't help enough; he suggested the steriod nose sprays to follow the high dose prednisone and it made all the difference. He had seen it help in his practice. You can't duplicate that information on copilot or researching; it takes life experiences.

@kathleen1314 Wow, Kathleen! You amaze me.

I was actually JUST talking to my husband about this "really nice woman named Kathleen who is helping me." I told him how altruistic it is of you to help us navigate this unwanted field we find ourselves in, especially given that you've long-since figured it out for yourself how to have healthy bones.

More, I know how long it takes to make coherent posts as you are doing, and I want you to know that I recognize the gift given me—a complete stranger. I'm sure there are dozens more on here that you are helping who aren't as vocal as we are!

Thank you for the correction on strontium citrate.

As you can see, I'm getting my research confused. Likely, because I'm in pain with this fracture and just began PT, which, I'm finding out, is going to make things worse before they get better. Not to mention I'm researching as much as possible, and it's all jumbled up in my mind.

It is for this reason that I joined Lucas' 1:1 program. Until I find all the right providers, I feel like I need a one-stop-shop to help me make sense of everything until I have it down myself like you do. Lucas seems ligit and is focused on reversing osteoporosis by natural means.

For now, given what you said, I'm going to increase the strontium and calcium to the therapeutic dose. *Please don't worry; I'm going to research it again as well*

At this moment, I'm taking all AlgaeCal products: calcium, strontium, collagen, Vitamin D/K/A/M, and have drastically changed my diet to include calcium-rich foods. Weirdly, I've always consumed dark leafy greens and put a premium on eating healthy and exercising, so I'm surprised this happened to me.

I'm so looking forward to learning more about BHRT.

Mostly because of all the women on all these sites who say they're in their 60s, 70s and 80s, and because they began hormone therapy, they now feel as good as they did in their 40s. I've never even thought about hormone therapy, and now I'm obsessed with it! Who doesn't want to feel as strong and flexible as they did in their 40s? Not to mention, the possibility of sleeping through the night again.

Thank you again for you kindness.

@kathleen1314 Thanks for that helpful information!

I may take Strontium Citrate but am hanging back for now. Research done on Strontium Ranelate shows enticing bone improvements.

But research articles say that strontium makes un-adjusted DEXA scans appear to show more calcium than you really have, and hence falsely more bone strength. I am not ready to commit to possible future explaining that to an insurance company if I want them to approve some other OP treatment. Estimates are that strontium stays in your bones for 10-30 years so it is a big decision.

Here is an example technical article that discusses adjustments that should be made to T-Score readings to get estimates of what bone strength really is when one has taken Strontium.
https://onlinelibrary.wiley.com/doi/10.1359/JBMR.050810
Excerpts:
"Without an appreciation of the effect of introducing a high atomic number element into bone on the measurement process, many will take the impressive increases in BMD in strontium-treated patients at face value."
"... much of the strontium present in bone at the end of treatment is likely to still be there a decade later. ... and a final terminal exponential with a half-life of ∼30 years."

@kfhoz
I can understand concerns over taking any osteoporosis treatment without the research needed to make you feel secure in your decision.

Just some information about concerns which you have raised about strontium citrate.

You say:"research articles say that strontium makes un-adjusted DEXA scans appear to show more calcium than you really have, and hence falsely more bone strength."
To clarify: Research has analyzed dexa machines and finds that strontium skews about 10% denser due to its denser nature; it is not correct that it shows more calcium; it does skew about 10% denser; it does not falsely show more bone strength.
https://pubmed.ncbi.nlm.nih.gov/20699129/
TBS reports, which are not affected by strontium the way dexa is, show strontium bones with good bone quality and in the top group of osteoporosis treatments (see attached bar graph from the research). REMS also shows good bone density and bone quality for strontium patients, are per self reporting. Hopefully, a study will be done in the future. The best report we have so far is one done on TBS. A report which shows strontium in the higher level of bone quality. (see attached bar chart) plus Page 7 in linked below
https://www.panoramaortho.com/wp-content/uploads/2019/03/TBS-Review-JBMR-2014.pdf
The research which you hotlinked is from 2009. Much of that information is useful, but because of its age much of it has been rendered moot because of tests like REMS and interpretation methods like TBS, neither of which were available in 2009. Both of these, REMS and TBS, have laid to rest the old, dexa skew concerns, because they both show good bone quality and bone density for strontium users.
Indeed, I just had a DEXA with TBS which showed good bone quality and normal/good bone density. I have been taking strontium citrate since 2009.

The concern about strontium being present in the bone after treatment is actually a plus. Other osteoporosis drugs, specifically bisphosphonates (like alendronate, risedronate, and zoledronate), remain in the bone for years or even decades after treatment stops. They accumulate in the bone matrix, creating a reservoir that continues to provide anti-fracture benefits for 1-2 years or longer, allowing for a "drug holiday" after 3-5 years of use. Strontium also stays in the bone and creates what one report calls "sacrificial bond formation" that correlate to reduced fracture risk. In other words, strontium seems to work mainly because it changes the physiochemical relationship in bone to allow bone the ability to absorb shock and dissipate instead of break....give instead of break. Section 4.2
https://www.sciencedirect.com/science/article/pii/S2352187220300334
Strontium Citrate holds a unique position in the world of osteoporosis medicine between supplements and osteoporosis drugs. It is virtually side effect free and may be begun easily or ended easily without problems. It can cut the risk of fracture around 41 to 49%; it is found to improve bone quality on the comparable level to Prolia and Forteo without the side effects which those drugs have. (see attached bar chart and above linked research)

Also, there was the amazing research done using biopsies of bones, those of a placebo group and those of strontium users. The biopsies showed good bone density and quality. (See attached photo with the link to the research)

The treatment which we choose for our osteoporosis is a uniquely individual decision. It is not just made up of logic, there is a component of emotion in finding something with which we feel comfortable. I try hard not to downplay anyone's choice of treatment. There are lots of good treatments for osteoporosis, and I frequently point people towards information and people who know more than I do about osteoporosis pharma drugs. I honor and do not demean anyone's choice of treatment. We all have to decide what is best for us and rejoice when that treatment works for any of us.

Strontium Citrate works for me, and I am enormously grateful that I found it.

@squitirogloria
So glad to have met you Gloria.

I reply because I owe a debt to the people who helped start me on the path which I am on. Many strontium citrate users stop participating on sites once they begin strontium . This is because they no longer consider their disease to be a problem, but there are a few of us that continue. PhoneyBoney is one as is BoneLady who has her own great blog called Strontium for bones. https://strontiumforbones.blogspot.com/

Osteoporosis is a disease frequently of aging. We just can't easily overcome the lack of hormones. We joke on Inspire that all of us "always consumed dark leafy greens and put a premium on eating healthy and exercising, ". Funny, but true.

Yes, I have recently had to up my BHRT hormones and oh how much better I feel. I am 73 years old.

Medicine is a great deal about keeping our bodies in a good state of balance…we are all very individual…if you have meds for a few or more conditions, you have to be super careful about the supplements you use and how to use them..the results some have may be great…check out how the supplement you’re considering will interact with your own essential medications…sometimes they can upset things you may not notice, like kidney function…definitely don’t want to mess with good kidney function…and the list goes on…sometimes we think if a little bit helps, why not go for a higher dose ? Just be careful —it is complicated and we are often on our own as many docs don’t help certain things ….