The Strontium Debate: Is it good for bone health?

@kathleen1314 What, if any, other things do you do for bone health? I just listened to a Hack My Age podcast where she was interviewing Dr. Lucas about Strontium(12/22/25) and he made a point that it is hard to know which factor made an increase in bone mass or quality when we are doing so many things, ie diet, exercise, other supplements.

@kathleen1314 What, if any, other things do you do for bone health? I just listened to a Hack My Age podcast where she was interviewing Dr. Lucas about Strontium(12/22/25) and he made a point that it is hard to know which factor made an increase in bone mass or quality when we are doing so many things, ie diet, exercise, other supplements.

@loplady
This is what read in the research:
The standard therapeutic dose for Vitamin K2 (MK-4) is 45 mg daily, which is almost always taken as 15 mg three times daily.
Take with some fat and do not take if you use blood thinners.
The mk4 which you take as a supplement is probably synthetic whereas what you get from food is a natural source.

@loplady
Dr Doug Lucas is legit and Science based. I belong to his online group The Osteocollective (TOC). Check his videos on YouTube and his MasterClass … free… online.

@kathleen1314 I pay attention to your comments which are always based on research and careful thought. That's why I particularly took note when in regards to MK-4 you said "....do not take if you use blood thinners."

I take Eliquis (a blood thinner) but had planned to resume taking MK-4. I'd taken MK-4 and MK-7 for a few years prior to developing afib (2023) but stopped taking both when I started Eliquis. My afib episodes were episodic and each episode lasted several hours. I elected to have a heart ablation in Sept 2025 to try and stay ahead of afib.

I was diagnosed with estrogen-positive breast cancer in the fall of 2024. Based on my age of 75, a high FRAX score of 26%, a status of osteopenia, and now the addition of an aromatase inhibitor (a drug well known to cause damage to bones), my oncologist recommended a Zometa infusion which I had in October 2025.

I hoped to start with an anabolic osteoporosis drug, but was told that was a no-no for someone with hormone positive breast cancer. I did not want to start Prolia so next best option was Reclast/Zometa.

I provide this history to say all my bone health supplements prior to the afib and then estrogen positive breast cancer have been abandoned. I stopped nattokinase and strontium citrate with Eliquis. My wish to resume bone health supplements that I think MIGHT help my bones also seems particularly challenging and limited to food.

I used to make nattokinase but it can interfere with Eliquis so had to stop. I used to also take strontium citrate but think there was a reason I stopped it though have forgotten which drug it might interact with! (main drugs with possible interactions include eliquis, letrozole, kisqali, naturthroid, lyrica) I hadn't even explored resuming MK-7 because I ruled it out with a history of afib.

But MK-4 I held out as my new holy grail. The one supplement I might add. And then I read your brief statement and realized I might be mistaken. I've asked my electrophysiologist who did my heart ablation and my regular cardiologist about taking MK-4 while on Eliquis and neither voiced concerns about it. Now, I'm suspicious that they didn't look into it very far.

I will see another cardiologist soon and will ask her about MK-4 and Eliquis. She specializes in oncology. It will be interesting to see what opinion she has on this subject.

Meanwhile, I presented the issue to Google AI and it echoed your concerns about Eliquis and MK-4. Eliquis is the drug that simply won't play nice with others. I'd like to go off the Eliquis and try and self-monitor my afib but that's definitely going against mainstream advice. My electrophysiologist, though, would support me in trying this. It's just that the stakes are so high if you get it wrong.

If you can cite any of the sources you used to say that you shouldn't take MK-4 if also on blood thinners, that would be helpful. Perhaps the blood thinner they refer to is warfarin rather than the newer class (DOACs - Direct oral anticoagulant) but I fear that's not the case.

If you have the time or inclination to respond to this, much appreciated, but if not, no worries.
Thank you for guiding us with so much useful information!!

@kathleen1314 I pay attention to your comments which are always based on research and careful thought. That's why I particularly took note when in regards to MK-4 you said "....do not take if you use blood thinners."

I take Eliquis (a blood thinner) but had planned to resume taking MK-4. I'd taken MK-4 and MK-7 for a few years prior to developing afib (2023) but stopped taking both when I started Eliquis. My afib episodes were episodic and each episode lasted several hours. I elected to have a heart ablation in Sept 2025 to try and stay ahead of afib.

I was diagnosed with estrogen-positive breast cancer in the fall of 2024. Based on my age of 75, a high FRAX score of 26%, a status of osteopenia, and now the addition of an aromatase inhibitor (a drug well known to cause damage to bones), my oncologist recommended a Zometa infusion which I had in October 2025.

I hoped to start with an anabolic osteoporosis drug, but was told that was a no-no for someone with hormone positive breast cancer. I did not want to start Prolia so next best option was Reclast/Zometa.

I provide this history to say all my bone health supplements prior to the afib and then estrogen positive breast cancer have been abandoned. I stopped nattokinase and strontium citrate with Eliquis. My wish to resume bone health supplements that I think MIGHT help my bones also seems particularly challenging and limited to food.

I used to make nattokinase but it can interfere with Eliquis so had to stop. I used to also take strontium citrate but think there was a reason I stopped it though have forgotten which drug it might interact with! (main drugs with possible interactions include eliquis, letrozole, kisqali, naturthroid, lyrica) I hadn't even explored resuming MK-7 because I ruled it out with a history of afib.

But MK-4 I held out as my new holy grail. The one supplement I might add. And then I read your brief statement and realized I might be mistaken. I've asked my electrophysiologist who did my heart ablation and my regular cardiologist about taking MK-4 while on Eliquis and neither voiced concerns about it. Now, I'm suspicious that they didn't look into it very far.

I will see another cardiologist soon and will ask her about MK-4 and Eliquis. She specializes in oncology. It will be interesting to see what opinion she has on this subject.

Meanwhile, I presented the issue to Google AI and it echoed your concerns about Eliquis and MK-4. Eliquis is the drug that simply won't play nice with others. I'd like to go off the Eliquis and try and self-monitor my afib but that's definitely going against mainstream advice. My electrophysiologist, though, would support me in trying this. It's just that the stakes are so high if you get it wrong.

If you can cite any of the sources you used to say that you shouldn't take MK-4 if also on blood thinners, that would be helpful. Perhaps the blood thinner they refer to is warfarin rather than the newer class (DOACs - Direct oral anticoagulant) but I fear that's not the case.

If you have the time or inclination to respond to this, much appreciated, but if not, no worries.
Thank you for guiding us with so much useful information!!

I just watched the latest Video of Dr. Doug Lucas and Dr. John Neustadt where they talk about Strontium, which neither recommend, K2 MK4 vs K2 Mk7 and Calcium. Here it is if you'd like to watch it. This gives me pause about taking Strontium. The discussion about Strontium starts at 13:35.

@loplady Thanks for sharing this link. This was an excellent science-based review of vitamin K, strontium, and calcium in osteoporosis and I agree with both doctors’ opinions on the subject. I always enjoy discussions like this where the participants have the appropriate medical and scientific background to converse about the topic and are open to changing their opinion. A healthy sign of someone who is continuing to learn and improve their practice.

I am doing a small dose of vitamin K2 MK4 at the moment but I am intrigued with the studies on higher dose K2 MK4.

@prarysky
Is does get so much harder as we age to find something that works doesn't it.

Yes, frankly vit k is my go to if I can't use strontium citrate. But I was thought to have had a reaction to vit k in the past so there is that concern.

Think why you might have quit strontium citrate. It does not usually react with other drugs. Your body is set up with receptors to recognize and use strontium which you don't have for pharma meds, ha. But less likely to react because the body is set to use and process strontium.

Please talk with your doctor about the vit k and your blood thinners ...they know your medical history, any nuances of your medical history, and they have a wealth of knowledge based on their medical practice and seeing so many people.

MK4....what the research, standards and the product information sheets seem to say is that the advice not to use mk4 with blood thinners is correct for certain types of blood thinners, particularly warfarin (Coumadin). MK-4 is a form of Vitamin K2, and Vitamin K is the primary nutrient that helps your blood clot. The advice is also for all blood thinners to check with your doctor. There are just so many variations and your doctor may want to follow you closer with some blood tests to make sure that there are no problems.

Warfarin seems to be the big problem drug with the vit k products....other blood thinner drugs, not so much, but still worthy of a close watch with your doctor.

Warfarin works by blocking the action of Vitamin K in your body to prevent unwanted clots. Taking a supplement like MK-4 provides the body with the exact nutrient the medication is trying to block, which can make the blood thinner less effective.

If the medication becomes less effective due to high Vitamin K2 intake, your risk of developing a dangerous blood clot (like a stroke or DVT) may increase.

Doctors use a test called INR to measure how fast your blood clots. Taking MK-4 can cause your INR levels to drop, leading to unpredictable and potentially dangerous results.

But there seem to be newer blood thinners that may be used with mk4...and Eliquis seems to be one that you could use....again ask your doctor :
Ai google says:
"Not All Blood Thinners: Newer "direct" oral anticoagulants (DOACs) like Eliquis (apixaban) or Xarelto (rivaroxaban) do not rely on blocking Vitamin K to work. While they are generally less affected by Vitamin K intake, research on high-dose supplements like MK-4 and these drugs is still limited."
"You should not start or stop MK-4 or any Vitamin K supplement without first consulting your doctor, as they may need to adjust your medication dosage or monitor your blood more frequently."

I do prefer copilot more for health questions; AI google sometimes is "off" and doesn't seem to think beyond the immediate question. Copilot says it is limited by its programming...ha
But ai google is great for standards and usual practices.
https://www.myheartdiseaseteam.com/resources/can-you-take-vitamin-k2-with-blood-thinners-for-heart-disease.
https://www.drugs.com/drug-interactions/vitamin-k2-with-warfarin-4087-19568-2311-0.html.
https://health.clevelandclinic.org/vitamin-k-can-dangerous-take-warfarin