The Strontium Debate: Is it good for bone health?

@oopsiedaisy
The strontium research cited left out the newest and additional research beyond the cited earlier research used by EMA monitoring board. Different research which negated the cardio risks from strontium ranelate and tied the clot risk to the normal risk that all osteoporosis patients have was not presented.
Research has to be a layered approach, and you have to look at all of it. Yes, it gets complicated and maybe doesn't fit well into a video interview, but you can't ignore research and get a full picture.

It is always best to check the sources on anything including videos found on line. I spent a day checking the sources just on strontium from the video and then checking to see what if anything any new research was saying.
I found the above negations and concerns.
None of this is hidden; it just takes looking.

The main driver of the strontium ranelate conclusions seem to be the warnings by EMA about strontium ranelate. That warning has been questioned, given the newer and conflicting research, but strontium ranelate is no longer marketed in the UK or the European union. So basically the question and the concerns have become moot for the EMA. So the conflicts in research have not been updated and are basically ignored.

Anyway, here is a post of the research which I located; research used by the EMA and research that was not evaluated by the EMA because strontium ranelate is no longer marketed in the Uk or the EU.
This is a journal post in progress, so i will be checking and updating it as needed. It takes some work to make all that research more readable and I am still working on it.
Plus, I am not a doctor, but the post just reports the research from scientists, doctors and uses their words and conclusions. So this is many doctors and scientists speaking and my post layers all their research and helps provide a fuller and more accurate picture of strontium via ranelate and what the research actually says by showing all the research which I can find. This then also gives a clearer picture of the research as it pertains to strontium, clots and cardio events.
https://www.inspire.com/m/Kathleen1314/journal/117867-strontium-research/

@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

@kathleen1314 What is the reaction that you were thought to have had with Vitamin K?

@prarysky I watched a YouTube video by Dr. Doug Lucas and Dr. John Neustadt where Dr. Neustadt says that Warfarin is the drug that MK4 interfers with. It was a great discussion about Strontium, MK4 vs MK7 and Calcium. The MK4 discussion starts at 25 minutes and the discussion about Warfarin is at 31:50. Of course you should always discuss this with your doctor.

@kathleen1314 One can never extrapolate study results with strontium ranelate to the over the counter supplement that some people are taking that includes strontium citrate. This is the point that both doctors made that I agree with.

I would like to see studies done using strontium citrate at pharmacological dosages that far exceed what one would ingest through their diet, which is what people are ingesting without any evidence that it’s effective.

People are free to come to their own conclusions but we should be careful not to confirm our own bias but extrapolating data from studies on unrelated compounds.

I am well versed in scientific principles as I have two degrees in science, one of which is in microbiology. I was also a practicing registered nurse for many years. However, that doesn’t qualify me to provide advice to others on how to treat their osteoporosis. I can only share what I’ve learned and done for myself. But this is what I hold as a value for myself and others here approach this differently. I have seen people who recommend medications and supplements outright and that concerns me.

I have known about strontium for years and chose not to go down that path until there is evidence for taking strontium citrate. Others are free to form their own decisions about that and I wish them well.

There isn’t a one size fits all solution to osteoporosis and many factors play a role, as I’ve found in my case. Today I should learn whether my changed approach over the past two years has been effective as I should be getting the results from my DEXA from last week.

I haven’t fractured again after 27 months which means I have defied the odds of up to 30% of having another fracture within 2 years. This was using a pharmacological approach combined mostly with HRT, exercise (LIFTMOR-style training and other weight exercises, impact, and HIIT), and nutrition.

Depending on how well this has worked, I will continue as I am or perhaps I’ll look at other options. But I will firmly hold to using scientific evidence for my approach.

@kathleen1314 I am so appreciative of your reply! It rounds out the picture which is getting clearer to me. No one really knows enough because there simply isn't much reported experience or study to say. Based on what you presented and what I've found using sites like consumerlab.com, it seems as if MK-4 MIGHT be okay but only a doctor knowledgeable about K2s will help you establish how best to proceed. Since my oncologist, cardiologist, and electrophysiologist all seem unfamiliar with the various K2s, that's a bit of a problem. I see one more cardiologist who specialized in oncology next week and will see what, if any advice, she has. One resource I haven't tried yet is my pharmacist.

I think the use of INR is largely used when doctors prescribe warfarin. It does not appear to be used by most cardiologists (at least mine) when prescribing a DOAC. Since I'm a challenging needle stick and rely on my port, more blood tests aren't something I'd like to add.

One of your referenced websites (www.myheartdisease.com) says "However, research is still limited on high-dose vitamin K2 supplements and their interactions with these medications."

That suggests to me that the Japanese dosage of 45 mg/day of MK-4 would be excessive for someone like me. But I'm tempted by the idea of one dose of 15 mg/day of MK-4. Although not the prescribed dose for treatment in Japan, it still might provide a bit of help.

I'm also appreciative that you mentioned copilot AI which I'm not familiar with. The one AI I'd like to try is Claude so decided now's the time. This is the bottom line from Claude:

"Based on current evidence, MK-4 is unlikely to interfere with Eliquis, and this combination is generally considered lower-risk than vitamin K with warfarin. However, I'm not a doctor, and individual health situations vary. It's still worth a quick conversation with your prescribing physician or pharmacist before adding it — especially if you're taking Eliquis for a serious condition like AFib or clot prevention. They can give you a green light with confidence."

I will also go back and research possible interactions between strontium citrate and my prescriptions which are quite the list now. I don't recall why I stopped. Ease of use and timing might have been issues too. I can't swallow pills so have to open large capsules and mix them with something non-dairy.

My thanks again for your consistently well-researched and thoughtful and timely response. You are wonderful and so much appreciated in this online community!

After reading these posts, I watched Doug Lucas's interview with a doctor who was against using strontium. I don't recall his name. He said that there was NOT ONE STUDY on strontium. I don't recall exactly which aspect of strontium he was speaking about, but for a while I have been seeking out NIH studies on strontium. Here are a few:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8235140/
https://pubmed.ncbi.nlm.nih.gov/38612883/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3265100/
If you just do a command-F (on a Mac computer) and put in strontium citrate, you'll see exactly where it's mentioned in these studies.

I myself am probably not going to take it because I don't want to burden my kidneys. Also, I have a hard time taking it on an empty stomach, because I tend to eat often, and I'm pretty sure my stomach isn't empty even when I wait two hours after eating. I was taking it in the middle of the night when I get up to go to the restroom, but at that time, I don't want to drink a lot of water, which would make it even harder on my kidneys. If I took strontium, I would want to drink a lot of water to help my kidneys flush it through.

In any case, another comment on the interview: I thought from the time he began speaking that that doctor was radically against supplements. I can understand that point of view. If you listen to the CEO of consumer labs, he says he would never take any supplements, using the analogy of having worked in a cafeteria in his school days. After doing that, he would never eat there again. He's managed lots of third party testing of supplements, and he thinks they're adulterated with all kinds of who knows what.

Additionally, in the interview, it seemed like Lucas and the doc were getting ranelate and citrate forms of strontium mixed up and then speaking about one or both as if they were the same.

I've seen many of Lucas's youtubes, and it seems to me that he acts as a funnel for information that he gets from experts. I would rather go back to other sources higher up on the food chain to get information. I like Margaret Martin's interviews. I think she had one with Clinton Rubin about vibration plates, which I found very helpful. She is very discerning. Also Dr. Susan Ott is a great expert on Osteoporosis. She has several animations of what the osteoporosis meds do to bone over time. Though I do not agree with everything she says.

Back to supplements. I had brain fog after COVID, which frightened me. I took NAC because I found out from a Yale research article that it helps brain fog. After a day or two of taking it, the fog was gone! (My brain is far from perfect, but it was restored to its condition before COVID.)

Pub Med/NIH studies can be difficult to understand, but they are worth reading, have good charts, and you don't have to read the entire study to get some value out of them.

Hope this is at all helpful.

@oopsiedaisy
you say: "One can never extrapolate study results with strontium ranelate to the over the counter supplement that some people are taking that includes strontium citrate."
Answer:
Well, yes and no.
The bone-building mechanism (the way the strontium atom itself interacts with bone cells) is considered the same for both. Whether it’s attached to ranelate or citrate, the strontium ion is what actually gets incorporated into the bone matrix.
What I believe that you are saying is that these points enumerated below may change between different formulations:
1. Bioavailability; Ranelate does seem to be more bioavailable than citrate; to me that is a plus
2. Clinical Proof: As in.... there are no large clinical studies on the supplement strontium
citrate; normal for supplements, but not for what I would wish.
3. The carrier and safety in that, for example Strontium Ranelate has side effects which seem
to be attributed to the specific drug formulation. These were not found in the strontium
citrate studies. But then large scale studies may be needed to find rare side effects.

I believe that I made all the above points in my previous replies and the links to posts which I provided.

Strontium Citrate is a supplement which is regulated by the FDA as a dietary supplement; it is also available from Canada where it is regulated more stringently as a Natural Health Product (NHP) which have to be licensed and reviewed for safety and quality.

You say strontium citrate studies are needed; I agree that we need more:
Here is what we seem to have so far:
1.3 cases studies from Sara Dehart, https://strontiumforbones.blogspot.com/2018/01/in-memory-of-sara-shackleford-dehart.html

2.Mots and Comb and a study comparison: https://strontiumforbones.blogspot.com/2017/02/mots-and-comb-study-comparison.html

3 Case studies: https://strontiumforbones.blogspot.com/2018/02/bmd-increases-by-varying-amounts-with.html

4.Moise studies: https://strontiumforbones.blogspot.com/2014/10/monitoring-bone-strontium-intake-in.html

5. Various formulations including strontium citrate, animal study: https://pmc.ncbi.nlm.nih.gov/articles/PMC11012416/

6.AlgaeCal studies: https://blog.algaecal.com/wp-content/uploads/Doctor-Info-Sheet-SB.pdf

7.AlgaeCal studies: https://www.algaecal.com/research/clinical-studies

8.Case studies: https://symbiosisonlinepublishing.com/nutritionalhealth-foodscience/nutritionalhealth-foodscience67.php

I am happy that you have found a bone regime that works for you. I celebrate your good news and would never downgrade or question what you are doing or question the research that went into your decisions or imply that you need to justify it with lists of research and information.

Indeed, I think that your decisions are about more than "you coming to your own conclusion". I think that you spent time and that you thought much about what was best for you and how to best accomplish your goal. I think that your "choice" was actually a reasoned and thoughtful decision based on good logic and information. I rejoice that it is working for you, and I appreciate you sharing it with all of us so we may learn from your experiences.

I do not think that you are " providing advice to others on how to treat their osteoporosis" or donning a mantle of qualification which you do not have. I think that you are kindly answering questions and sharing your life experiences.

I also do not think that you are "recommending medications and supplements outright" nor a certain style of training covered by a licensing model for which many pay, when you share your life choices. experiences and the reasons for which you have made those choices. I welcome your input and am thankful for the information.

Thank you.

While many have success with strontium, one should be careful if you have any kidney problems, as it can be hard on the kidneys…review it with your PCP, and if you are a cancer patient, review it with your team !