Strontium citrate, fractures and lack of research

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?

***Director's Note:***
There’s not enough clinical research to know if strontium citrate effectively prevents or treats osteoporosis. Mayo Clinic does not recomend its use. Clinically researched osteoporosis medications have demonstrated fracture prevention benefit with less risk.  

The FDA doesn’t regulate supplements in the same way as prescription drugs, so it's not possible to know if if they are safe or work well or even how much of the main ingredient they contain.

If you wish to take a strontium supplement, it is advised to discuss with your doctor. 

All information shared by members on the Mayo Clinic Connect is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on the community.

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

Profile picture for marymj7 @marymj7

@karenjaninaz Can you share which specific tablets/capsules you have found that incorporate all of the elements recommended in the studies? Thanks!

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Just look at the studies; they have a list. Right now I am on Prolia as a preventive because I have osteopenia. I started taking strontium citrate 340mgm with it but then thought they might not mix well. I don’t want another Prolia because I had 2, and now the dreaded Reclast. I am still on lowering doses of prednisone so that’s considered a high risk. I’m also eating prunes for what that’s worth. I stopped Algae Cal because I can never tolerate any calcium supplements in it; I use lactose free yogurt smoothies and cheeses.
My primary doc, a geriatrician, OK’d the strontium citrate. I’ve yet to run it past my endocrinologist.
Since strontium is ubiquitous in the soil drug companies make no profit on drug development. There are studies on animals though by other countries.

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Profile picture for karenjaninaz @karenjaninaz

Just look at the studies; they have a list. Right now I am on Prolia as a preventive because I have osteopenia. I started taking strontium citrate 340mgm with it but then thought they might not mix well. I don’t want another Prolia because I had 2, and now the dreaded Reclast. I am still on lowering doses of prednisone so that’s considered a high risk. I’m also eating prunes for what that’s worth. I stopped Algae Cal because I can never tolerate any calcium supplements in it; I use lactose free yogurt smoothies and cheeses.
My primary doc, a geriatrician, OK’d the strontium citrate. I’ve yet to run it past my endocrinologist.
Since strontium is ubiquitous in the soil drug companies make no profit on drug development. There are studies on animals though by other countries.

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Thank you for your info...I have a question, when you say you cannot tolerate calcium supplements.... What happens?

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Profile picture for mcchesney @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
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.

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Thank you for this thorough post. My endocrinologist went as far as to say that she would no longer treat me if I were to use AlgaeCal, citing an FTC lawsuit (which mainly pertained to the marketing claims). You can do a simple search for case No. 12-12382-AA against "Garden of Life"

I am, however, interested in trying strontium citrate. I see the amount in AgaeCal is 680 mg. I am curious as to the dose you are currently taking, as this seems high?

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Profile picture for karenjaninaz @karenjaninaz

Just look at the studies; they have a list. Right now I am on Prolia as a preventive because I have osteopenia. I started taking strontium citrate 340mgm with it but then thought they might not mix well. I don’t want another Prolia because I had 2, and now the dreaded Reclast. I am still on lowering doses of prednisone so that’s considered a high risk. I’m also eating prunes for what that’s worth. I stopped Algae Cal because I can never tolerate any calcium supplements in it; I use lactose free yogurt smoothies and cheeses.
My primary doc, a geriatrician, OK’d the strontium citrate. I’ve yet to run it past my endocrinologist.
Since strontium is ubiquitous in the soil drug companies make no profit on drug development. There are studies on animals though by other countries.

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Did your endocrinologist ok taking Reclast and Strontium Citrate?

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Profile picture for communications @communications

Thank you for your info...I have a question, when you say you cannot tolerate calcium supplements.... What happens?

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Intestinal issues with all calcium supplements. I have IBS.

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I decided not to take it at the same time. I will be seeing my endo in a few weeks when I’ll tell her I don’t want anymore Prolia so looks like Reclast. When I’m done with Reclast I’ll go the strontium citrate route. I only took 340 mg which is half of one of the study’s dose; the Duquesne study used around 400mg capsules supplied by Pure Encapsulations.

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Profile picture for equalshot @equalshot

Did your endocrinologist ok taking Reclast and Strontium Citrate?

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I decided not to take it. My primary doc had no problem with it and I did take it for a couple of weeks lately but stopped. I don’t know if there is a possible interaction . After the Reclast is done I would like to go back later on.

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I thought I read somewhere on this forum that taking strontium makes your Dexa scores invalid because strontium absorbs the x-rays from the Dexa more than calcium. So, your t-scores appear to have improved, when your bone density hasn't actually improved. It would be interesting to see if the people having the improved t-scores after taking Algae-cal showed improvement when a REMS Echolight scan was used instead (which doesn't depend on x-rays.). I'm not for or agains Algae-Cal BTW. But I remember someone saying that Dexa scores had to be adjusted if you took strontium.

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Profile picture for equalshot @equalshot

Thank you for this thorough post. My endocrinologist went as far as to say that she would no longer treat me if I were to use AlgaeCal, citing an FTC lawsuit (which mainly pertained to the marketing claims). You can do a simple search for case No. 12-12382-AA against "Garden of Life"

I am, however, interested in trying strontium citrate. I see the amount in AgaeCal is 680 mg. I am curious as to the dose you are currently taking, as this seems high?

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@equalshot Is your endocrinologist ok with Strontium Citrate but just not Algaecal because of the lawsuit from 2012?

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Profile picture for loplady @loplady

@equalshot Is your endocrinologist ok with Strontium Citrate but just not Algaecal because of the lawsuit from 2012?

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Could you please elaborate re the lawsuit?

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