Strontium citrate, fractures and lack of research

@drsuefowler
I started a reply, but then lost it somehow, so apologies if something appears twice.
I have read that no one is exactly sure how Strontium works. It appears to fill in where bones are lacking, and this does improve dexa numbers....but what does that really mean for strength and flexibility? Bones have to remain flexible enough to take stresses without cracking, splintering and breaking. In my head I compare it to tires on the car. An old tire with a patch is fine and functional for a while, but a new tire has much more strength and will last a long time compared to the old one that has been patched. Since I'm taking Tymlos, I'm supposed to be building new tires...I mean bones (time will tell on that one).

I would love to have a REMS test, but none are offered in my area. I am seeing a new endo at a university who specialized on osteoporosis. I will have to travel to see her but am ok with that now. Hopefully the university has REMS on their machines.

@windyshores thank you for your informative answer! I have read some about how strontium replaces calcium, which makes sense that it would bolster up a dexa score. But is that really better or does that really improve bone strength because strontium is denser?

Unfortunately I didn't know about bone markers before I started Tymlos so never had them checked. I've seen 2 endos and 1 rheumatologist over the past year and none of them recommend or use them. I've found a new endo I'm seeing in Jan for my yearly check up who specializes in osteoporosis only, so I'm hopeful that she is more open minded. The others were very conservative and only interested in the pharmaceutical route.

I'm on month 11 of Tymlos and although I'm having some side effects that are manageable, I'm getting tired of being tired all the time. I started looking into strontium and now I'm very interested in anyone who has had success/experience with this supplement. How much per day? Does it interact with Tymlos or any other supplements for that matter? What is the best way to add it to your diet? I take a daily vitamin, fish oil, K2, D3 and magnesium. I eat enough calcium per day to not take an extra supplement, also exercise, walk, bike, weight training, yoga, pilates. No fractures. Last dexa score was -3.6 in the spine and in the -1s in hips. Based on the spine my endo said Tymlos was the cure all, be all. I am not due for another dexa until Jan 2025 and that will be a full year of Tymlos, so hoping it is doing something. Thanks one and all for your input!

@psnmonna,
I'm glad you found a specialist at a university. I have seen 3 endocrinologists near where I live, but feel like I know more than they do. My regular endo even said I do. I am tired of doing my own doctoring!

I think that part of the trouble with bone markers is that they are difficult to order. My doctors kept messing up trying to order them, especially P1NP. My insurance covers them both and repeatedly, when ordered correctly.

I too am taking Tymlos. I am considering going back on Strontium. My regular endo thinks I should take that and raloxifene. The Strontium is just in case it helps. The Raloxifene is to lower my CTX which is up to 1414 on Tymlos.

Good luck with your new endocrinologist!

2mcchesney I think it is important to mention that strontium at that level (680mg) is not actually "natural." That is not to say it is not helpful. Not sure how much is in groundwater that you cited and of course any website should be viewed with skepticism:
https://saveourbones.com/strontium-science-based-facts-vs-fiction/.
Excerpted: "A typical strontium citrate supplement dosage (around 680mg) is 170 to 340 times the naturally occurring strontium levels in the average person’s daily diet."

My concern is that it makes bones look denser and healthier on DEXA because strontium is denser than calcium and replaces it. So once we take it, the DEXA is likely skewed unless there is a radiologist skilled in interpreting.

Another concern is that the European medical board banned strontium ranelate for a time due to cardiovascular risks. Noone seems to know if strontium citrate poses the same risks. It is back on the market in Europe but only as a last resort for people who cannot tolerate anything else. In the US, supplements are not regulated so we need to be careful what brand we use.

I took it briefly 15 years ago and would consider it after treatment with meds for maintenance. I have been told strontium is not strong enough to deal with osteoporosis that is not mild. It would be dangerous for me to rely on it but those with osteopenia or very mild osteoporosis could try it. Just have to know the DEXA may look better than it is.

ps another issue is how long before strontium leaves the bones...not sure, need to research

The raloxifene is a synthetic form of hormone which does not match chemically the hormone which is produced in the human body.
Bioidentical hormones used topically match your bodies' chemical hormones.
Also, DHEA supplements or creams or pregnelone supplements work at the adrenal level to up your hormones naturally.
I would not take any hormone with out a good hormone specialist monitoring and the results from a good hormone work up, saliva test or serum base line test.
A compounding pharmacist will have the names of hormone drs in your area with which they work.

@kathleen1324,
I am still off Strontium. Since I have too much calcium in my urine, I have been afraid to take it. I thought that since it is so similar to calcium, it could increase my chances of a kidney stone. I know in my own experience that it improved my DEXA scores. There was a study cited on this forum that showed that Strontium helps some. Are you able to cite the research you are referring to or tell us how to find it? Thanks so much for posting about this.

@kathleen1324,
I have been trying to find a doctor who will prescribe estrogen patches for me, but no luck so far. I have not taken the Raloxifene for fear of blood clots. Although my Endo told me that it was safer than estrogen, I'm not sure that I believe him. Thanks for your suggestions. I will check with the compounding pharmacists in my area for a good hormone specialist.