Strontium Should Increase BMD, But…

June 12, 2013 Leave your thoughts

Based on advertizements and extensive research on the internet, a patient recently added Strontium Citrate to her treatment for falling Bone Mineral Density (BMD).  What she read claimed that Strontium will increase BMD and prevent fractures.  Furthermore, the media have talked about rare complications of FDA approved pharmaceuticals, but never about complications of Strontium Citrate – the Strontium preparation available in the USA.

At the National Osteoporosis Foundation this spring we reviewed the data on Strontium.  Sarah Morgan, RD, MD, has spent several years searching for the results of studies about the effects of Strontium Citrate in humans.  She shared her journey with us.

The firms marketing Strontium Citrate have not produced any studies showing increased BMD in humans.  (There is one study of less than 100 mice).  There are no Fracture Prevention studies in any species.  The research quoted studied Strontium Ranelate – a pharmaceutical not available in the USA.

We know that Strontium can take the place of Calcium in bone from studies of children exposed to radioactive fallout from atomic bomb testing in the 1950’s.  Strontium is bigger and heavier than Calcium, so BMD is increased.  Because Strontium is bigger, the crystaline structure of bone is distorted, which should make it stiffer.

The manufacturers of Strontium Ranelate claim a fracture preventing effect similar to other osteoporosis drugs because of the Ranelate.  The human Fracture Prevention study was not large enough, or long enough, to satisfy the US FDA.  Recently the European FDA has begun investigating reports of complications, including fractures, possibly due to increased stiffness of bones treated with Strontium Ranelate.

Returning to my patient, we expect increased BMD next year.  Unfortunately, we do not know if that will mean lower, or higher, Fracture Risk.

Jay Ginther, MD

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