Archive for the ‘Strontium’ Category

Strontium for Increasing Bone Mineral Density

Wednesday, February 27th, 2013

IMPORTANT UPDATE: On October 1, 2014 the European Medicines Agency’s Pharmacovigilance Risk Assessment Committee (PRAC) recommended that strontium ranelate (Protelos/Osseor, Servier) no longer be used to treat osteoporosis because of data demonstrating serious negative side effects.

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Three of the six people who answered my request for information about successfully increasing bone mineral density (BMD) used strontium. A week ago, I had never even heard of strontium as a supplement for bone health, but I have come to find that it’s all the rage!

Strontium is a mineral that has some properties similar to calcium. It appears to cause both an increase in bone formation and a decrease in bone breakdown. Strontium ranelate has been approved for use as a drug in Europe. The FDA has not approved strontium ranelate, but strontium citrate is available in the U.S. The ranelate is separated from the strontium in the digestive tract and has no pharmacological value, so strontium citrate and other versions are thought to be similarly effective.

The Cochrane Database group published a systematic review of the evidence for treating low BMD or osteoporosis with strontium ranelate in 2006, and later updated it in 2008 (1). They concluded:

“There is silver level evidence to support the efficacy of strontium ranelate for the reduction of fractures (vertebral and to a lesser extent, non-vertebral) in postmenopausal osteoporotic women and an increase in BMD in postmenopausal women with/without osteoporosis. Diarrhea may occur, however, adverse events leading to study withdrawal were not significantly increased. Potential vascular and neurological side-effects need to be further explored.”

2 grams per day is the amount typically given and found to be especially effective.

Since 2008, a bit more evidence has come to light:

A 5-year study comparing strontium ranelate to a placebo group was extended to 10 years, but without a placebo group (2). The participants were also put on calcium (< 1000 mg/day) and vitamin D (400 to 800 IU/day). It was an open label trial, meaning the participants knew they were taking strontium ranelate. The extra five years of strontium showed it to be as effective as the first five years, which had been effective at preventing fractures and a loss of BMD.

In March of 2012, the European Medicines Agency issued a press release cautioning people with a history of venous thromboembolism or who are immobilized or bed ridden not to use strontium ranelate (3). They also recommended that people over 80 not use strontium ranelate. Finally, people should be aware of potential skin rashes with its use and discontinue if a skin rash or other allergic reaction occurs.

Please talk to your doctor before taking strontium!

References

1. O’Donnell S, Cranney A, Wells GA, Adachi J, Reginster JY. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD005326. DOI: 10.1002/14651858.CD005326.pub3. | link. PubMed: link

2. Reginster JY, Kaufman JM, Goemaere S, Devogelaer JP, Benhamou CL, Felsenberg D, Diaz-Curiel M, Brandi ML, Badurski J, Wark J, Balogh A, Bruyère O, Roux C. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos Int. 2012 Mar;23(3):1115-22. | link

3. European Medicines Agency confirms positive benefit-risk balance of Protelos/Osseor, but recommends new contraindications and revised warnings. March 16, 2012. Accessed February 27, 2013. | link