Two Studies Show Tremendous Benefit of Strontium on Bone Health
Two Studies Show Tremendous Benefit Of Strontium On Bone Health
If you are recently diagnosed with osteopenia or osteoporosis I am guessing you are confused about what supplements to take.
Most people, including physicians, immediately think of vitamin D and calcium.
What do you know about strontium supplements? If you google the subject, you’ll find a fair amount of controversy.
The main point of today’s post is to make the case for low-dose strontium citate for most people with osteopenia or osteoporosis. Many people have heard scary things about strontium. Here are some questions that may come up:
Should I just take strontium?
Won’t strontium displace calcium?
Isn’t it possible to take too much strontium?
What else should I be taking?
What about the side effects caused by the prescription drug strontium ranelate?
Let’s take a closer look at strontium:
Its a mineral found on the periodic table of elements
The body uses it for strengthening bones and teeth
The exact mechanism of action is unknown
Strontium is found in toothpaste for sensitive teeth because it builds up dentin (Pinto et al., 2012).
Strontium is found in the earth’s crust
It naturally occurs in food and in the water
Naturally occurring strontium has nothing to do with the radioactive byproducts called strontium-90
The use of artificially fertilizers and depleted soil may be reducing the amount of strontium found in our food
There is no test for a strontium deficiency
We may be lacking in this essential micromineral due to modern farming techniques!
We typically ingest about 4 grams of strontium in the diet (Kolodziejskaetal et al., 2021)
Strontium is known to increase bone bone-building cells, osteoblasts, and to decrease the cells that naturally break down bones, osteoclasts. (Kolodziejskaetal et al., 2021)
What is strontium ranelate?
Strontium ranelate is strontium combined with synthetic ranelic acid, a combination not found in nature.
It was used as a prescription drug in Europe for many years at a typical dose of 680 mg. It was never approved for use in the states. Strontium ranelate was found to be moderately effective at improving bone density. Side effects included clotting and other cardiovascular issues (Maria et al., 2017).
I found two fascinating studies using strontium citrate to improve bone mineral density.
Both studies involved a combination of supplements – not just strontium citrate on its own. Combining products makes sense due to the potential synergy of various bone-building substances working together to improve bone health.
We get a tiny amount of strontium through the diet, about 4 grams (Kolodziejskaetal et al., 2021). 99% of strontium is stored in the bones, suggesting this mineral plays an important role in bone health.
Let’s look at the first study
The first study looked at using melatonin, strontium, vitamin D, and K2 to improve bone mineral density. The results were very promising!
At first glance, one may wonder what in the world does melatonin have to do with bone health? In this study, it was found to “renormalize bone marker turnover in perimenopausal women” (Maria et al., 2017).
It is well known that women in perimenopause and menopause often complain of disrupted sleep. Melatonin can help improve sleep. Improved sleep reduces stress. Stress is the enemy of bone health.
Melatonin was also shown to help with something called osteoblastogenesis – the making of the cells that build up bones. It was found to be more effective for the spine than the hips. It also acts as a powerful antioxidant. The study used 5 milligrams of melatonin.
Recently, a narrative review evaluating the therapeutic potential of melatonin for the treatment of osteoporosis concluded that “melatonin has been shown unequivocally to have an anti-osteoporotic effect” (Zhao et al., 2022).
How might melatonin improve bone health?
It is powerfully anti-inflammatory
Inflammatory conditions can lead to osteoporosis
Inflammation drives osteoclastogenesis, the process of creating the cells that break down bone (Zhao et al., 2022).
If you’ve never used melatonin, I recommend starting with 1 milligram and slowly increasing from there. Not everyone tolerates melatonin. For some, it can cause nightmares and next-day grogginess.
The same study used 2000 IU of vitamin D and 60 mcg of K2. Vitamin D increases the absorption of calcium and K2 directs that calcium to the bone and keeps it out of the cardiovascular system.
Participants of the study were also given 450 mg of strontium citrate.
The combination of melatonin, vitamin D, K2, and strontium citrate was found to increase BMD (bone mineral density), especially in the lumbar spine and the neck. It also increased osteoblastogenesis, the creation of new bone-building cells (Maria et al., 2017).
Strengths and Limitations of the Study:
A relatively small number of participants (under 25)
All relatively healthy postmenopausal white women
Only one year
There was a control group that received a placebo instead of supplements
Let’s look at the second study
The COMB study from ten years ago consisted of mostly postmenopausal women who were given a supplement regime over 12 months.
As usual, D3 and K2 were important players. However, this study also included magnesium, the essential fatty acid DHA, and strontium citrate. The participants were encouraged to get their calcium through food sources rather than supplements. The combination of magnesium and vitamin D was thought to help with calcium deposition.
The COMB study also included strontium citrate, which is known to “recalcify osteopenic areas in pathological bone conditions” (Genius & Bouchard, 2012).
Limitations of the study:
A relatively small number of participants
Mostly postmenopausal women
Lack of a blinded placebo-controlled control group
Only one year
There are always compliance issues when participants are asked to take supplements on their own
If you have osteoporosis or osteopenia, what should you do?
Track your calcium intake with an app and strive for at least 1000 mg and only consider a quality calcium supplement if you fall short.
Increase your magnesium through diet as well as supplementation. Magnesium glycinate is well-absorbed. Taking 400 mg at night will have the added benefit of improving sleep, which lowers stress, which is also good for bone health
Take 1000 to 2000 IU of vitamin D (see my past post about the risk to bone health posed by high-dose vitamin D supplementation https://www.lisajonutrition.com/blog/2022/4/30/top-4-supplements-for-post-menopausal-bone-health
Obtain DHA by taking a good omega-3 supplement that contains both EPA and DHA and aim for at least 1 gram daily.
Consider taking low-dose melatonin (unless you are getting 7-8 hours of restorative sleep)
Consider taking a low dose of strontium and if you do, take it away from calcium because they compete for absorption when taken in a dose beyond what is naturally found in the diet.
The diet provides between 10-50 mg of naturally occurring strontium
Most strontium supplements are dosed between 227 and 750 mg.
Stick to the lower end of the supplement recommendations.
Who should avoid strontium?
Anyone with renal disease or poor kidney health
Pregnant women
Anyone with a blood-clotting disorder
If you are taking a pharmaceutical drug for osteoporosis, consult with your physician before taking any supplements
Final note
I personally take just one capsule of strontium citrate daily. Most products list the serving size as 3 capsules, 750 mg. While I supplement with both calcium and strontium, I am conservative with both. Feel free to reach out if you’d like suggestions on specific products.
Disclaimer
The included information is not meant to or should not be used to replace or substitute medical treatment, recommendations, or the advice of your physician or health care provider. The information contained within is strictly for educational purposes and is based on evidence-based nutrition. If you believe you have a medical problem or condition, please contact your physician or healthcare provider.