Most have heard of calcium for it’s bone supporting properties, but have you heard of it’s periodic table cousin-Strontium? Strontium can be found in our soil and seawater, and it’s actually a supplemental treatment for Osteoporosis in the United States, as well as pharmaceutical in Asia and Europe. Although many people have not heard of Strontium before, it’s a very interesting and somewhat controversial supplement. It’s often compared to calcium for it’s bone boosting abilities.
What is Strontium?
Strontium’s atomic symbol is Sr, it’s atomic number is 38 and it’s atomic weight is 87.62. Strontium is an alkaline earth metal most similar barium and calcium. It’s also referred to being a “soft metal” like lead. You are probably wondering what strontium looks like, right? Natural strontium has a silvery white metallic color with a tint of yellow. It can be found naturally in the soil and seawater, as well as some foods.
Seafood is a top source of strontium, but it can also be found in smaller quantities in certain foods like dairy, spinach, lettuce, grains, and beans.
In the human body 99% of strontium is located in the bones.
Research has shown strontium to provides natural bone support through its ability to
naturally increase the formation of osteoblasts (cells that build up bone) and slow down the formation of osteoclasts (cells that break down bone tissue) helping to maintain healthy bone density. As a result, strontium can impart a balancing effect on the osteoblastic-osteoclastic ratio and boosts skeletal strength via two different mechanisms.
Controversy with Strontium
While the use of Strontium for improved bone mineral strength in both humans and animals for over 50 years, the confusion between normal stable strontium and it’s radioative isotypes have caused some clinicians and patients to shy away from it. The unique benefit of Strontium is it’s ability to directly incorporate into the bone (max of 1 out of 10 calcium atoms), which allows it to strengthen the bone matrix while also stimulating osteoblast formation and limiting osteoclastic activity.
Strontium ranelate is a form of strontium that is sold as a prescription medication for osteoporosis and bone fractures in Europe and Australia. The Journal of Clinical Endocrinology looked at the effects of Sr of 261 men with with primary osteoporosis. For two years, 174 men received 2grams of strontium ranelate per day while 87 men received a placebo. To measure the effectiveness, researchers measured bone mass in the the cervical spine, lumbar, and femoral necks (hips). Overall the results of the 2013 study demonstrated that strontium ranelate supplementation appears to improve bone density in men similar to way it has been shown to improve postmenopausal women struggling with osteoporosis.
One scientific review published in 2014 by Jean-Yves Reginster, MD with admitted ties to a pharmaceutical drug makers concludes “The increased risk for cardiac events with strontium ranelate has been detected in randomized clinical trials but not in real life observational studies.
Some recent articles suggest that Strontium supplements could make bone density tests inaccurate. Because strontium atoms are heavier than calcium atoms, swapping some of the strotium for calcium some claim will only allow bone to merely appear stronger on bone density scans. Some people claim Strontium is giving us false positives for bone density, while several other studies have shown beneficial effects of strontium of bone density and quality of life when combined with other micronutrients (MOTS Study).
With the information above we will now explain what osteoporosis is, and some research on the various things you can do to promote and support healthy bone metabolism.
When we think of bone density and osteoporosis, most of us immediately consider it as a disease of aging. However, if it was in fact a disease of aging everyone would get osteoporosis. Obviously, this is not the case. Osteoporosis goes beyond aging, although the prevalence is age-dependent due to the disease process taking decades to develop. One of the most important factors in determining one’s risk of developing osteoporosis is their peak bone mass (PBM) in their 20’s and 30’s.
Osteoporosis disease severity is defined by the World Health Organization by an individuals bone mineral density compared to their peak young adult mass. Bone mass which is less than 1 standard deviation from the average is considered osteopenia, while BMD less than 2.5 standard deviations is diagnostic for osteoporosis. Take a look at the chart below, for a better understanding of the bone mass through the various decades for both males and females.
You can see from the chart above how important getting bone mass as high as possible when you are younger will reap you great benefits throughout the rest of life. This has made the quote “Osteoporosis is a pediatric disease” from Charles Dent so profound. Reaching sufficient peak bone mass is accomplished in the first few decades of life and is influenced by genetics and modifiable factors such as diet (calcium and protein intake) and weight-bearing activities. One of the most critical times in our lives for PBM development is just after the onset of puberty in which the greatest phase of bone development takes place.
positive research for strontium
While research for higher doses of the pharmaceutical strontium raenalate have shown beneficial for bone health, the higher dose has the stigma of replacing calcium atoms and having potential to decrease bone remineralization.
Lower doses of strontium citrate in supplement form have shown positive bone growth effects without any issues or defects with normal bone mineralization. Other studies have shown low dose of strontium can have a calcium preservation effect in the bone, as research done on bone strength of teeth has demonstrated this. Strontium unlike calcium has the ability to recalicfy osteopenic areas in pathological bone areas.
Now, strontium isn’t the only option in bone health. In fact, some studies even point to a combination of micronutrients including strontium and other vitamins and minerals can have a synergistic effect on supporting and strengthening bone density.
Positive strontium bone health studies
- MOTS study
- COMBS study
To save you time I have the conclusions to each study below.
MOTs study conclusion: Melatonin, strontium (citrate), vitamin D3 and vitamin K2 combination therapy study. In conclusion, combination melatonin, strontium (citrate), vitamin D3 and vitamin K2 significantly increased lumbar spine BMD by 4.3% and left femoral neck BMD by 2.2%, with a trend (p=0.069) towards an increase in hip BMD from baseline after one year in postmenopausal osteopenic women.
COMBS study conclusion: “After 12 months of consecutive supplemental micronutrient therapy with a combination that included vitamin D3, vitamin K2, strontium, magnesium and docosahexaenoic acid (DHA), repeat bone densitometry was performed. The results were analyzed in a group of compliant patients and demonstrate improved BMD in patients classified with normal, osteopenic and osteoporotic bone density. According to the results, this combined micronutrient supplementation regimen appears to be at least as effective as bisphosphonates or strontium ranelate in raising BMD levels in hip, spine, and femoral neck sites. No fractures occurred in the group taking the micronutrient protocol. This micronutrient regimen also appears to show efficacy in individuals where bisphosphonate therapy was previously unsuccessful in maintaining or raising BMD.”
With the above studies above you can see that using strontium in combination with other important bone building micronutrents is getting positive results for increasing bone density. We know bone health doesn’t simply come from one single source, below you find several other lifestyle and nutritional factors to help support healthy bone metabolism.
LIFESTYLE and Nutrition ways to support bone health
With all the talk about strontium helping Osteoporosis being controversial. Let’s dive into some other lifestyle and nutrition factors that support healthy bone function.
LIfestyle factors that affect bone health
- Physical Activity
- Avoiding excessive alcohol consumption
- Smoking cessation.
- Evidenced based supplements
What are some better food options to eat when you have osteopenia or osteoporosis? Make a priority to enough protein to maintain healthy lean body mass, and also a variety of foods that provide essential nutrients like calcium, vitamin k2, magnesium, phosphorus, manganese.
physical activity and exercise
Exercise is beneficial for people with osteoporosis for many reasons: it can help to build bone mass, improve balance and flexibility, relieve stress, reduce inflammation and more. What exercises should you avoid if you have osteoporosis? To be safe, work with a trainer or rehab specialist to help you build strength in a progressive manner.
Walking and other weight-bearing activities are simple and great for supporting bone strength. Types of exercises that are recommended most for people with low bone density include:
- brisk walking (a treadmill may be best to prevent falls)
- elliptical or stationary bike
- resistance training (free weights or machines)
- exercises like squats and assisted push-ups
If you are elderly and do not have a trainer or partner to assist you, try to use chair, wall, bands, light weights and tubes to assist you. Even gentler forms of exercise are helpful; some studies have shown that adults who practice tai chi have a 47 percent decrease in falls and 25 percent the hip fracture rate of those who do not.
If you experience pain and soreness for more than one or two days after exercising, this is probably not the right type of exercise for you. Always speak with your doctor, chiropractor, or physical therapist if you’re unsure of what type is best.
- Magnesium (500 mg daily) — Magnesium is required for proper calcium metabolism.
- Calcium (1000 mg daily) — Choose a calcium chelate form which is best absorbed.
- Vitamin D3 (5,000 IU daily) — Vitamin D helps improve calcium absorption.
- Vitamin K2 (100 mcg daily) — Needed to form a protein critical for bone formation. Take a high quality vitamin K2 supplement or foods
- Strontium Citrate(680 mg daily) — A metallic element that can help improve bone density. It’s found naturally in seawater, nutrient-rich soil and certain foods, but most people need to supplement to get enough. Strontium should be taken under the guidance of your health care practitioner in cases of abnormal bone scores like osteopenia or osteoporosis.
- Ipriflavone-promotes bone health from excessive estrogenic bone loss. Up regulates osteoblast activity and can inhibit osteoclast activity.
- Boron- supplementation can reduce urinary excretion of calcium and magnesium and increased blood levels of 17 beta- estradiol and testosterone.
Osteoporosis is is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. This causes weak bones and increases the risk for bone breaks/fractures and injuries. With everyone looking for the next single nutrient or supplement, from the research you might be better served to consult with a doctor who can better guide you on what stage of bone health you are in, and what exercise, diet, and supplements will be best for you.
Opinion: What do I think on strontium? In the supplement form strontium citrate, strontium seems to have a good safety profile in lower doses, and has the ability to increase bone mineral density and decrease fracture risk. The studies that combined strontium with other bone building supplements like vitamin d, vitamin k2, magnesium, melatonin, and calcium had the best outcomes. Strontium seems to be safe and effective when used in advanced stage bone disease. This seems like a supplement that should be not be taken just to “try”, in isolation, or in really high doses until more studies are done. Always consult with your doctor before consuming Strontium Citrate or any other dietary supplement for that matter.
Do you have thoughts or feedback on strontium citrate? Leave your thoughts in the comments below!
Melatonin-micronutrients Osteopenia Treatment Study (MOTS): a translational study assessing melatonin, strontium (citrate), vitamin D3 and vitamin K2 (MK7) on bone density, bone marker turnover and health related quality of life in postmenopausal osteopenic women following a one-year double-blind RCT and on osteoblast-osteoclast co-cultures https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310667/
Combination of Micronutrients for Bone (COMB) Study: Bone Density after Micronutrient Intervention https://www.hindawi.com/journals/jeph/2012/354151/