Strontium Side Effects are Overblown – Get the Facts

Nutrition / Osteoporosis / Strontium / July 13, 2017

doctor with patient

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What is Strontium?

Strontium is a mineral from the earth that is naturally found in your body in small amounts.

In fact, 99% of the total amount of strontium in the body is found in bone, a trait it shares with calcium.

Strontium Myths

Experts now believe strontium is, “an essential trace mineral necessary for the optimal normal development and accretion of peak bone mass, and the sustained health of our bones.”

Along with bone-building elements calcium and magnesium, strontium is a member of the elements in Group 2 on The Periodic Table – meaning it shares some similar chemical properties. Strontium is found in varying amounts throughout the world in the soil, and thus in plants grown in the soil, and in the water – so it is a natural part of our diet.

In the U.S., Canada and Europe, the typical diet contains 2–4 mg strontium/day. However, commercially-produced plant foods grown on fields using synthetic fertilizers, pesticides and herbicides have far lower levels of strontium than their organic counterparts.

Plus, it is well-known that our consumption of plant foods is far below recommended amounts – so it is unlikely you are getting sufficient strontium in your diet. To learn about the most strontium-rich foods, check out our Strontium Food Sources page.

Consumers of conventionally-grown foods are at risk of strontium deficiency, which, as you will soon see, is a factor that increases our risk of osteopenia/osteoporosis as we age.

However, you may have heard some less-than-confidence inspiring things about strontium. So I’m here to set the record straight…

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3 Myths About Strontium

Having reviewed the published research on the different forms of strontium: natural strontium, the strontium ranelate drug, along with the radioactive form of strontium, I can confidently assure you that the natural form of strontium, strontium citrate, is a safe and effective bone health supporter. That goes for both the density and the tensile quality of your bones. (I’ll explain more in detail on how they differ shortly.)

But there are still several misconceptions about strontium citrate pills:

  • Strontium Increases Fracture Risk. Some strontium critics conclude that strontium causes the outer cortical bone to become thicker, reducing tensile strength (resistance to breaking under tension) and increasing the risk of fractures. However, peer-reviewed research shows otherwise.
  • Strontium Supplements Have Side Effects. Strontium has been painted a villain due to undesirable and serious side effects of one form, the drug, strontium ranelate…
  • Strontium Skews DEXA Results Too Much To Be Reliable. Since strontium is denser than calcium, it affects bone improvement readings on a DEXA scan. So, some question whether strontium is really increasing bone density or if improvements are just a false positive result.

Let’s take a closer, research-based look at each of them. You’ll soon see these misleading statements hold no weight.

But before we do that, it’s important to understand that there are different forms of strontium – and they all do different things…


The 3 Different Types of Strontium Salts You Should Know About

Strontium salt

Natural Strontium Salts

The element strontium is present in natural strontium salts. The most common stable strontium salts are strontium sulfate and strontium carbonate, which are found in soils, and strontium citrate which is used for nutritional supplements.

Stable strontium itself has never been found to cause any harmful effects — with one caveat: to maintain proper balance between calcium and strontium, more calcium than strontium must be consumed.

In more than 100 years of research on strontium, including a number of recent human studies discussed below, no adverse effects have been reported for any natural stable strontium salt when more calcium than strontium is consumed.

Natural strontium salts are safe (at reasonable dosages, of course) and highly beneficial.

Neither of the two forms discussed next are safe. In fact, each has harmful side effects…

Ranelate icon

Strontium Ranelate Drug

Strontium’s beneficial effects in the treatment of osteoporosis were reported way back in 1910 — but strontium products never entered the market back then due to confusion between the normal, stable forms of strontium with its radioactive isotopes. What everyone heard about was radioactive strontium for building atomic bombs – and no company was willing to launch healthful strontium products with public perception as it was.

But more recently, the poor track record and serious side effects of the osteoporosis drugs, renewed interest in the bone health benefits of strontium by the French pharmaceutical company, Servier.

Since natural minerals cannot be patented, Servier developed a chemical drug form of strontium called strontium ranelate. Servier now had a patentable, exclusive strontium bone drug which was sold beginning in the early 2000’s under the trade name ProtelosTM.

Ranelic acid is the synthetic compound used to create the unnatural strontium salt, strontium ranelate.

Unfortunately, this drug form of strontium is potentially harmful. For additional sources on its toxicity go to Toxin Profiles and the Agency for Toxic Substances & Disease Registry.

Strontium Ranelate has a long list of adverse side-effects, starting with common ones like:

  • Nausea
  • Skin irritation
  • Fainting
  • Loose Stools
  • Headache

And less common, but possibly deadly effects like:

  • Venous thromboembolism
  • Serious autoimmune reactions, such as DRESS (the acronym for drug rash, eosinophilia and systemic symptoms)

Strontium Ranelate and Blood Clots

Overall, the likelihood that you will be among the ones affected may be small– although a review of the research on strontium ranelate published in 2005 states “Strontium [ranelate] caused a 50% increase in the risk of venous thromboembolism (including pulmonary embolism).”

In the health information provided for medical professionals, Servier, the pharmaceutical company with the patent on strontium ranelate states:

“In Phase III studies, the annual incidence of venous thromboembolism (VTE) observed over 5 years was approximately .7%, with a relative risk of 1.4 in strontium ranelate treated patients as compared to placebo.”

In other words, over a 5-year period in the Phase III studies, each year, 7 of every 1,000 participants taking strontium ranelate developed VTE.

Saying that those taking strontium ranelate had a relative risk for VTE of 1.4 compared to placebo means that strontium ranelate increased risk for VTE by 40%.

Natural strontium citrate has never been found to increase risk of VTE.

Strontium Ranelate and DRESS Syndrome

Another potentially deadly side-effect of taking strontium ranelate is DRESS syndrome.

Symptoms of DRESS syndrome typically begin 1-8 weeks after exposure to the medication. Classic symptoms include widespread rash, fever, and involvement of one or more internal organs.

Approximately 50% of patients will have hepatitis (liver inflammation), 30% will have eosinophilia (high levels of white cells in the blood indicating immune system activation), 10% will have nephritis (inflamed kidneys), and 10% will have pneumonitis (inflamed lungs).

DRESS syndrome is often severe and can result in death if not diagnosed early – for which reason, you’re urged to see your doctor immediately if you develop a rash after taking strontium ranelate.

Another important note:

The use of strontium ranelate has never been approved in the U.S. or Canada and is now significantly restricted in Europe, while strontium citrate is freely available.

Radioactive icon

Radioactive Strontium

Radioactive strontium is formed in nuclear reactors or during the explosion of nuclear weapons.

Therapeutically, radioactive strontium is used to treat metastatic cancer but can damage bone marrow and act as a potential carcinogen itself at high doses.

Radioactive strontium isotopes (85Sr and 89 Sr) are also used as delivery agents for chemotherapy drugs and for diagnostic purposes in kinetic studies. (Kinetics is the study of the rate at which chemical processes occur.) Radioactive strontium is not sold as supplements!

Radioactive strontium, which shows up in imaging and is easily traced, is often substituted for calcium in kinetic research because strontium and calcium behave very much alike in the human body.

All forms of strontium and calcium have strong bone-seeking properties, and both share common transport pathways, so they compete for absorption in the intestines and for reabsorption in the kidneys.

I want to underscore here that this is a competition that calcium always wins, which explains why:

  • Strontium cannot displace calcium when adequate supplies of calcium are present.
  • Strontium supplements should be taken at a different time of day from calcium, or else little, if any, strontium will be absorbed.

Ok, now that you see the differences in the 3 main types of strontium, let’s dig into the common misconceptions surrounding this valuable mineral.

Myth #1: Strontium Increases Fracture Risk

Some strontium critics claim that strontium causes cortical bone to become thicker, and since cortical bone is less flexible, may increase risk of fractures.

The scientific facts are so different from these assertions, it’s unclear why they publish such misinformation.

The very tiny amount of strontium ions that deposit in our bones prefer to do so in trabecular, not cortical bone.

Trabecular bone is the soft, spongy, more metabolically-active inner portion of our bones. Cortical bone is their hard, outer layer. If your bones were M&Ms, cortical bone would be the outer candy shell and trabecular bone the soft chocolate center.

trabecular vs cortical

Some strontium critics assert that strontium deposits primarily in cortical bone and that somehow translates into reduced bone strength.

They base their claims on these 2 studies:

  1. Boivin, Deloffre, Perrat, et al.. Strontium distribution and interactions with bone mineral in monkey iliac bone after strontium salt (S 12911) administration. J Bone Miner Res. 1996 Sep;11(9):1302-11.
  2. Blake and GM, Fogelman I. (2006 JBMR 21(9) 1417-24 Strontium ranelate: a novel treatment for postmenopausal osteoporosis: a review of safety and efficacy. Clin Interv Aging. 2006;1(4):367-75.

But in both cases the authors of the studies drew POSITIVE conclusions about strontium’s bone supporting role, yet the uncredentialed author of the website drew negative conclusions!

Here is the researcher’s conclusion for the first study:

“In conclusion, taken up by bone, Strontium … induced no major modifications of the bone mineral at the crystal level. As a result, a treatment with Strontium should not induce any alteration of bone mineral.”

Nowhere in the above study, is it proposed that strontium is weakening bone.

The second study (Blake and Fogelman) drew this conclusion:

“Strontium … is the only treatment proven to be effective at preventing both vertebral and hip fractures in women aged 80 y and over.”

Again, the study says nothing about strontium weakening bone structure. And neither study shows strontium depositing primarily into cortical bone. It doesn’t. Strontium primarily deposits in trabecular bone.

The new-forming bone in the trabecular part of your bones is far more active and incorporates more strontium ions than the cortical bone. Cortical bone also accumulates far more slowly. So its incorporation of strontium – which is less than 1 strontium ion for every 100 calcium ions even in trabecular bone – is even less than cortical bone.

What the research shows is that strontium, in addition to its numerous beneficial effects that boost osteoblast and slow osteoclast activity, also indirectly inhibits resorption of the calcified bone matrix by stabilizing hydroxyapatite crystals.

Another fact: strontium is the only trace mineral present in human bone whose level in bone correlates with bone compressive strength, i.e., resistance to fracture.

The bottom line is: Strontium citrate improves healthy bone mineralization and resistance to fracture.


Strontium Myths

Myth #2: Strontium Supplements Have Side Effects

The drug, strontium ranelate, has a long list of side effects, and since the drug has much more media exposure than the health supplement strontium citrate, the two are often confused.

Most blogs, websites, and even doctors do not know that strontium citrate is a completely different molecule from strontium ranelate. Equating them is like suggesting sodium chloride (table salt) and sodium bicarbonate (baking powder) are the same. They both contain sodium, but when you connect that sodium molecule to another molecule, its actions are completely different!

Another issue to consider is that the strontium ranelate drug, Protelos, contains Aspartame – an ingredient which is known for causing reactions on its own.

Natural strontium citrate has never been found to cause any harmful effects– with one caveat: to maintain proper balance between calcium and strontium, more calcium than strontium must be consumed, preferably twice as much calcium.


Myth #3: Strontium Skews DEXA Results Too Much To Be Reliable

The common myth is that strontium supplementation results in larger concentrations of strontium in your bones. And more strontium in your bone causes the DEXA to overstate your bone density increase.

The truth is, strontium does weigh much more than calcium, and its mass does impact DEXA readings…but only a little.

Strontium Myths

Strontium has nearly twice the atomic weight of calcium.

Because of this difference in mass, strontium’s substitution for calcium weakens X-ray penetration during DEXA scanning and results in overestimation of BMD. But strontium ions replaces less than one calcium ion out of 10, so the overestimation is not great enough to discount DEXA results showing improvements in BMD.

The latest science shows your result may be overstated by 8.5% – 11.2%. But don’t throw the baby out with the bath water. Even after adjusting your score down by about 10%, an increase in bone density is still an increase!

For example, if you gained a modest 1% after taking strontium and you reduce that score by 10%, you STILL GAINED .9% of new bone. That’s a big win when you normally would have been losing bone density!

Don’t be fooled by the strontium critics. The increased density in the strontium studies (including the AlgaeCal studies) are still outright increases in bone density in older adults who should be losing bone. And increased bone density is closely correlated with lowered risk of breaking a bone.

Besides, strontium has been shown to reduce fracture risk independent of bone density. In other words, whether your bone density increases or not, strontium reduces your risk of breaking a bone!

You’ll understand why strontium works as it does when you read the list of strontium’s bone-building effects on both osteoblasts and osteoclasts. (I will be publishing a post on its positive bone-building mechanisms in the near future.)

woman put effervescent tablet in glass

Deciding on Dosage

How much supplemental strontium do you need for healthy bones?

If you have low bone density, you will receive the most benefit from a 680 milligram per day dose of strontium citrate.

This is the dose that has been used in almost all the human research conducted on stable strontium salts. (It’s also the same dose of strontium citrate provided by 2 capsules of bone-building Strontium Boost.)

If your bones are currently in great shape, you may still wish to consider supplementing with strontium citrate at a dose of 340 milligrams per day. This dose will help protect and maintain the long-term health of your bones.

A personal note: this is my situation. Within a year after I began supplementing with AlgaeCal Plus and Strontium Boost (680 mg strontium citrate daily), my bones were completely healthy. My DEXA results were excellent, showing bones in the healthy, normal range, where they have remained, which I credit in large part to taking AlgaeCal Plus, Strontium Boost and, since it became available, Triple Power Omega 3 Fish Oil.

(You can read about my journey from rapidly advancing osteopenia in my early 40s back to healthy bones)

After two years of excellent DEXA results, I thought I no longer needed extra help and stopped taking Strontium Boost.

But now, after my in-depth review of the current research on strontium – which involved reading more than 70 recently published papers in the peer-reviewed medical literature – I am convinced that strontium citrate has so much to offer that will help ensure my bones remain healthy that I’ve begun supplementing with Strontium Boost again!

Now, however, I’m taking a prophylactic (preventive) dose of 340 milligrams per day, which I also recommended to my husband to help keep his knees healthy, so, at 69 he can keep playing basketball with men half his age.

What is strontium’s optimal dosage?

In the most recently published studies in which the effects of natural strontium salts on bone health were researched, strontium citrate was effectively absorbed and deposited in bone at both a 340 mg per day and a 680 mg per day dose.

It should be noted that:

  • The studies showing a 340 mg daily dose of strontium citrate was effective were quite small, including just 10 osteopenic and/or osteoporotic women.
  • Participants in a much larger study in which the 680 mg per day dose was used — 172 women who were followed for a period of 7 years — were taking not only strontium citrate (Strontium Boost), but also AlgaeCal Plus. So, all the credit for the highly significant gains in BMD seen every year — which averaged +1.04% per year over the 7-years — cannot be attributed solely to strontium. However, because strontium is the only mineral that both lowers the rate of bone resorption and promotes the rate at which new bone is built, it’s obvious that strontium contributed to the exceptional results seen in this 7-year study.
  • It’s also vitally important to recognize that THERE IS NO SINGLE MAGIC BONE-BUILDING BULLET! Building bone requires a nutrient “team effort”! You’ll achieve optimal results when you combine strontium citrate and ALL 12 of the other essential bone-building nutrients. These are: calcium; magnesium; boron; copper; manganese; silicon; nickel; selenium; phosphorus; potassium; vanadium; and zinc. And you’ll need vitamins D3; K2 (in the form of MK-7); and C too. That’s why you’ll be taking all of these bone-essentials when you follow the AlgaeCal protocol (thanks to the Bone Builder Pack)

Avoid consuming calcium for at least 2 hours before taking strontium

As explained above, calcium will be preferentially absorbed over strontium. Humans absorb about 25-30% of the elemental strontium consumed when it is administered alone. But if strontium is taken at the same time of calcium, our absorption of strontium is reduced to just 15-18% if it’s taken with calcium. So it’s important that you take the two minerals at least 2 hours apart.

In additional to calcium-containing foods, foods that contain alginate (found in kelp) lower strontium absorption, and so do certain medications, including quinolone antibiotics, and medications that contain aluminum hydroxide or magnesium hydroxide.

For at least 2 hours before and after taking your strontium citrate supplement, avoid consuming:

  • Supplements containing calcium.
  • Foods naturally rich in calcium: such as dairy products (cow’s milk, cheese, yogurt, kefir), bone broth, sardines, spinach, kale, collard greens, turnip greens, mustard greens, beet greens, watercress.
  • Foods fortified with calcium: such as calcium-fortified almond, rice and soy milks, tofu, calcium-fortified orange juice and other fruit juices.
  • Kelp: Alginate, which is found in kelp, reduces strontium absorption so greatly that it is used to prevent strontium toxicity in cases of radioactive strontium poisoning. Alginate is a thickening agent used in sauces, yogurt, puddings and pies.
  • Quinolone antibiotics: like calcium, strontium is likely to form complexes with quinolones in the gastrointestinal tract, preventing absorption of the antibiotic. Broad-spectrum antibiotics, the quinolones include ciprofloxacin (Cipro), levofloxacin (Levaquin), ofloxacin (Floxin), moxifloxacin (Avelox), gatifloxacin (Tequin), and others.
  • Medications that contain calcium: such as calcium-containing antacids and oral tetracyclines. Calcium-containing antacids include calcium carbonate (Tums & others), dihydroxyaluminum sodium carbonate (Rolaids & others). Tetracyclines include demeclocycline (Declomycin), doxycycline (Vibramycin), minocycline (Minocin), and tetracycline (Achromycin, Sumycin).
  • Antacids that contain aluminum hydroxide or magnesium hydroxide: both can reduce absorption of strontium by 20-25%. Antacid medications that contain aluminum or magnesium hydroxide include magaldrate (Riopan), Amphojel, and aluminum hydroxide/magnesium hydroxide combinations (Maalox, Mylanta, others).
  • Chelating agents: It is not uncommon for people over age 50 to have accumulated high levels of heavy metals, such as mercury, cadmium and/or lead. If you have been found to have high levels of heavy metals and have been prescribed an oral chelating agent, such as DMSA, take strontium citrate 3-4 hours before or after consuming your chelating medication.

At this point, you’re probably wondering…


When to Take Strontium Citrate

What schedule can help me optimize strontium absorption and let me lead a normal life? I suggest the following:

  • AlgaeCal Plus: 2 capsules with breakfast
  • AlgaeCal Plus: 2 capsules with lunch
  • Strontium Boost: 2 capsules right before bed (on an empty stomach)

how to take Algaecal Plus and Strontium Boost

Print your own How to Take Your AlgaeCal Supplements PDF.

Why this regimen?

It is best to take strontium supplements and calcium at different times of day to get the most benefit.

Take your strontium before bedtime at night. It has been suggested that bone resorption is most active at night, so taking strontium citrate just before bed may result in strontium exerting more of its antiresorptive effects when they are needed most.

Strontium can be taken with or without food. Just be sure the food does not contain calcium.

Calcium on the other hand, should be taken with food so that when food nutrients are being metabolised, the calcium absorption happens along with the other nutrients in the same digestive phase.

Both the strontium and the calcium supplements are absorbed in our gastrointestinal tracts using the same mechanism. Thus, if we take both the supplements together or at the same time, the two will compete for absorption by the body. Scheduling your supplementation like above, will ensure that this does not happen.

What Else Can Be Done To Optimize Strontium Citrate Absorption?

How to boost your ability to absorb strontium and get the most from your strontium supplement…

Our active intestinal absorption of strontium is vitamin D-dependent and decreases with aging, and with consumption of phosphate additives as well as calcium.

You can further optimize your absorption of strontium by:

Ensuring your intake of vitamin D3 is adequate

What’s “adequate” vitamin D3? Sufficient to bring your blood level of 25(OH)D into the 50-80 ng/mL range. 25(OH)D is the vitamin D form circulating in the bloodstream and the marker typically used to assess vitamin D levels. Ask your doctor to get tested to know your current levels and how much you need to bring your levels up to the healthy range.

Avoiding consumption of processed foods

Phosphate, as well as calcium, significantly lowers strontium absorption. Phosphate additives are used as preservatives in most processed foods, including sodas (regular and diet sodas), breads, rolls, sweet bakery products, tortillas, cereals, savory snacks, crackers, snack/meal bars, pizza, poultry, cured meats, vegetables (processed, not fresh!), egg products (e.g., Egg beaters, powdered eggs), seafood, and candy (including chocolate). Read labels!

healthy habit - smelling flowers

Strontium Safety Issues

Individuals with chronic kidney disease

Strontium is eliminated by our kidneys, so it may accumulate in patients with chronic kidney disease, as their kidneys’ ability to filter the blood is compromised.

In patients with chronic renal failure, blood levels of strontium are increased four-fold when creatinine clearance is less than 50 mL/minute. Supplemental strontium should be avoided in individuals with a creatinine clearance less than 50 mL/minute or who are on dialysis. A creatinine clearance rate of 90 or greater indicates normal healthy kidney function. A creatinine clearance rate of 60-89 indicates the initial stage of kidney disease.

Creatinine is a breakdown product of creatine phosphate in muscle; it’s usually produced at a fairly constant rate by the body and is eliminated in urine. How quickly our kidneys filter creatinine from the bloodstream, which is called the creatinine clearance rate, provides a measure of how effectively your kidneys are filtering your blood. (The creatinine clearance rate is also called the glomerular filtration rate because tiny capillaries in the basic structural and functional unit of the kidney, the nephron, are called glomerular capillaries.)

Bone levels of strontium are often high in chronic kidney disease patients on dialysis

People with chronic kidney disease are less able to remove waste and excess water from the blood. Dialysis is a way of carrying out this process. Dialysis fluid can contain high concentrations of strontium, so not surprisingly, some dialysis patients are known to have elevated bone strontium concentrations and a high strontium/calcium ratio in bone. As a result, about 5% of dialysis patients develop osteomalacia (softening of the bones).

However, osteomalacia is also frequently seen in end-stage kidney failure patients who are not yet on dialysis and who have normal bone strontium levels. The reasons for this are that failing kidneys lose their ability to:

  • Activate vitamin D (vitamin D is converted into its active, hormonal form in the kidneys –which is the form in which vitamin D helps us absorb calcium from the digestive tract)
  • Re-absorb calcium passing through the kidneys in the bloodstream instead of losing it in urine

So, if you are on dialysis or have end stage of kidney failure, ask your doctor for advice on whether to proceed with strontium supplementation.

 

Key Takeaways From This Article

  • Strontium delivers a unique combination of bone health benefits no other nutrient provides. Strontium is the only mineral in our bones that both lowers the rate of bone resorption and promotes the rate at which new bone is built.
  • Three types of strontium salts are in use today: (1) Natural stable strontium, e.g., strontium citrate, (2) Unnatural stable pharmaceutical strontium called strontium ranelate, and (3) Radioactive (unstable) strontium.
  • Natural strontium salts, (strontium citrate), are safe (at the dosages discussed above and when twice as much calcium is consumed as strontium) and highly beneficial; neither strontium ranelate nor radioactive (unstable) strontium is safe.
  • Strontium ranelate comes with risks of unwanted side effects. The long list of adverse side-effects attributed to strontium – ranging from commonly seen adverse effects like nausea and skin irritation to possibly deadly effects like venous thromboembolism and serious autoimmune reactions, such as DRESS – are caused by ranelic acid (the “ranelate” portion of strontium ranelate), not strontium.
  • The use of strontium ranelate has never been approved in the U.S. and is now significantly restricted in Europe, while strontium citrate is freely available.
  • Don’t worry about strontium taking the place of calcium in your bones. Strontium and calcium share a common carrier system in the intestinal wall, which will always choose to carry calcium rather than strontium from our digestive tract into our bloodstream. Strontium competes with calcium for absorption – and calcium wins every time. Also, strontium is eliminated more readily than calcium from kidneys.
  • Strontium is almost twice as large as calcium, and its larger size impacts DEXA readings. Available data indicate that approximately 10% of the increase seen in BMD is due to strontium’s larger size – which also means that 90% of the increase seen in BMD is accurate. Besides, strontium has been shown to reduce fracture risk independent of bone density. In other words, whether your bone density increases or not, strontium reduces your risk of breaking a bone!
  • Strontium’s beneficial effects are not due to its replacing calcium in your bones. They are the result of strontium’s bone-building effects on a very wide range of key molecules involved in bone remodeling.
  • Strontium increases our ability to absorb and deposit calcium in our bones– yes, calcium. And that’s another reason why the Bone Builder Pack of AlgaeCal Plus and Strontium Boost have not only slowed bone loss, but built new bone for the thousands of people who’ve tried it.

  • If you have low bone density, you will receive the most benefit from a 680 milligram (mg) per day dose of strontium citrate. If your bones are now in great shape, you may still wish to consider supplementing with strontium citrate at a dose of 340mg per day. This dose will help protect and maintain the long-term health of your bones.

  • Avoid consuming calcium for at least 2 hours before or after taking strontium. Certain foods and medications contain calcium as well as calcium supplements. Ideally, take strontium at night right before bed.

  • Calcium and strontium are chemically similar and compete at the same sites for absorption. If you take them at the same time, calcium will out-compete strontium, and you will not get the benefit of strontium.

  • No. Strontium is not more readily absorbed than calcium. Both minerals use the same transport and absorption mechanisms, and furthermore, calcium will always be preferentially absorbed over strontium. This is why, to receive benefit from supplemental strontium, it should always be taken 3-4 hours apart from when calcium is consumed.

  • Although supplemental strontium does continue to become part of the bone matrix for as long as has been studied in the research (5 years), strontium citrate does not negatively affect bone mineralization or bone quality. In fact, strontium improves both. This was a finding from the clinical trials conducted as part of the Ryerson and McMaster University Strontium in Bone Research Study. All natural, stable forms of strontium improve bone’s ability to undergo physical stress and resist fracture. That’s due to the numerous mechanisms of strontium to build and maintain healthy bones. Strontium increases the amount of osteoblast (remember, bone-building) precursor cells and their differentiation into mature osteoblasts. It also increases collagen type I synthesis and bone matrix mineralization, but inhibits the differentiation, maturation and activity of osteoclasts (bone-resorbing cells). Furthermore, strontium greatly improves our production of new bone and bone quality via its effects on our osteoblasts and osteoclasts, not by taking the place of calcium in our bones. The number of calcium ions replaced by strontium ions in our bones is extremely small, and remains so because strontium is much more rapidly removed from bone than calcium. Research conducted for 36 months on human hip bone tissues from postmenopausal osteoporotic women treated with strontium ranelate, found a very small number of calcium ions were replaced by strontium ions in the hydroxyapatite crystals in newly formed bone. It was a strontium substitution of up to one atom in every one hundred calcium atoms being replaced. However, the thickness and length of the bone mineral crystals were not affected, and there was no indication of a change in human bone tissue quality. Let me repeat, the strontium ions in strontium ranelate exert all strontium’s beneficial effects; the ranelic acid portion is what is responsible for the adverse side-effects seen with this drug. The only potential for concern with natural strontium supplementation would be IF calcium intake were low, AND strontium intake high. One human study reported an adverse effect from consumption of high levels of natural strontium. That was a paper published in 1996 showing an increased incidence of rickets in children in the Sivas province of Turkey, due to high levels of strontium in the soil AND a low intake of calcium. The recommendation made to avoid this: calcium supplements. If you are taking AlgaeCal Plus and Strontium Boost, (the Bone Builder Pack) a daily dose of AlgaeCal Plus for bone building is 4 capsules per day, which provides 720 mg of calcium. The Standard American Diet, on average, also provides ~400-600 mg of calcium per day. So total calcium from all sources is anywhere from 1100 – 1300 mg per day. Strontium Boost provides 680 mg of natural strontium citrate per day in 2 capsules. This bone-building combination provides you with twice as much calcium as strontium, which is backed by the research.

  • You can further boost your ability to absorb strontium and get the most from your strontium supplement if you: (1) Ensure your intake of vitamin D3 is adequate; (2) Avoid consumption of processed foods– all contain phosphate additives, which interfere with strontium absorption.

  • Yes, the natural, stable strontium salt, strontium citrate, has shown no adverse effects when more calcium than strontium is consumed.

Author: Lara Pizzorno, MDIV, MA, LMT

Comments
Pen
Pen

Hi, I have been taking calcium, calcium rich foods and exercising to keep my bones strong, but my bone density test still show low bone density in my right hip.
I found your product and started taking it this week, however when I take the Strontium at night, I get this weird pain in my right thumb, where the thumb joins the hand and I can’t use it to lift anything it is very weird. At first I thought it was a one time fluke, but it is happening every night. Could the Strontium be causing it and should I reduce the dose?

Patricia
Patricia

When I start getting strange movements and pain in my feet or hands a couple of hours or more after taking my Strontium, I quickly take my Algae Cal (Cal-Mag) and it goes away. I don’t mind the small inconvenience because I know I am rebuilding my bones.

Megan AlgaeCal
Megan AlgaeCal

Hi Patricia, thanks for sharing!

Strontium does indeed increase our absorption of calcium, which increases our need for magnesium (important for muscle and nerve function). So it could be that taking the AlgaeCal helps rebalance the magnesium in your body!

-Megan @ AlgaeCal

Elle
Elle

So would taking a magnesium tablet solve the problem?

Megan AlgaeCal
Megan AlgaeCal

Hi Elle!

Some people do require additional magnesium. We recommend trying to increase the magnesium in your diet as a first approach and have a handy list here that can help.

-Megan @ AlgaeCal

Lara Pizzorno
Lara Pizzorno

Hi Pen,

Strontium Boost has 2 effects that might be contributing to your thumb pain:

First, strontium increases our absorption of calcium, and when we absorb more calcium, we may need more magnesium if our diet is not providing a sufficient amount of magnesium to maintain a 2:1 calcium:magnesium balance. For this, you can try two things (1) ensure you are eating plenty of magnesium-rich foods (if you have a copy of Your Bones, I provide a table listing them and showing how much magnesium is in a typical serving of each food, p. 226. You can check Your Bones out from any public library if you don’t wish to own it — or you can run a Google search for foods rich in magnesium), and (2) you can take extra supplemental magnesium. AlgaeCal Plus is giving you 350 mg, an amount that perfectly balances the 720 mg of calcium it provides. You could try taking 150 mg of magnesium citrate along with your Strontium Boost.

Secondly, Strontium Boost is strontium citrate. Citrate is a favorite food of unfriendly bacteria. If any of these critters are present in your digestive tract, which is extremely common, they will co-opt the citrate and use it to fuel their own activities. Their metabolic byproducts are highly inflammatory and cause damage to the gut wall, so they can get into your bloodstream and make their way to your joints, causing inflammation and pain.

The thumb joint pain you describe does sound like arthritis. Our susceptibility to thumb joint pain increases as we age. I experience this off and on myself, particularly if I’ve been doing a lot of gardening, cooking, and housecleaning chores. (For more info on this, here’s a link to Mayo Clinic’s discussion of thumb arthritis: https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/syc-20378339)

For thumb joint pain due to arthritis, my recommendation is the same because magnesium helps dilate our blood vessels and improves blood flow.

Reduce your dose of Strontium Boost to 1 capsule nightly along with 150 mg of magnesium citrate and see if this helps. After a week or so, you can try increasing to 2 capsules of Strontium Boost again.

Hope this helps,

Lara

Sherry
Sherry

Lara
I have been taking strontium citrate for 10 years. I had a “normal” DEXA for 2017 and 2019. I have read some articles about using a lower dose of strontium. I am confused what dose I should now be using. My last density, 2019, for the worse area was -.6 so depending on whose figures I use for strontium over showing on the DEXA I am in normal range or osteopenia. Would you share some studies with me (70 studies were mentioned in the article) that would clarify your decision to continue with the 682 mg dose as a maintenance dose. Thank you in advance for your help.

Lara Pizzorno
Lara Pizzorno

Hi Sherry,

Great to hear that you are definitely in normal range or in the one area you mention having a T score of -0.6, are barely osteopenic!

For my post on strontium on AlgaeCal.com, I did review more than 70 studies, but not all the studies I cite there apply specifically to your question about an appropriate maintenance dose of strontium for you. The links below will take you to those papers that do include information that applies to your question.

In articles posted on AlgaeCal.com and in #AskLara’s on our AlgaeCal Community, I always provide links to the studies that support what I am saying immediately after the statements made – although in checking the post on AlgaeCal.com, I see some of the references I provided have been removed, so only some are given in the links. I have added the ones that were removed that apply to your question in my comments below:

As I have explained:

Strontium is almost twice as large as calcium, and its larger size does affect DXA readings. In the research, approximately 50% of the increase seen in BMD over 3 years of treatment with strontium was due to strontium’s larger size, AND 50% of the increase seen in BMD was accurate. https://www.ncbi.nlm.nih.gov/pubmed/?term=15336592

Strontium’s larger size than calcium’s also affects how quickly strontium is eliminated from the body. We lose strontium much more rapidly than calcium: three times as much strontium is lost in urine compared to calcium. https://www.ncbi.nlm.nih.gov/pubmed/?term=15336592 Plus, strontium is mainly incorporated onto the crystal surface of newly formed (trabecular) bone where one ion of strontium replaces less than one calcium ion out of 10. Trabecular bone is much more metabolically active than cortical bone, so when strontium treatment is stopped, the small number of strontium ions that were exchanged for calcium ions are soon released during normal healthy bone renewal, and this results in a rapid decrease in total bone strontium levels. https://www.ncbi.nlm.nih.gov/pubmed/?term=11336927

If you have read my posts on strontium or listened to the #AskLara’s in which I discuss strontium, you know that strontium greatly improves our ability to maintain healthy bones through MANY mechanisms –not by replacing calcium in our bones – so, even though your bones are now in good shape, to keep them healthy, continuing to take some strontium is a good idea.

Since your bones are now in such good shape, however, I suggest you consider using only a half dose (1 capsule of Strontium Boost) daily instead of the full 2 capsule dose. This is what I began doing for myself several years ago now after I read – and reported in this post on AlgaeCal.com – that a half-dose was effective for maintenance. Here are links to this research (I see only one of the papers I cited is now provided as a link in the post on AlgaeCal.com. There were a series of studies run as part of the Ryerson and McMaster University Strontium in Bone Research Study in Toronto, Canada, that confirm this, so I am giving you links to several of these papers here: https://www.ncbi.nlm.nih.gov/pubmed/22549020 https://www.ncbi.nlm.nih.gov/pubmed/26910208 https://www.ncbi.nlm.nih.gov/pubmed/24434614

FYI– the amount of strontium provided in the full dose is not 682 mg. Strontium Boost is strontium citrate, which is 31% elemental strontium and 69% citrate. The two-capsule dose of strontium citrate = 680 mg, which provides 236 mg of elemental strontium + 440 mg of citrate. One capsule gives you 118 mg of strontium and 220 mg of citrate.

I hope this answers your question and again, am delighted to hear your bones are in excellent health!

Lara

Sherry Lamb
Sherry Lamb

Thank you Lara,

Great information. Especially thanks for the links to research.

If you do not object, I may use this information on some posts.

I am trying to compile information on research on strontium citrate and this will greatly add to my body of information.

Also, your answer gives me peace of mind in deciding to half my dose of strontium citrate. Thank you

Blaire AlgaeCal
Blaire AlgaeCal

Glad you found Lara’s information helpful, Sherry! Feel free to use the information as you need 😊

Any further questions, don’t hesitate!

– Blaire @ AlgaeCal

Sherry Lamb
Sherry Lamb

Lara
I recently found this research study

https://eje.bioscientifica.com/view/journals/eje/165/3/469.xml

and was intrigued by table 1 in it.

To me it seems to show, over a 5 year period, bone on strontium aging and becoming more infused with calcium and phosphorous and less with strontium.
Am I understanding the new bone/old bone terminology correctly here.
I am assuming that the new bone at 2 months is the old bone at 60 months or at least some of it is.

But I do not know how the interstitial cortical bone and cancellous bone work in relationship to growing and becoming.
Thanks for looking and for your input.

Ellen
Ellen

Above you describe that secondly S booster can feed unfriendly bacteria. I’ve been getting abdominal discomfort, bloating and cramping. Can this be what’s going on? I’ve tried taking only one capsule, and even one half capsule with some mashed applesauce or banana. What else can be done so I can still take the s booster? Is there a treatment? Thank you!

Blaire AlgaeCal
Blaire AlgaeCal

Hi Ellen,

Thanks for reaching out!

We’re so sorry to hear that you have been experiencing abdominal discomfort, bloating, and cramping – this certainly could be due to the citrate if you have an infection with any species of the pathogenic bacteria Clostridia. Many people have this infection and are not aware of it. Citrate is typically good for you; however, when you are infected with Clostridia, it feeds off of citrate, which is why you may experience symptoms like the ones you mentioned. Not to worry, this can be rectified! We recommend speaking with your doctor and potentially ordering an Organic Acids Test (OAT). You could also ask your doctor about running a stool test, preferably a Comprehensive Digestive Stool Analysis (CDSA). A CDSA is not as sophisticated as the OAT but it may be sufficient and it is more likely to be covered by insurance than the OAT. In the meantime, it’s best to cut back to just 1 capsule of Strontium Boost daily (if your body allows), or completely stop taking Strontium Boost until you know the cause.

Hope that helps and that you feel better soon! Feel free to give our Bone Health Consultants a call at 1-800-820-0184 if you have further questions ❤️

– Blaire @ AlgaeCal

Alice M.
Alice M.

I have been trying to take Algae Cal and Strontium Boost since mid-August. I have a history of IBS and have avoided gluten and used probiotics which has helped my GI tract to return to normal. When I tried both Algae Cal and Strontium as suggested I developed Gi loose bowels and discomfort. I backed off and started with just Algae Cal 2 capsules at breakfast and things went back to normal. I have found what works is 2 Algae Cal at breakfast, 1 at lunch, and 1 at dinner and all is well. However, even adding 1 Strontium at bedtime causes the loose bowels and squeezing discomfort to return. Do you have any suggestions?

Lara Pizzorno
Lara Pizzorno

Hi Alice,
For now, agreed, you should stop taking Strontium Boost. How is your digestion otherwise? I’m asking because the mineral strontium does not cause these effects, but the citrate provided by Strontium Boost, which is strontium citrate, can if some unfriendly bacteria are present in your digestive tract. Strontium citrate is 31% elemental strontium and 69% citrate. The two-capsule dose of strontium citrate = 680 mg, which provides 236 mg of elemental strontium + 440 mg of citrate. One capsule gives us 118 mg of strontium and 220 mg of citrate.

For most everyone, citrate is REALLY good for us — it’s metabolized in the body as an alkalinizing agent — in other words, it promotes an alkaline pH inside our cells. Many cellular processes do not happen effectively in an acidic environment, and furthermore, an acidic pH (called metabolic acidosis) over activates osteoclasts and promotes bone loss. But, in people whose digestive tracts are infected with unfriendly bacteria, such as Clostridia, citrate can be co-opted by these bactera and used to fuel their metabolism. It turns out that citrate is a favorite food for Clostridia (C.difficile). https://www.nejm.org/doi/full/10.1056/NEJMoa1408913

And the incidence of C. difficile infection has been increasing every year. https://www.ncbi.nlm.nih.gov/pubmed/27855653 https://www.ncbi.nlm.nih.gov/pubmed/27102582

What all this means is that infection with Clostridia is not at all uncommon and in people who are infected with Clostridia, consuming citrate turns up the activity of this pathogenic bacteria, which produces and releases some really toxic stuff that can cause all the symptoms you mention.

Clostridia infection in the U.S. is VERY common — back in 2011, at least half a million people were infected with C.difficile, In the U.S., average daily consumption of citrate is around 500 mg/d, so the full 2 capsule dose of adds another 680 mg, enough to make a difference. In addition, the 500 mg intake level for citrate is the average — this means that many people typically usually consume less citrate, so adding in Strontium Boost would have a bigger effect and those who typically consume less citrate and are carrying Clostridia would react.

I discuss this on the AlgaeCal Community in an #AskLara on testing that identifies C.diff and other pathogens. https://www.facebook.com/lara.pizzorno.5/videos/10218830498263978/

First, it’s best that you stop taking any Strontium Boost until you have no symptoms. Then after a few days, see if you can take 1 capsule daily without provoking symptoms. If you still have symptoms at this half dose, please ask your doctor about running a CDSA (Comprehensive Digestive Stool Analysis) or the OAT (a far more comprehensive test, the Organic Acids Test) to check what’s in your gut. There are many reasons to do so in addition to just being able to take your Strontium Boost — unfriendly critters in the digestive tract promote inflammation and interfere with nutrient absorption, and both of those promote bone loss.

kalpana S
kalpana S

Useful information. Strontium is a chemical element that naturally found in our body in small amounts. I observed three types of strontium salts and side effects of strontium supplements like nausea and headache etc. You have given some tips how much of dosage we have to take. Thanks for sharing. Springdale clinic where we can get suggestions on mental health issues.

Megan AlgaeCal
Megan AlgaeCal

Glad you enjoyed the information, Kalpana!

Thanks for sharing and we hope you enjoy some of our other blog articles 😊

-Megan @ AlgaeCal

Linda Kirwin
Linda Kirwin

I have been trying to take the Strontium Boost but it gives me headaches. I have tried taking it different times of day and I have tried taking only one capsule, either way I have a headache. When I stop taking it the headaches stop. Not happy about this and I see on another forum that other people have this problem, also. I am wondering what to do? Wondering what you might recommend? Would silica be a good supplement instead of Strontium?

Lara Pizzorno
Lara Pizzorno

The reason for your headaches is not the citrate. Strontium increases our absorption of calcium — yes, calcium! So when we take strontium if our diet is not providing adequate magnesium, we may need a bit more magnesium to maintain the optimal 2:1 balance between calcium and magnesium — this is the provided in AlgaeCal Plus. Try taking 150 mg of magnesium citrate along with one capsule of P-5-P (pyridoxal-5-phosphate) in the evening along with your Strontium Boost. P5P is the active form of B6, which helps our cells effectively absorb magnesium.

Laura
Laura

Hello! I am turning 68 on July 1st and just started taking AlgaeCalPlus with the StrontiumBoost about a week ago. Thrilled to have found this which appears to be so promising. I do have low bone density in my spine (-2.5 T score) and also in my hips (-3.3 on one side, -3.0 on the other) so am pretty concerned at this point. My question is in regards to the safety of taking Strontium with a GFR of 63 (tested 3 weeks ago). Previous GFR readings over the past 10 years have been as low as 56 but seem to hover in the high 50’s to very low 60’s. I read in the discussion that a GFR of 50 or less would indicate that I should not take Strontium. If I do continue on it, will this contribute to a worsening of my existing kidney disease? Thanks so much!

Lara Pizzorno
Lara Pizzorno

If you have chronic kidney disease, you should not risk taking strontium. The ability of patients with CKD to clear strontium (and everything else requiring elimination in urine) is compromised. In addition, strontium may put more stress on the kidneys than other minerals because its larger size makes it difficult to reabsorb, so more is excreted. Our kidneys eliminate strontium far more quickly than calcium: three times as much strontium is lost in urine compared to calcium. My best advice for you is to focus on determining what factors are causing your CKD – get rid of them and HEAL. Our bodies have tremendous capacity to heal once the factors that are harming us are removed. Also, AlgaeCal Plus alone, or with Triple Power, which I definitely recommend especially for you because CKD indicates chronic inflammation, will support your bones ability to rebuild — just a bit more slowly without Strontium Boost, which, as it’s name implies, boosts the rate at which new bone is formed.

Alison N.
Alison N.

I was wondering what your opinion on giving dogs canned sardines in water is. Specifically based on strontium levels and safety. I typically give my 75lb boxer a can of sardines once a week and I give it to him all at once. It’s usually a Friday or Saturday night treat for him. However, I just read a site from Dr. Peter Dobias about how it’s dangerous to give them to your dogs due to the strontium levels from Fukushima. Do you agree, disagree? Thanks!

Jenna AlgaeCal
Jenna AlgaeCal

Hi Alison,

Unfortunately, we aren’t familiar with the safety of canned sardines for dogs. Perhaps one of our readers will have insights to share with you! 🙂

– Jenna @ AlgaeCal

Lara Pizzorno
Lara Pizzorno

I disagree — actually, this attempt to frighten you into not giving your dog his weekly can of sardines is so over the top, it made me laugh. If you are a member of The AlgaeCal Community, please check out an #AskLara I taped entitled, “What can I believe?” In this video, I discuss in detail how to investigate assertions like the one you’ve sent in. In brief, check this person’s credentials (where did this man get his medical training? is he board certified, etc.?), then check the references he provides (probably none) to ensure the papers he is basing his claims upon actually say what he is using them to assert. Or don’t bother. Just enjoy giving your boxer his sardines. One other suggestion — we order our fish from Vital Choices (www.vitalchoices.com) You can look at their website, see their products and their excellent quality control. Probably a bit more expensive but worth it.

Michael Ho
Michael Ho

Hi Lara, I understand that Strontium Citrate do not cause blood clot. What about someone with coronary artery disease? Is it safe to take it.

Thank you.
Michael

Lara Pizzorno
Lara Pizzorno

No research indicates that strontium citrate would cause problems for someone with coronary artery disease; however, this is something you should definitely discuss with your doctor before taking strontium or calcium for that matter. It is extremely important that you are consuming optimal levels of vitamin K — both as K1 (phylloquinone) AND as K2 (menaquinone). K1 has significant anti-inflammatory effects. K2 is required to activate the proteins that regulate where calcium is deposited in your body: Osteocalcin, which delivers calcium to bone where you want it, and Matrix Gla protein, which prevents calcium from depositing in soft tissues — including your coronary arteries — where you don’t. Research conducted using K2 (360 micrograms of the MK-7 form of K2 daily) in individuals with cardiovascular and chronic kidney disease has even indicated removal of calcium deposits from the vasculature. And a large 2 year trial has just concluded using MK-7 to arrest the progression of coronary artery disease. https://www.ncbi.nlm.nih.gov/pubmed/26516910 Hope this helps, Lara

KATHY D RISNER
KATHY D RISNER

I have recently been diagnosed with coronary artery disease AND low bone mass. I was put on several new medications for the heart disease (blood thinner, beta blocker, aspirin, statin, and blood pressure!) Will the strontium interfere with these medications? Is it safe to take along with the heart meds? What about the AlgaeCal Plus? I need to make sure there is not any contradictions between the heart meds and supplements for bones. Thank you

Megan AlgaeCal
Megan AlgaeCal

Hi Kathy, thanks for reaching out!

Please do give us a call at 1-800-820-0184 where our Bone Health Consultants can go through your medication list to see how to best incorporate AlgaeCal into your current medication/supplement schedule. They can provide tailored information based on the specific medications you’re taking.

Furthermore, with specific medical conditions, we highly recommend discussing AlgaeCal with your doctor.  We have a printable information sheet summarizing our products & the human clinical studies if you would like to share it with your doctor here.

Hope this information helps!

– Megan @ AlgaeCal

Alma
Alma

Hi Lara,
I just started taking AlgaeCal Feb. 10th – I scrolled on your FB page &a read something about too much Stronium is not good for kidneys? I might’ve read it too fast. I only have (1) one kidney so should I take the 2 supplements? or is 1 sufficient? Any help would be greatly appreciated!
The CountryLife calcium I was taking, was NOT doing it for me. I could feel a pin prick in my liver or kidney. Don’t know what that is from. And ever since being off it, I don’t feel it hardly anymore…
Maybe it’s just me. I’m a vegetarian & eat healthy. My bloodwork is also great!

Lara Pizzorno
Lara Pizzorno

Hi Alma,
If your kidney function is normal, then this is not an issue for you.
It is an issue for individuals with chronic kidney disease.
Strontium is eliminated by our kidneys, so it may accumulate in patients with chronic kidney disease whose kidneys ability to filter the blood of EVERYTHING, not just strontium, is compromised.
In patients with chronic renal failure, blood levels of strontium are increased four-fold when creatinine clearance is less than 50 mL/minute. Supplemental strontium should be avoided in individuals with a creatinine clearance less than 50 mL/minute or who are on dialysis. A creatinine clearance rate of 90 or greater indicates normal healthy kidney function. A creatinine clearance rate of 60-89 indicates the initial stage of kidney disease.
Creatinine is a breakdown product of creatine phosphate in muscle; it’s usually produced at a fairly constant rate by the body and is eliminated in urine. How quickly our kidneys filter creatinine from the bloodstream, which is called the creatinine clearance rate, provides a measure of how effectively your kidneys are filtering your blood. (The creatinine clearance rate is also called the glomerular filtration rate because tiny capillaries in the basic structural and functional unit of the kidney, the nephron, are called glomerular capillaries.)

Because people with chronic kidney disease are less able to remove waste and excess water from the blood, dialysis is used as an artificial way of carrying out this process. Dialysis fluids may already contain high concentrations of strontium, so not surprisingly, some dialysis patients are known to have elevated bone strontium concentrations and a high strontium/calcium ratio in bone. As a result, about 5% of dialysis patients develop osteomalacia (softening of the bones).
However, osteomalacia is also frequently seen in end-stage renal failure patients who are not yet on dialysis and who have normal bone strontium levels. The reasons for this are that failing kidneys lose their ability to:
• activate vitamin D (vitamin D is converted into its active, hormonal form –which is the form in which vitamin D helps us absorb calcium from the digestive tract–in the kidneys)
•re-absorb calcium passing through the kidneys in the bloodstream instead of losing it in urine
So the desired ratio of 2:1 calcium to strontium becomes harder to maintain.

Andrea B.
Andrea B.

I have been taking AlgaeCal Plus for over 10 years (3-4 capsules daily). I am now 55 years old. Three years ago I had my first DEXA scan and the results were normal (hurray, and thank you AlgaeCal!!). I just had another DEXA scan and the results are also normal, but less good than 3 years ago. In order to not loose more bone, I decided to also take StrontiumBoost, which I just ordered. My question is should I take 1 or 2 capsules of Strontium, given that my DEXA results are in the normal range? Many thanks!

Lara Pizzorno
Lara Pizzorno

Hi Andrea, If you scan my post on strontium, you’ll see I discuss several studies done in Canada in which a half dose ( 1 capsule daily) of strontium citrate was used with excellent results. That’s what I recommend for you. And it’s what I do for myself. My bones have been in excellent shape now for more than 6 years (within 6 months after I started taking AlgaeCal Plus), but I continue to take a half dose (1 capsule) of Strontium Boost daily to ensure they stay healthy!

Jane Maney
Jane Maney

So you take half the dosage of strontium (1 capsule) Do you still take the full dosage of algae cal plus (4 capsules)? Or do you half that too?

I have a hard time with taking the strontium at night. I take 2 algae cal with dinner ( anywhere from 6-8pm). I have to wait 4 hours after meal to take stontium (right) so I have to stay up late or end up getting up in the middle of the night to take strontium. Any suggestions on when to take?

Lara Pizzorno
Lara Pizzorno

Yes, I take the full dose (2 capsules twice daily) of AlgaeCal Plus, but now that my bones are in great shape, I only take a half dose (1 capsule) of Strontium Boost. I usually wake up in the middle of the night with a full bladder (one of the joys of now being 70 years old 🙂 and just take my strontium then. If you do not wake up at night, you can take your strontium during the day — you just want to take it when you are not also consuming calcium, so with a breakfast or lunch that does not contain calcium. Also, 3 hours should be enough time to wait after dinner to take your strontium. The reason 4 hours is recommended is that even if your digestion is slower than normal, you will have absorbed any calcium that was present in your meal or supplements by then. For most people, 3 hours or even 2 hours will be sufficient.

Pen
Pen

Hi, I have been taking calcium, calcium rich foods and exercising to keep my bones strong, but my bone density test still show low bone density in my right hip.
I found your product and started taking it this week, however when I take the Strontium at night, I get this weird pain in my right thumb, where the thumb joins the hand and I can’t use it to lift anything it is very weird. At first I thought it was a one time fluke, but it is happening every night. Could the Strontium be causing it and should I reduce the dose?

Lara Pizzorno
Lara Pizzorno

This type of pain in your thumb is not due to strontium; it indicates arthritis in the joint. https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/syc-20378339 Unfortunately, as we age, cumulative damage to our joints over the years, particularly when low levels of chronic inflammation are present (which also promote bone loss), starts to show up. Also, sometimes crystals can form and deposit in a joint — a thumb joint version of gout. https://www.arthritis.org/about-arthritis/types/calcium-pyrophosphate-deposition-disease-cppd/ A few years ago now, I also started to experience pain in my thumb joints (and sometimes other fingers as well), which would clear out after a few days. I no longer have this problem because I treated the reasons for this pain — primarily by increasing my intake of anti-inflammatory omega-3s. I do this by taking Triple Power, which in addition to EPA/DHA, also contains two very powerful but safe anti-inflammatory agents: curcumin and astaxanthin. I suggest you take double the usual dose of Triple Power (so 2 TBS instead of one) for 6 weeks, then you may be able to drop down to 1 TBS without experiencing a recurrence of your thumb joint pain. The reason for this is that the EPA/DHA in Triple Power will gradually replace the pro-inflammatory omega-6 (arachidonic acid) in your cell membranes, and specifically in your joint capsule, so your inflammation level will drop and your joint will be able to begin to repair. One other supplement that may help is Ultimate Glucosamine (N-acetyl-D-Glucosamine) — this is the form in which glucosamine is used inside our joints. Hope this helps. Keep me posted, Lara

Jeanette Svensk Li
Jeanette Svensk Li

Hello!
I am 48 and not yet menopaused. I am interested in already now starting to strengthen my bones, by taking AlgaeCal and Strontium. I am having some issues with plantar fasciitis and possible arthritis in both thumbs. I am active and healthy otherwise, on no other medication. Should I take full dose or maybe half?
Thankful for reply before I order. Best regards Jeanette

Lara Pizzorno
Lara Pizzorno

Hi Jeanette, At age 48, you are perimenopausal. Most of us begin the transition through menopause from age 48-52, so it’s great that you are being proactive about protecting your bones now, particularly since you are already experiencing conditions that indicate chronic inflammation (the plantar fascitis and arthritis). As woman age, we become more susceptible to “itis” (which means inflammation), in part because our estrogen production drops off. Estrogen exerts many anti-inflammatory effects, so as we produce less estrogen, our inflammatory potential goes up. And chronic low grade inflammation, regardless of its source, activates our bone-resorbing cells, which are called osteoclasts, continuously and thus promotes bone loss. I suggest you consider taking both AlgaeCal Plus and Triple Power. AlgaeCal Plus provides the key nutrients our bones must have to maintain themselves, regardless of our age, and in amounts shown in the research to be sufficient for most people. I believe it is a foundational health supplement for everyone — not only postmenopausal women. I have my son, a 30 year old M.D. currently doing his residency in Emergency Medicine; my daughter, who is 40 years old and an MS, RD nutritionist, and my husband, Dr. Joe Pizzorno, taking AlgaeCal Plus along with me — we all take the full dose daily. I highly recommend it for you as well. Also, I suggest you have your blood levels of vitamin D (25[OH]D) checked after you have been taking AlgaeCal Plus for 3 months just to be sure it is providing enough vitamin D for you. AlgaeCal Plus provides 1,600 iu of D3 daily, but some of us need more depending upon where we live (latitude impacts our ability to produce vitamin D from sun exposure) and our genetic inheritance, which can greatly affect our ability to maintain healthy levels of vitamin D, which, for 25(OH)D, should be in the range of 50-80 ng/mL. I also have my son, daughter and husband taking Triple Power along with me. Triple Power delivers EPA/DHA and two potent anti-inflammatory compounds — curcumin and astaxanthin. Unless you eat a lot of fish, you are almost certain to not be getting adequate EPA/DHA — the omega-3s that our bodies metabolize into compounds called the resolvins and protections because they resolve inflammation and protect us from chronic inflammation’s adverse effects. Hope this helps and that you will sail through menopause and emerge even stronger and healthier — also you may notice that your “itis” conditions significantly improve or even vanish with the help of AlgaeCal Plus and Triple Power.

Vickie Harris
Vickie Harris

Thank you for the information about the DXA scan and the TBS. I will be having the scan done at my rheumatologist’s office, the same place I had it done before and I will be sure to ask for the TBS.

Vickie Harris
Vickie Harris

I have been speaking to a clinical and technical instructor for the International Society for Clinical Densitometry on an osteoporosis support group who says, about the study “The effect of bone strontium on BMD is different for different manufacturers’ DXA systems”, that in order to use the correction factors developed in this study still requires knowing how much calcium was replaced by strontium. That currently is only possible after removing the bone, ashing it and chemically analyzing the minerals. If this is the case, how is it possible to get a proper BMD reading from your DXA scan if you’ve been taking strontium? Is it the case that you’ve just got to estimate it? If that’s so, how could you possibly come up with an accurate number? I will be having my next DXA scan in a month, after two years on AlgaeCal Plus and Strontium Boost, and I want to be able to at least have a fairly accurate knowledge of what my BMD is.

Lara Pizzorno
Lara Pizzorno

Hi Vickie,

Yes, your DXA BMD score will be impacted by strontium. Strontium is larger than calcium, and as I’ve explained in my post here on AlgaeCal, available data indicate that approximately 50% of the increase seen in BMD over 3 years of treatment with strontium is due to strontium’s larger size – which also means that 50% of the increase seen in BMD is due to improved bone mineral accumulation.

You should also know that your BMD score will be impacted if you have your DXA run on a different machine from the one used for your prior DXA.
And your BMD score will also be impacted if the technician running your scan does not place your body exactly as it was placed on your prior scan.

In other words, your DXA BMD score is, in fact, an estimate – it’s a very good estimate, but it is not 100% an “accurate” number in the way you are using this adjective.
The good news here is that you do not need to be stressed out about this! Your DXA will definitely give you the most important information you need to have, which is, “Has my BMD improved?”

A few other things to keep in mind regarding strontium and calcium:
Both minerals share a common carrier system in the intestinal wall, which will always choose to transport calcium rather than strontium from our digestive tract into our bloodstream. Since you are taking AlgaeCal Plus and thus getting at least twice as much calcium as strontium, you are never going to absorb more strontium than calcium. In your bones as well as in your digestive tract, strontium and calcium compete for absorption, and calcium wins every time.

Strontium, like calcium, incorporates into both trabecular and cortical bone, but strontium deposits almost entirely into new trabecular bone, with one strontium ion substituting for less than one calcium ion out of 10. In other words, for every 10 calcium ions your bones absorb, they will absorb less than 1 strontium ion. Because strontium is almost twice as large as calcium, even this tiny number of strontium-for-calcium ions exchanged in your bones can impact DXA readings. But this very tiny amount of strontium nonetheless has major beneficial impacts on your bones’ health, strength and flexibility.

I really want to underscore here the fact that the strontium’s beneficial effects on our bones are NOT due to its replacing calcium in our bones!
They are the result of strontium’s bone-building effects on a very wide range of key molecules involved in healthy bone remodeling. Strontium increases your bones’ ability to absorb calcium, regulates / helps balance the activity of RANKL and OPG, activates Wnt signaling, increases osteoblast production and activity and lifespan, improves osteoblasts’ mineralization of bone, inhibits osteoclast formation and activity, improves bones mechanical resistance to fracture … and more.

DXA only checks BMD, which is a measure of quantity. DXA does not check for quality – that’s what TBS analyzes – and quality is critical for your bones’ ability to resist fracturing, which is the real goal here, right? Here’s a link to my talk on TBS: https://www.algaecal.com/expert-insights/how-to-analyze-your-dexa-results-for-bone-quality/ The really good news is that your DXA images can be used to calculate your TBS, so please request that this be done for you when you go in for your next DXA.

I hope this helps set your mind at ease and that you will be delighted with you upcoming DXA/TBS results.

Be WELL!
Lara

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thuoc uong tri xuat tin som

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Lorraine
Lorraine

Also, Is it OK to take the strontium with a banana?

Jenna AlgaeCal
Jenna AlgaeCal

Yes, you can take strontium with a banana because they are quite low in calcium! We just need to keep anything high in calcium (100 mg or more) a minimum 2 hours away from strontium to avoid an absorption interaction.

– Jenna @ AlgaeCal

Lorraine
Lorraine

I am Interested in taking this strontium first thing in the morning so I don’t have to think about what I’m eating before bed. I have a smoothie for breakfast that contains a bunch of kale. If I have strontium two hours before the kale will that be sufficient? alternatively, is there a vegetable that I could substitute the kale for to put in my smoothie that is low in calcium so I could take with the strontium? I like to get vegetables in as much as possible.

Jenna AlgaeCal
Jenna AlgaeCal

Hi Lorraine,

You can definitely take your strontium first thing in the morning! A 4 hour separation is ideal, however as long as there is at least a 2 hour separation between strontium and calcium you can take it at any time of the day – so taking your breakfast smoothie 2 hours later would be sufficient. 🙂

– Jenna @ AlgaeCal

Kay
Kay

Hi Lara,
I recently did a test for toxicity from QuickSilver. The only red flag I received was for Strontium. My number was 98. The range that it should be was given as less than 61. Any ideas as to why I could be high here? I looked up foods that might bring this about and the only one on the list that could possible be a culprit was spinach. I know you focus on strontium supplementation but should I be concerned if I have too much strontium? I follow the Bresdan protocol, eat a whole foods Keto diet, am gluten,dairy,soy and sugar free, walk 3 miles daily, and eat organic 90% of the time. I do have Hashimoto’s and have been on a compounded T3 for over 20 years. I also take WP which is similar to Armour. I am concerned when I read that too much strontium can cause softening of the bones. Osteoporosis does run in my family with both my grandmother and my mom struggling with this. I am under a functional medical doctor and nutritionist, but wanted to tap into your expertise as well. I know that I am my own best advocate when it comes to my health and appreciate your willingness to help those of us who are trying to educate ourselves.

Lara Pizzorno
Lara Pizzorno

Hi Kay,
Of course, happy to do what I can to be of help, and yes, each of us is our own best advocate, although you are definitely in good hands if you are working with a fully IFM certified functional medicine physician and nutritionist. I’m not familiar with Quick Silver; what labs do they run? Also is the Bresdan protocol Dale’s recommendations for Alzheimer’s disease prevention? Are you ApoE4? Need more info on YOU and and why you are restricting soy and dairy as well as gluten. What issues have you had that have lead you to these choices? How old are you? Are you perimenopausal? postmenopausal? How is your digestion? How are your kidneys? Are you currently taking supplemental strontium? If so, what product and at what dosage?

sharon
sharon

If strontium is high 1.03 rising from .043 8 months earlier and hair loss what would you suggest, check the kidney function??

Lara Pizzorno
Lara Pizzorno

Hello Sharon,

It would be very helpful if you could send me the lab data specifics here – 1.03 what? What is the measurement being used here? This level may be excellent and may simply be indicating you are effectively absorbing strontium. Baseline levels of strontium will always be low – unless you live in Turkey in the one region where strontium levels in the soil are extraordinarily high.

If your current level actually is too high, then cut your dosage in half. If you are taking 680 mg/d, cut this back to 340 mg/d; the latest research indicates you will still receive significant benefit from this lower dosage.

Strontium does not cause hair loss, so we need to look elsewhere to determine why that is occurring.

The most likely cause is thyroid dysfunction. Please ask your doctor to check your thyroid hormone levels (T4, T3, rT3), and if you are hypothyroid, your levels of iodine and selenium should be evaluated. You need both trace minerals to produce and utilize thyroid hormones. Providing them, if you are currently deficient –and many people are — may restore healthful thyroid function. If not, thyroid hormone replacement is commonly done, but just remember to have your doctor check your thyroid hormone levels after the first 6 months and then at least annually to ensure the dosage you are being given is correct for you. Too high a dosage promotes bone loss.

Your doctor will be aware of the connection between hypothyroidism and hair loss, but may not be aware that hyperprolactinemia is another potential cause, so I’m pasting in a recent citation on this here: Ziai M, Cifuentes L, Grosber M, et al. Diffuse hair loss associated with hyperprolactinaemia: report of three cases. J Eur Acad Dermatol Venereol. 2015 Mar;29(3):607-8. doi: 10.1111/jdv.12407. Epub 2014 Feb 25. PMID: 24612329

Many commonly prescribed drugs cause hyperprolactinemia. Please take a look at my post titled Commonly Prescribed Drugs Cause Bone Loss and check any drugs you regularly take to see if they have this adverse side effect (https://www.algaecal.com/expert-insights/prescription-drugs-that-cause-osteoporosis/). If so, discuss alternatives with your physician.

I very much hope this information will be helpful for you,

Lara

Claire Dant
Claire Dant

Just started taking AlgaeCal and Strontium Boost (separately as instructed). Have been experiencing quite a bit of nausea. Could this be a related side effect?

Lara Pizzorno
Lara Pizzorno

Hello Claire,

Sorry to hear you’re experiencing nausea – not fun! But, it might be a positive indication that you are producing a healthy amount of stomach acid, which would enable you to quickly dissolve your supplements for absorption. If this happens on an empty stomach with no food present to disperse the highly concentrated vitamins and minerals, the result can be nausea.

So, my first question for you is, “Are you taking your AlgaeCal Plus & Strontium Boost on an empty stomach?”
Any vitamins taken on an empty stomach are likely to cause nausea. Supplements should always be taken with food, both to provide a buffer if your stomach acid production is good and to trigger sufficient stomach acid production if your ability to produce stomach acid has begun to decline.

You don’t have to be eating a full meal; a small snack will be sufficient. However, do remember to take your Strontium Boost with a snack that does not contain calcium – an apple, a couple of whole grain (preferably gluten-free) crackers, a handful of nuts (peanuts, pumpkin seeds, sunflower seeds are fine; almonds, walnuts, cashews, sesame seeds contain calcium, so not your best option a snack when taking Strontium Boost).

Next, I’m wondering:
“What is your digestion like, normally? Any issues?”
“Has anything else – diet or medications or an infection, like the flu — changed recently?” (Having the flu can depress your stomach’s ability to secrete stomach acid for a bit, so can antibiotics if you’ve been told to take them for any reason.)
“Are you taking any prescription or over-the-counter drugs?” (Many impair digestion, not just the acid blockers.)
“How old are you?” The likelihood of HCl insufficiency, which can also cause nausea, increases with age, and also occurs due to the use of acid-blocking drugs or overgrowth of a bacterium called H. pylori, which is surprisingly common.

If you still experience nausea when taking your supplements with food, try supplementing with HCl with betaine (Here’s a link to the discussion of this in our recent ACV post for directions on how to do this: https://www.algaecal.com/expert-insights/video-lara-pizzorno-apple-cider-vinegar-calcium-absorption/).
If this does not help, you should see your doctor to rule out other causes of gastritis (stomach inflammation), such as H. pylori infection or problems with your gallbladder or pancreas — both of which are involved in digestion (the gallbladder secretes bile, pancreas produces pancreatic enzymes), so their dysfunction can cause nausea.

Connie Chiasson-Douglass
Connie Chiasson-Douglass

I ordered the AlgeaCal plus and the Strontium – can I just take the calcium without the other and still see results with diet and exercise (elliptical 3 xs a week , kettlebell 3 xs a week and yoga 2 x’s per week? or is the Strontium a must – I am 56 years old – left hip -2.45. Just prefer not to take anything that may have side effects.

Lara Pizzorno
Lara Pizzorno

Hi Connie,
I hope my full review of strontium will put to rest any concerns you might have regarding the potential for any adverse effects from the natural form of strontium, strontium citrate, which is what is present in Strontium Boost. The only form of strontium for which ADRs have ever been reported is the unnatural, drug form, strontium ranelate, which has never been approved for use in the U.S. and whose use is now severely restricted in Europe.
Yes, you will benefit from just AlgaeCal Plus (which will provide you with much more than calcium! Vitamin D3, K2 (MK-7), magnesium, boron, vitamin C — all are essential for bone health). However, because you have significant bone loss (-2.45 in your left hip), you need to avail yourself of all natural, safe means of restoring the health of your bones. Please review the dozens of ways I share from the current research in my review of strontium via which strontium promotes healthful bone formation — for all these reasons, I urge you to include Strontium Boost as part of your protocol.
Since the most current research indicates that half the typical dose of strontium (i.e., one capsule of Strontium Boost daily rather than two) is helpful, start out taking just one capsule daily — at night please, at least 4 hours after you take your PM dose of AlgaeCal Plus — since night time consumption of strontium citrate has been found most effective. This is what I do for myself. Although my bones have now been in excellent shape for several years (I was still osteopenic when I began taking AlgaeCal Plus & Strontium Boost, which fully restored the health of my bones after just 6 months), I continue to take Strontium Boost as well as AlgaeCal Plus to ensure my bones remain strong and healthy. And I make sure my husband, who does not have bone density problems, but does have knee joint problems, takes both (he also takes just one capsule of Strontium Boost at night), so he can continue to play basketball. When I started him on this protocol about a year ago now, he was limping, wearing a knee brace, and fearing his bball playing days were over. Now, he’s outplaying men half his age (he just turned 70), no brace, no limp. NO adverse side effects. (And he is MUCH happier! and recommending this protocol to other men). Please give Strontium Boost a try.

JoAnn Petrov
JoAnn Petrov

Hi Lara

I just received my AlgaeCal Plus and Strontium Boost today. Should I stop taking my Calcium supplement and my Multivitamin for Women 50+ before taking the AlgaeCal and Strontium?
I have been diagnoised with Osteoprosis.

Lara Pizzorno
Lara Pizzorno

Hi JoAnn,
Great! You’re on your way back to healthy bones! You will not need your former calcium supplement. AlgaeCal Plus provides 720 mg of calcium per day (4 capsules — 2 AM and 2 PM) and your diet should be giving you the remaining 380 mg of calcium you need to reach a daily intake of 1,200 mg/day. If you have a copy of Your Bones, please check the section on calcium where I have provided a table showing the best food sources of calcium (p. 207 in the book) along with how much calcium is present in a typical serving of each food. Keep a diet diary for 4-5 days and you should be able to easily see how much calcium your diet is providing for you. Optimal intake is 1,2– – 1,500 mg per day for someone with osteoporosis. I do not know what your multivitamin contains. You can send AlgaeCal a list of what it contains or send me a link to this supplement, so I can take a look for you, but it’s unlikely that it contains much calcium or amounts of any other nutrient that would be potentially problematic.

Cinzia
Cinzia

Hello Laura,

I take a Progessive MultiVitamin for women over 50 three times a day as suggested. That means I am getting 250 mg of calcium. I think that’s too much along with the 720 from AlgaeCal but don’t wanr to miss out on the other vitamins & minerals if I stop taking the multivitamin. Do you take a multivitamin as well? Thank you so much for your feedback. https://www.progressivenutritional.com/products/multivitamin-for-women-50

Lara Pizzorno
Lara Pizzorno

Hello Cinzia,
You should be consuming from 1,200 -1,500 mg of calcium daily. Your multiple (250 mg) plus AlgaeCal (720 mg) delivers 970 mg. Your diet should be providing at least 450-600 mg. If you have a copy of Your Bones, 2nd edition, you can use the Foods Rich in Calcium table in the book to quickly get a good estimate of the amount of calcium your foods are providing for you.
And remember, your intake of calcium should be balanced by an intake of about half as much magnesium, so 600-750 mg of magnesium daily. AlgaeCal Plus provides this balance, giving you 350 mg of magnesium, and it looks like your multiple also maintains this balance. Check your diet to see how much magnesium it provides, again, you can use the Foods Rich in Magnesium table to do so quickly if you have Your Bones. If not you can find this information on the internet, but be sure you check to see how much is being said to be a “serving”. Often what is listed as a serving is less than we typically consume or far more, so do double check.

JoAnn Petrov
JoAnn Petrov

Hi Laura

I just received my AlgaeCal Plus and Strontium Boost today. Should I stop taking my Calcium supplement and my Multivitamin for Women 50+ before taking the AlgaeCal and Strontium?
I have been diagnoised with Osteoprosis.

yanntreguier
yanntreguier

Hello Lara, would you be so kind to post links to the most recent independent scientific studies and tests done on Strontium Citrate? You recently stated the following: “Strontium, like calcium, incorporates into both trabecular and cortical bone, but strontium deposits almost entirely into newly forming trabecular bone, with one strontium ion substituting for less than one calcium ion out of 10 in the bone matrix.” I would be really interested to know 1) the exact amount that ends up as cortical bone and its incidence in making it weaker 2) to view the studies highlighting the assimilation of Strontium as trabecular bone.

Thank you!

Lara Pizzorno
Lara Pizzorno

Hello yanntreguier,

Following is my reply to your questions asking for 1) the exact amount of strontium that ends up as cortical bone and its incidence in making it weaker 2) to view the studies highlighting the assimilation of Strontium as trabecular bone.

Re #1, the specific data you requested does not exist. The research – both animal and human — does not specify the precise amount of strontium that deposits in cortical bone, but clearly show that the majority of the strontium incorporated goes into trabecular bone. Furthermore, the strontium that does deposit in cortical bone does NOT render it weaker, but more stable and resistant to fracture – as explained in this paper, which I mention again below. Riedel C, Zimmermann EA, Zustin J, et al. The incorporation of fluoride and strontium in hydroxyapatite affects the composition, structure, and mechanical properties of human cortical bone. J Biomed Mater Res A. 2017 Feb;105(2):433-442. doi: 10.1002/jbm.a.35917. Epub 2016 Oct 21. PMID: 27684387

Re #2, following are the citations of a few of these papers (all are available on PubMed) with my italics added for emphasis and my comments on the relevant text:
Pors Nielsen S. The biological role of strontium. Bone. 2004 Sep;35(3):583-8. PMID: 15336592 DOI: 10.1016/j.bone.2004.04.026.
Pors Nielsen summarizes the results of numerous studies in this review article. Here’s what he reports from the following 2 papers he discusses that is relevant to your question:
1) Boivin G, Deloffre P, Perrat B, et al. Strontium distribution and interactions with bone mineral in monkey iliac bone after strontium salt (S12911) administration. J Bone Miner Res 1996;11:1302– 11.
2) Delannoy P, Bazot D, Marie PJ. Long-term treatment with strontium ranelate increases vertebral bone mass without deleterious effect in mice. Metabolism 2002;51:906– 11.

“Strontium was dose-dependently incorporated into bone mineral of both trabecular and compact bone, mainly into new bone, and mainly into trabecular bone…No changes in the crystal lattice, in crystallinity, or crystal structure were observed. Less than one Ca ion out of 10 was substituted for by one Sr ion in each crystal
Long-term studies in rats confirmed pronounced dose-related increments in trabecular bone volume, mineralised bone volume, osteoblastic surface, and a reduction in osteoclast number, but osteoid thickness was not affected.”

Dahl SG, Allain P, Marie PJ, et al. Incorporation and distribution of strontium in bone. Bone. 2001 Apr;28(4):446-53. PMID: 11336927 again discusses that strontium primarily deposits in newly forming trabecular bone. Here’s a quote from this paper summarizing the results of several studies discussing this:
“Sr21 is taken up into bone by two different mechanisms: (1) an initial rapid mode, depending on osteoblastic activity, which is eventually saturated, and whereby Sr21 is taken up by ionic exchange with bone Ca21, binding of Sr21 to preosteoid proteins, or combinations of these; and (2) a second slower mechanism involving the incorporation of Sr21 into the crystal lattice of the bone mineral. The concept of two different phases involved in the uptake of strontium into bone has since been generally accepted — that is, a relatively rapid uptake into new bone and long-term exchange processes in old bone.”

(Lara comment —the new bone referred to here is trabecular bone; a much slower second phase of uptake occurs in cortical bone.)

“X-ray crystallographic experiments have demonstrated that incorporation of strontium into the bone of cynomolgus monkeys treated with oral strontium ranelate for 13 weeks took place mainly by ionic exchange at crystal surfaces [Lara — i.e., trabecular bone], and to a minor extent by heteroionic substitution (with a maximum of one calcium atom out of ten being substituted) into the crystal lattice [Lara—i.e., cortical as well as trabecular bone]. The differences in strontium incorporation into bones were further analyzed at a microscopic level using the X-ray microanalysis technique, and the influence of the presence of strontium on the size of the crystal was studied by X-ray powder diffraction and Raman microspectrometric techniques. These techniques were applied on bone mineral samples obtained from the iliac crest of male cynomolgus monkeys treated for 13 weeks with oral doses of strontium ranelate. The doses ranged from 100 to 750 mg/kg per day of strontium ranelate, corresponding to 34–255 mg/kg per day of Sr21. The X-ray microanalysis method provided a semiquantitative evaluation of the amount of strontium taken up by the bone mineral substance, and its localization. Combined with X-ray diffraction and secondary Raman spectroscopic images, it was demonstrated that strontium was dose-dependently taken up by the bone mineral and heterogeneously distributed in compact and cancellous bone, with a higher amount in newly formed bone tissue than in old bone tissue. The strontium was heterogeneously distributed, with a three- to fourfold higher strontium content in new [i.e., trabecular] than in old compact [i.e. cortical] bone, and approximately 2.5-fold higher strontium content in new than in old cancellous [so strontium uptake is greater in new vs older trabecular bone] bone. At all the applied doses, incorporation of strontium produced no significant change in the crystal lattice parameters, even if the ionic radius of Sr21 (1.13 Å) is slightly larger than that of Ca21 (0.99 Å) (Table 1). Neither were there changes of the cohesion properties of the mineral crystals, which exhibited properties of “young” bone (i.e., low intracrystal distances). Even at the highest dose of 255 mg Sr21/kg per day, the apatite crystals in the treated animals were intermediates between a “physiologic” calcium hydroxyapatite and an apatite where one calcium atom out of ten was substituted by a strontium atom. In vitro chemical experiments have also shown that Ca21 may be exchanged by Sr21 in synthetic calcium hydroxyapatite.”

Lara: The incorporation of strontium into bone after oral strontium treatment depends upon the skeletal site — more specifically, the amount of trabecular vs cortical bone in the skeletal site. Here’s a quote on this from the above cited Dahl et al., paper:

“The main biological determinant of bone mineralization is the rate of turnover… The skeletal repartition of strontium is related to the relative cortical and cancellous proportions of the bone, because bone turnover is higher in cancellous than in cortical bone, and newly formed bone is more abundant in cancellous than in cortical bone. This is demonstrated in Figure 5, which shows that the strontium content was higher in cancellous bone than in cortical bone of cynomolgus monkeys, treated for 13 weeks with various strontium doses. (Lara — Sorry, I cannot copy this figure here for you – copyright on the article prevents that, but you can look at the full article via PubMed)

The research conducted in the above papers used strontium ranelate, however, other papers show the same findings using natural forms of strontium, e.g.:
Peng S, Liu XS, Huang S, et al. The cross-talk between osteoclasts and osteoblasts in response to strontium treatment: involvement of osteoprotegerin. Bone. 2011 Dec;49(6):1290-8. doi: 10.1016/j.bone.2011.08.031. Epub 2011 Sep 9. PMID: 21925296:

Lara Pizzorno
Lara Pizzorno

In animal research, female rats whose ovaries had been removed (the standard protocol used to simulate human menopause) were given strontium chloride over a 2-month period. Strontium’s effect of increasing OPG production was a key factor in the following bone-protective outcomes: greater trabecular bone volume, an increase in the number of trabecular bone cells, larger areas of the bone surface occupied by osteoid cells (osteoid is the last step before final mineralization occurs to produce fully developed new bone tissue), [all trabecular bone] an increase in bone formation rate, and fewer, smaller areas of bone in which osteoclasts were active.
Marie PJ, Ammann P, Boivin G, et al. Mechanisms of action and therapeutic potential of strontium in bone. Calcif Tissue Int. 2001 Sep;69(3):121-9. PMID: 11683526:

Animal studies using strontium chloride found that within 4 weeks, strontium increased the number of bone-forming sites, trabecular bone formation and bone volume in vertebrae and alveolar bone (the jawbone), and reduced the number of osteoclasts present. [again, areas richer in trabecular bone]
Marie PJ, Ammann P, Boivin G, et al. Mechanisms of action and therapeutic potential of strontium in bone. Calcif Tissue Int. 2001 Sep;69(3):121-9. PMID: 11683526:

Administration of strontium carbonate for 6 months in osteoporotic patients stimulated bone formation confirmed by hip bone (iliac crest) [another area richer in trabecular bone] bone biopsies. Strontium carbonate administration increased both the extent of osteoblast surface and the amount of bone matrix formed, confirming that strontium increases trabecular bone formation in humans with osteoporosis.

Lara – so to reiterate, strontium deposits primarily in trabecular bone, the inner spongy portion of bone, where metabolism is much more active than in cortical bone, the outermost hard, older portion of our bones.

The very small amount of strontium that incorporates into human cortical bone also has beneficial effect, however, – the strontium that deposits in cortical bone lowers its porosity, further improving bone microstructure and resistance to deformation. Riedel C, Zimmermann EA, Zustin J, et al. The incorporation of fluoride and strontium in hydroxyapatite affects the composition, structure, and mechanical properties of human cortical bone. J Biomed Mater Res A. 2017 Feb;105(2):433-442. doi: 10.1002/jbm.a.35917. Epub 2016 Oct 21. PMID: 27684387

The most recently published human study that discusses strontium’s incorporation into trabecular versus cortical bone is Moise H, Chettle DR, Pejović-Milić A. Monitoring bone strontium intake in osteoporotic females self-supplementing with strontium citrate with a novel in-vivo X-ray fluorescence based diagnostic tool. Bone. 2014 Apr;61:48-54. doi: 10.1016/j.bone.2014.01.002. Epub 2014 Jan 14. PMID: 24434614
In this study, 10 female volunteers recruited as part of the Ryerson and McMaster University Strontium (Sr) in Bone Research Study had their bone strontium levels measured as they self-supplemented with strontium supplements of their choice (all used strontium citrate) over a 4-year period. Of the ten volunteers, nine had osteopenia and/or osteoporosis.

Strontium measurements were taken at the finger and ankle, representing primarily cortical and trabecular bone, respectively. After 24 hours, the mean strontium signal rose in both the finger and ankle, and strontium levels continued to increase in both finger and ankle throughout the length of the study.

However – and this is why I am unable to tell you exactly how much strontium is deposited in cortical and in trabecular bone in real individual people – the strontium signal varied widely between individuals such that after three years, the highest strontium signal observed was 28.15 for the finger (cortical bone) and 26.47 for the ankle in one volunteer and only 3.15 for the finger (cortical) and 4.46 for the ankle (trabecular) bone in another. These results indicate that all benefitted, although to varying degrees and also that both trabecular and cortical bone strontium levels do continue to slowly increase at both sites after 4 years of strontium citrate intake.

Here are a few quotes (italics added by me) from this paper, again stressing that strontium deposits primarily in trabecular bone:
“While the human skeleton is composed of approximately 80% cortical and 20% trabecular bone, it has been observed that Sr absorption is different between these two types of bone, with trabecular bone showing a higher Sr concentration than cortical bone, likely due to the fact that cortical bone has a slower turnover rate compared to trabecular bone. Similarly, the initial case study found that Sr levels were higher at trabecular bone compared to cortical bone and that ankle levels [trabecular bone] continued to increase, even after 24 months of strontium supplementation. This is in agreement with the findings available in the literature.”

“…the frequent bone Sr measurements in all subjects show that the Sr signal is higher in the ankle (primarily trabecular bone) than in the finger (primarily cortical bone), which is in agreement with literature findings that different bone sites will show different bone Sr concentrations.”

I hope this information is helpful for you. The key take-away here is that natural forms of strontium significantly improve our ability to build new trabecular bone and maintain healthy (older) cortical bone – a win-win for our skeletal health.

yanntreguier
yanntreguier

Thank you Lara for that thorough response! Quick follow-up questions. In the study of the 10 women supplementing with strontium over 4 years: what was their daily intake of strontium?

Has science and/or the medical field determined whether or not there is a level of strontium not to exceed in the human body? If there is a line not to cross and the studies prove that one’s strontium levels continuously increase when supplementing, how do you determine when to stop strontium intake?

Thanks!
Yann

Lara Pizzorno
Lara Pizzorno

Hi Yann,
You’re so welcome. Great questions!
In the studies that involved 10 women self-supplementing with strontium (strontium citrate)as part of the Ryerson and McMaster Strontium in Bone Research Study in Canada, 9 were taking 340 mg per day, and one was taking 680 mg/d. Interestingly, the women taking 340 mg/d had comparable or better results than the woman taking 680mg/d — an outcome the researchers thought might have been due to the fact that the women taking 340 mg/d took their strontium at night (when bone remodeling is more active), while the woman taking 680 mg/d took her strontium supplement during the day. Here’s the citation for the most recent paper on this research: Moise H, Chettle DR, Pejović-Milić A. Modeling elemental strontium in human bone based on in vivo x-ray fluorescence measurements in osteoporotic females self-supplementing with strontium citrate. Physiol Meas. 2016 Mar;37(3):429-41. doi: 10.1088/0967-3334/37/3/429. Epub 2016 Feb 24. PMID: 26910208
The key issue regarding the safety of natural forms of strontium is calcium intake, which to err on the side of safety, should be at least double that of the amount of strontium consumed. Since consumption of more than 1,500 mg per day of calcium is not recommended, consumption of no more than 750 mg/day of strontium is indicated.
Although strontium levels in bone do continue to increase over time, the number of strontium ions incorporated into the bone matrix is so miniscule– remember one strontium ion replaces less than one calcium ion out of ten, plus as bone remodeling is continuous, these strontium ions are resorbed (just as calcium ions are during normal bone remodeling), so for all practical purposes, strontium intake can be continued throughout life.
Once bone health is restored, a maintenance dose of 340 mg per day should be both safe and sufficient. This is the dose I now take myself as my bones have now been in perfect shape for several years — thank you, AlgaeCal Plus and Strontium Boost! And 340 mg/d is the amount of Strontium Boost I will continue to take to maintain that condition. I hope to be taking 340 mg/d of Strontium Boost for the next ~50 years. I’m now almost 70; the maximal human lifespan is currently thought to be ~120 years – and my son, who is just graduating from medical school this May (with honors), has had not time to even think about a relationship, much less marriage and children. I’m counting on Strontium Boost (and AlgaeCal Plus) to keep my bones in good shape for my, as yet, non-existent grandchildren.
Be well, Lara

Grace du Prie
Grace du Prie

I have just started with Strontium Citrate (also the 750mg dose). I take the Nutralife Calcium with VitD3 and VitK. I know now to separate these two. But…I also take Magnesium and usually 2 caps before going to sleep. Can I take Strontium and Magnesium at the same time? The Magnesium has these contents: Nutra-Life Magnesium Complete Ingredients:
Each capsule provides:
Magnesium (as Oxide) 197mg
Magnesium (as Orotate) 8mg
Magnesium (as Phosphate) 21mg
Magnesium (as Amino Acid Chelate) 75mg
Total Magnesium 300mg

Monica
Monica

Hi Grace,

Yes, you can take Strontium and Magnesium at the same time.

– Monica @ AlgaeCal

Lara Pizzorno
Lara Pizzorno

Hi Linda,
I’m very glad you wrote in as I am concerned about the amount of strontium you are taking.
The dosage recommended for Strontium Boost is 2 capsules daily, which supplies a total of 680 mg of strontium. Since your supplement is giving you 750 mg of strontium in 3 capsules, it looks like you are taking a different strontium citrate supplement.
First of all, 750 mg/d is an excessively high dose — higher than that used in all the research I’ve seen on strontium. Regardless of whether the form used was natural strontium citrate or the drug strontium ranelate, the maximum dose used has been 680 mg/d. I do not recommend taking 750 mg/d.
If you are going to use up your current supplement, be sure you are getting twice as much calcium as strontium from your food and the supplements you are taking. This would be 1,500 mg of calcium per day, which is greater than the 1,200 mg RDI for calcium for postmenopausal women.
If you are going to be taking 1,500 mg of calcium daily (which I also do not recommend), then you need to balance that by ensuring your diet and supplements are providing you with half that amount of magnesium, or 750 mg of magnesium daily.
The expiration date for your supplement should be listed on the bottle. You’ll find the expiration date for Strontium Boost clearly printed on the bottom of each bottle. A bottle of Strontium Boost will be good for 2.5 years. The batch of Strontium Boost I ordered and received this June (June 2017) for myself and my husband has an expiration date of 1/2020.

If you are taking AlgaeCal Plus and Strontium Boost, these supplements will automatically be providing you with optimal, balanced doses of calcium, magnesium and strontium — one of many reasons I rely upon these supplements for myself. If you are using something else, please do check that your diet and supplements combined are not giving you more than 1,200 mg of calcium, 600 mg of magnesium and 680 mg of strontium citrate each day.
In Your Bones, 2nd edition, I have provided tables for calcium and magnesium listing commonly eaten food sources and the amount of each mineral provided in a typical serving, hoping to make it easy for you to figure this out. And, of course, you can run a search for food sources of calcium and magnesium on the internet to get this information. Just check that the websites listing this information have derived it from the USDA National Nutrient database.
Be well,
Lara

LINDA WELLS
LINDA WELLS

I have some older bottles(2 years) of strontium citrate—3 caps = 750mgs. First, does strontium expire? Secondly is 750 mgs an unadvisable dose. I do have mild osteoporosis.. I do take adequate amounts of calcium, magnesium and vitamin d3. Thanks

pam dassel
pam dassel

I too have the same concern about the replacement of bone with strontium vrs calcium. this does not seem like it honors the natural biological process of building bone structure.
I understand that strontium is an element with a higher weight on the periodic table and therefore occupies more space or creates a “denser” appearing bone structure on a DEXA. I want to build bone but am apprehensive about replacing calcium with strontium. I would appreciate your best scientific information Laura. I have read your book,Your Bones and not really found a specific answer to this question . thank you
pam

Lara Pizzorno
Lara Pizzorno

Hi Pam,

I’ve recently written an update of my earlier article on strontium that should be posted on AlgaeCal very shortly. The new article covers all the latest research and will answer your questions and concerns in (probably far more) detail than you want to wade through!

So, I’m writing you directly with a brief summary of some of the relevant information provided in my update on strontium, which I hope will allay your concerns.

Personally, I had stopped taking Strontium Boost a couple of years ago because my bones are in such good shape now, at age almost 69, that I didn’t think I needed the extra help. But, after reading all the current research (more than 70 papers) on strontium, I started taking it again at a half dose to ensure my bones remain healthy. My husband, Dr. Joe Pizzorno, is approaching age 70 and still playing basketball with men half his age; I had him read my review and he has started taking strontium at a half dose as well to protect his knees as I also showed him some good studies showing strontium helps maintain healthy cartilage in the joints.

Okay, here’s a quick overview of some of the information in my updated strontium article that is relevant to your concerns:

Strontium’s beneficial effects are NOT due to its replacing calcium in your bones. Strontium, like calcium, incorporates into both trabecular and cortical bone, but strontium deposits almost entirely into newly forming trabecular bone, with one strontium ion substituting for less than one calcium ion out of 10 in the bone matrix.

When you take strontium, it will take the place of an extremely small number of calcium ions, but this tiny amount of strontium will have MANY very positive effects on your bones’ ability to not just rebuild, but to become more resilient and resistant to fracture.

Again, I want to underscore that strontium’s beneficial effects on our bones NOT due to its taking the place of calcium. They are the result of strontium’s very positive bone-building effects on virtually all the key molecules involved in bone remodeling, including the following:

    RANKL &OPG: RANKL binding to RANK stimulates osteoclast production and activity; strontium inhibits RANKL binding. OPG is a decoy for RANKL and binds to RANK, decreasing osteoclast production; strontium increases OPG production.
    Wnt signaling: Wnt signaling is involved in osteoblast production & activity; strontium triggers Wnt signaling.
    Osteoblasts: Strontium increases the rate at which these bone-building cells are produced and increases their lifespan
    Osteoid: Osteoblasts secrete osteoid, the unmineralized portion of the bone matrix, as the first step in their bone building process. Strontium increases osteoblasts’ production of osteoid.
    Osteoclasts: Strontium inhibits the production of these bone-resorbing cells and the rate at which they remove old bone
    Mesenchymal stem cells: Exposure to strontium promotes these precursor cells’ development into osteoblasts rather than into adipocytes (fat cells)
    Osteocalcin: Osteocalcin is the vitamin K-dependent protein that, when activated by K2, delivers calcium into bone. Strontium increases the production of osteocalcin
    Strength/stability of apatite crystals – Apatite, which is composed primarily of calcium + phosphate, is the basic mineral component used in our bones and teeth. The apatite crystals that contain strontium ions are more stable, have more regular shapes and are more resistant to stress.

I hope this information helps – it is ALL fully referenced by articles in the PubMed listed journals – all the references will appear in the article with links to the papers once published.

Be well!
Lara

GARRETT CLINGWALL
GARRETT CLINGWALL

I can take strontium citrate with juice or tea?

Monica
Monica

Hi Garett,

As long as the juice or tea does not contain calcium. Some juices will add calcium carbonate to it so check the label, or if you drink tea, avoid any added milks or creams.

– Monica

Lynn Heney
Lynn Heney

I just started taking AlgaeCal Plus and Strontium Citrate.
I take a PPI for stomach issues.
Will this affect the absorption of the AlgaeCal Plus and Strontium Citrate.

Monica
Monica

Hi Lynn,
If you are taking AlgaeCal Plus and Strontium Boost, please take your PPI 4 hours apart so it won’t affect absorption.
– Monica

Lynn Heney
Lynn Heney

I just started taking AlgaeCal Plus and Strontium Citrate.
I take a PPI for stomach ulcers which is time release and works for 24 hours.
Will this affect the absorption of the bone building products?

hotel frankfurt-Oder
hotel frankfurt-Oder

Howdy! I just want to give an enormous thumbs up for the great info you’ve here on this post. I shall be coming back to your blog soon.

Lara Pizzorno
Lara Pizzorno

Hi Anne,

Thanks for sending me a link to this study.
I am just now going back over all the research on strontium and will be posting a full article on all this in the very near future. But, meantime, here are my thoughts in reply to your comment.

Yes, I do think strontium citrate may be of significant help to postmenopausal women with low bone density. Strontium both lowers osteoclast production and activity and increases osteoblast production and activity. Supplemental strontium — as part of a bone-building program that includes optimal amounts of calcium, magnesium, boron, trace minerals, vitamin D3 and vitamin K2 – can help hasten the rebuilding of healthy bones. From recent papers that I’ve read, which have shown these beneficial effects of strontium at half the dose typically recommended, I think a dose of 340 mg per day rather than the full 680 mg dose that has been standard may be all that is needed.

In regards to the study you ask about, published in Environmental Research in 2012, that suggested strontium might increase risk of breast cancer, thank you for bringing it to my attention! I pulled and read the full paper. What they found was that an increased risk of HER2/Neu+ breast cancer was seen only in premenopausal women with the highest levels of strontium in their urine.

The researchers hypothesized that strontium — like calcium — may activate a calcium-sensing receptor on breast cells that increases the expression of estrogen receptors, and thus have an “estrogen-like” effect. Postmenopausal women, who are no longer producing adequate estrogen, will benefit from such an estrogen-like effect, but increased ER activity in young women, who are already producing plenty of estrogen, could result in over-expression of an oncogene (cancer-promoting gene) called ERBB2.

ERBB2 encodes a protein called HER2 (from human epidermal growth factor receptor 2) or you may see it referred to as “HER2/neu.” HER2 is a member of a family of human epidermal growth factor receptors (the HER/EGFR/ERBB family). Signaling through this family of receptors promotes cell proliferation and opposes apoptosis (cell suicide), so too much signaling can increase risk of uncontrolled cell growth, i.e., breast cancer.

Over-expression of the ERBB2 gene (also referred to as “amplification”), occurs in approximately 15-30% of breast cancers and has been shown to play a role in the development and progression of certain types (the ER+ or HER2/Neu+) breast cancers. In recent years, HER2 has become an important biomarker and target of therapy for approximately 30% of breast cancer patients.

So, what’s the take-away from this paper by Chen LJ et al.? I’ll quote them: “…strontium may interact with estrogens to promote carcinogenesis among young [premenopausal] women, because young women have more estrogens and estrogen receptors.”

Chen LJ, Tang LY, He JR, et al. Urinary strontium and the risk of breast cancer: a case-control study in Guangzhou, China. Environ Res. 2012 Jan;112:212-7. doi: 10.1016/j.envres.2011.11.005. Epub 2011 Dec 15. PMID: 22172139

After reading a number of the papers Chen LJ et al. cited in the development of their hypothesis, I looked to see if any further research had been published since 2012 to confirm their theory. I could find nothing about strontium possibly increasing risk of breast or any other form of cancer, only papers discussing the use of a radioactive isotope of strontium called Strontium-89, which is being used to effectively treat bone metastases in cancer patients with breast and other cancers. Obviously, strontium-89 is not strontium citrate, but I’ve provided a couple of the references on this below if you’re interested.

Zenda S, Nakagami Y, Toshima M, et al. Strontium-89 (Sr-89) chloride in the treatment of various cancer patients with multiple bone metastases. Int J Clin Oncol. 2014 Aug;19(4):739-43. doi: 10.1007/s10147-013-0597-7. Epub 2013 Jul 24. PMID: 23877652
Yamaguchi Y, Uejima C, Tada Y, et al. [Breast Cancer Patient with Bone Metastases Who Was Able to Return Home without Using Opioids after Administration of Strontium-89 Chloride]. Gan To Kagaku Ryoho. 2016 Sep;43(9):1105-7. [Article in Japanese] PMID: 27628553

The bottom line here: To err on the side of safety, I would not recommend the use of strontium citrate in young, premenopausal women. Postmenopausal women with low bone density are likely to benefit from strontium citrate.

Betsy
Betsy

Hello –
I just came across this thread and have a question. I’m on an estrogen-blocker after having had breast cancer three years ago. I already had osteoporosis before I started on the drug and this drug is known to cause bone loss so I’m happy to have found algae cal plus, but do you have thoughts about whether the strontium is necessary or safe under these circumstances?

Thanks so much!

Megan AlgaeCal
Megan AlgaeCal

Hi Betsy, thank you for reaching out!

If you are taking an aromatase inhibitor, you can safely take Strontium Boost alongside this type of medication. Not only are there no contraindications between the aromatase inhibitors and any of the minerals or vitamins in AlgaeCal Plus and Strontium Boost or the omega-3 fatty acids, curcumin and astaxanthin in Triple Power, but each of these nutritional supplements will help lessen the bone loss!

Hope this helps! If you have any other questions or need clarification, please feel free to email [email protected] or call our Bone Health Consultants at 1-800-820-0184!

– Megan @ AlgaeCal

Anne Walch
Anne Walch

Hello Lara,

I was wondering if you had seen this article from Univ of Toronto, re lyme (borrelia burgdorferi) causing bone loss? https://www.utoronto.ca/news/u-t-researchers-find-ancient-iceman-s-infection-helps-lyme-disease-bone-loss-discovery

“The bacteria were not only detectable in the bones of mice, they were seen to cause significant bone loss in the longer bones, mere weeks after infection.

In fact, the bone loss developed at a rapid rate, taking just four weeks to advance to osteopenia, a forerunner to the more severe form of bone loss disease, osteoporosis. The study found that the amount of bone loss directly correlated to the bacterial load found in the bones. The more bacteria present, the greater the rate of bone loss.”

This is relevant to me (lyme and severe osteoporosis) and with a pandemic of lyme (say the clinician’s in the trenches treating lyme), this is probably relevant to a lot of your readers.

Thanks for all you do,

Lara Pizzorno
Lara Pizzorno

Hi Anne,
Thanks for sharing this research! That a chronic infection might promote bone loss makes a lot of sense. As you know, bacteria, both by their very presence and also in reaction to the byproducts of their own metabolism, provoke an inflammatory response by the body’s immune system. Inflammation, when chronic, promotes destruction of tissue in the joints (thus the osteoarthritis already noted) and activates osteoclasts excessively, increasing the rate of bone turnover. Since osteoblasts’ rebuilding of bone takes much longer than osteoclasts’ removal of bone, the end result is loss of bone mass. The immune system may react more strongly to some bacteria, such as those that cause lyme disease (borrelia burgdorferi), than others.
If you carry a source of chronic infection, what can you do to lessen the effects on your joints and bones? You want to identify and eliminate as fully as possible ALL other sources of inflammation in your diet, environment and lifestyle. One very important factor to consider is vitamin A. Vitamin A is the key nutrient required for immune tolerance (vitamin A is involved in causing the immune system to produce regulatory T cells of the IL-10 strain, which help tune down and resolve inflammation), and many of us are not getting adequate vitamin A, which also works in partnership with vitamin D and should be consumed in comparable amounts for the optimal benefits derived from both nutrients. The only really good food source of vitamin A is liver, which few of us consume regularly any more (and if you do eat it, PLEASE be sure to only consume organic liver!) Until about 8 years ago, it was assumed that everyone could convert beta-carotene to vitamin A, but we now know that, in fact, the vast majority of us are not able to make this conversion because our genetic inheritance includes slow or completely ineffective versions of the key enzymes responsible for this job. Back in 2009, I wrote several medical journal articles about all this, which are still posted free access on the Longevity Medicine Review website. Here is a link to one of these articles:http://www.lmreview.com/articles/view/vitamin-a-tolerance-extends-longevity/
I suggest you ask your doctor to run a test to have your vitamin A levels checked, and if they are not well within the normal range, that you consider supplementing with an amount of vitamin A comparable to the amount of vitamin D3 you consume. The UL for vitamin A is 70,000 IU per week or 10,000 IU per day. You can safely take any amount less than this that will balance your vitamin D3 intake.
Another action you can take that can dramatically lower your inflammation and help protect your joints and bones is to take 2 tablespoons daily of Triple Power. I’ve written a number of articles on the necessity of having adequate supplies of EPA/DHA to protect the health of our bones, which I believe you can access on AlgaeCal’s website. Triple Power also delivers 2 highly effective natural anti-inflammatory compounds, curcumin and astaxanthin. The combination of all 3 is synergistic.
Personally, I rely upon both vitamin A, which I take in an amount equivalent to the vitamin D3 I need to take, and 2 tablespoons of Triple Power each day, to keep my inflammation down and to protect not just my bones but my overall health. I love to exercise, have been addicted to barre classes for the last year and a half, and push my body quite hard, taking one class every day and two back-to-back classes on the weekends. I find if I am good about taking my vitamin A and Triple Power, I am rarely sore the next day. When I don’t remember, I pay for it!
I very much hope this information will be of help. It’s impossible to avoid all the things in life that provoke inflammation, but there is much we can do to combat it and stay well! Lara

Kim
Kim

Will taking AlgaeCal help with bone loss in jaw due to tooth loss and dentures?

Megan AlgaeCal
Megan AlgaeCal

Hi Kim!

AlgaeCal is clinically supported to improve bone density. While a bone density scan will typically measure critical fracture sites such as the spine and hip, you can be assured that benefits are being seen elsewhere in the skeletal system. For more information, feel free to give our Bone Health Consultants a call at 1-800-820-0184 🙂

-Megan @ AlgaeCal

Jannine
Jannine

Thank you so much for responding, Lara and for responding so quickly. I apologize for posting my message twice. Initially, it did not appear that my first message went through.

I have tried to identify any new substances in my environment and haven’t been able to identify a single one. I am very conscientious of my diet and eat very, very few processed foods. That said, your suggestion is a good one and I will keep a diary for a couple of weeks and see if something turns up.

Thank you again for your response. It really helped put my mind at ease.

Jannine
Jannine

Hello Lara, thank you for the information you have provided on this site. I have learned quite a bit about strontium citrate, including how/when to take it. I took the strontium citrate via a supplement through Orth Molecular called “0ro Bono”. That supplement is broken up into “AM” and “PM” formulations. The “AM” packet contains 1g of strontium citrate. I took it for a few weeks, but didn’t realize that I should also have avoided calcium in food when taking the “AM” packet that contained the Strontium Citrate, so I now realize that I should have avoided eating my cereal and almond milk for breakfast, as it contained calcium. My question is, are there any negative side effects of taking the strontium citrate and calcium around the same time? I am asking because I am getting small, itchy red bumps on my skin as well as my ski feeling kind of sun burned and wondering if it could be related to the strontium citrate. Your thoughts would be much appreciated.

Lara Pizzorno
Lara Pizzorno

Hi Jannine,

I have replied to your similar comment above.

– Lara

Jannine
Jannine

Hello Lara, I have learned a great deal about strontium citrate and the other bone supplements reading the answers to the questions posted. Thank you! One thing I learned was not to eat any calcium rich foods within a couple of hours of taking the strontium citrate. I did not know that; I did take the strontium citrate shortly after eating my breakfast cereal with almond milk, which was fortified with calcium. I now know that the strontium citrate was not likely too well absorbed, but are there any negative side effects of taking strontium citrate and eating a calcium rich meal? I have been breaking out in several small red itchy bumps all over my body and my skin feels “chapped”, including my eye lids. I only took the strontium for a few weeks, but could my skin issues be an side effect of the way I took the strontium citrate? I did take my actual calcium, Vit D, Magnesium, B vitamins, etc…later in the day as well. Your thoughts on this would be most appreciated. Thank you!

Lara Pizzorno
Lara Pizzorno

Hi Jannine,

The only negative effect of taking strontium citrate along with a calcium-rich meal is that you will get little, if any, benefit from the strontium. As I explained, calcium and strontium compete for absorption, and calcium will always be preferentially absorbed.

Regarding your skin — it is extremely unlikely that strontium is the cause of your itchy bumps or chapped-feeling skin. Strontium ranelate — the prescription drug form of strontium — is associated with a very serious rash-like syndrome called DRESS syndrome, so if you were taking that, I would be telling you to head to the emergency room right away!. Strontium citrate, however, has never been found to cause this — or any of the other ADRs produced by strontium ranelate.

You are most likely to be having a reaction to something in your environment — a housecleaning, hair or body care product you are using. Or you could have become sensitive to some component in your food. A number of the plethora of supposedly safe food additives in processed foods–preservatives, food colorings, “fake” flavorings, etc.–may be problematic in some individuals.
Also, if your digestion is impaired or you are taking an acid-lowering drug, you will not be properly breaking down the proteins in your food, and undigested protein fragments that gain entry into your bloodstream can provoke many kinds of adverse reactions, including the skin symptoms you are experiencing.

I suggest you take a careful look at the labels on the housecleaning and body care products you are using and eliminate any that may be suspect for 4-5 days. Also read the labels on the processed foods you eat — anything that comes in a can, box or plastic package and has a bunch of chemicals added. If something has lots of additives, eliminate it. It would also be a very good idea to increase your intake of probiotics (beneficial digestive tract bacteria). Yogurt is a great option here — if dairy products agree with you, look for whole milk, organic yogurt from pastured cows, which will also provide vitamin K2 as well as calcium for you. It’s important that the yogurt be full-fat, not reduced fat. Vitamin K2 is fat-soluble — it’s in the fat, so when the fat is removed, so is the K2. My favorite is plain, organic, whole milk Greek yogurt — we have a dish full every night along with some berries or other fruit and a handful of nuts or gluten-free granola for dessert. Try this and your taste buds as well as your digestive tract and bones will be delighted with you. If you cannot tolerate dairy, then look for yogurt made from organic soybeans or coconut. Kombucha is another excellent dairy-free source of pro-biotics. And so are my gluten-free sourdough breads — you can find the recipes here (add link)

Please just try these suggestions for 1 week — you are very likely to not only see your skin issues resolve but to feel more vital overall. Let me know how you do.

Be well,
Lara

samson
samson

Thank you so much for this information. I was a bit nervous about taking the strontium after reading certain websites, so the research has put my mind at ease.

Johna750
Johna750

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Loretta

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Joe
Joe

Great article, it clears up my concern for safety and Strontium! I was wondering what your thoughts are regarding taking strontium citrate along with Boron to help build stronger bones? And is Boron safe in your opinion?

Lara Pizzorno
Lara Pizzorno

Hello Joe,

Thanks for the compliment, very glad my article set your mind at ease regarding the use of strontium citrate to safely help you rebuild healthy bones.

Regarding boron, this trace mineral is also definitely needed. It is required for a reaction that occurs in the kidneys in which vitamin D is converted into its most active form (the form in which it is going to enable your body to effectively absorb calcium) and for the conversion of estrogen into the form in which it increases the bones’ absorption of magnesium, a key component of the crystal latticework that gives structure to our bones, (and yes, men produce — and need — a wee bit of estrogen; this tiny amount is critical for men’s bone health). I explain all this in detail in Your Bones, 2nd edition, pp. 223-224.

Although you only need 3 milligrams of boron daily, this is a trace mineral that is difficult to get even in that small amount from the diet. So it is best to take a supplement. You can, of course, purchase boron separately (and have to open yet another bottle and take yet another pill every day), but I, personally, just rely on AlgaeCal Plus, which contains not only the calcium our bones require, but also the 3 milligrams of boron, plus magnesium and vitamin D3.

Hope this helps, Lara

Lara Pizzorno
Lara Pizzorno

Hi Linda,
Great! As I mentioned, there have been no reports of stomach upset caused by the natural form of strontium, strontium citrate, in any of the studies conducted over the last 100+ years.
Re what I eat for lunch — typically, I have lots of vegetables (raw salads –e.g.,greens, cole slaw, cucumber salad, lightly steamed vegetables like broccoli, carrots, cauliflower and/or roasted vegetables like beets, squash, potatoes, yams, etc.). For protein, I add in a hard boiled omega-3-rich egg or 1/2 cup of beans (black beans, garbanzos, lentils, pinto beans, etc), or a couple of ounces of omega-3 rich fish (canned sardines, salmon, mackerel — all are extremely low in mercury, quick and easy to fix). When available–as now in our garden–I top my raw greens salad with some fresh blueberries. I also often add a handful of organic nuts (walnuts, pumpkin seeds, pine nuts, almonds, cashews, pecans–etc.) I use organic extra virgin olive oil and balsamic vinegar for salad dressing. I eat the calcium-dense foods (e.g., yogurt, goat cheese, cottage cheese, soymilk enriched with calcium, tofu, spinach) at breakfast and dinner. We do not eat meat, but if you do, be sure you choose meat from pasture-fed animals, not feedlot beef or cows that are given corn (which is typically GMO as well!) Meat from free range, pastured animals should be good for you — when consumed in small amounts along with plenty of vegetables.
Re wheat — I have just wrapped up my review of Alessio Fassano’s lecture on wheat/gluten-containing grains at the Institute for Functional Medicine’s 2013 symposium. In doing so, I read through much of his published research and that of a number of others regarding gluten. I will no longer eat it! Human beings cannot properly fully digest gluten — even if no apparent digestive upset occurs, it still is provoking at least 5 different and very nasty immune system reactions, plus causing a leaky gut. Gluten is a MAJOR contributing factor to all forms of auto-immune disease and its preferential target in the body is the brain and nervous system. NO THANK YOU! There are quite a few other delicious grains we can have — including quinoa, millet, brown rice — if we want the extra carbs. I find my body has more energy, sleeps better and just feels better when I minimize my grain intake. I do much better with starchy whole vegetables like potatoes, yams, corn, beets, winter squash. These are very filling and delicious and suit my physiology better than grains. You simply must experiment and see what works best for you. Regardless,, however, I urge you to NOT EAT GLUTEN-CONTAINING GRAINS! Modern wheat has been hybridized greatly over the last 50 years and is also deanimated (a process used to make the flour water soluble, so easier to use for food products) — the end result of all this is that modern wheat is MUCH more destructive to us than wheat used to be. It will definitely cause inflammation in your body — and as you know if you have read Your Bones — anything that provokes chronic inflammation activates osteoclasts excessively and causes bone loss.
Stay well, Lara

linda munnoch
linda munnoch

Hi Lara, Thanks for your reply. You were correct. It must have been something else that upset my stomach and I am now taking all the pills with no side effects. Interesting what you are saying about gluten. I’ve been attending a homeopathic doctor for 25 years now and she always advises her patients to adopt a wheat free diet. Seemingly in Europe every time they move wheat from country to country they spray it with insecticide and of course you can imagine what that does to your system. I’ve noticed in your previous posts that you take your strontium with lunch. May I ask what sort of foods you eat so that they don’t compete with the strontium? Thanks again Linda

linda munnoch
linda munnoch

Hi Lara, Thanks so much for your fantastic reply. Just finished your book-absolutely brilliant. I learned so much! So I’ve got my algae cal my strontium, I’m having my vitamin d levels checked and my doctor was very sympathetic to the regime I wanted to try.I took my 3 strontium tablets (strontium boost) last night and, trying to phrase this delicately, three hours later I was trotting to the loo. Needless to say I’m feeling a bit exhausted this morning. Should I introduce the strontium gradually, building up from one pill to two to three over a period of time or should I take one pill three times a day? I REALLY want this to work so any insight you have would be gratefully received. All my love Linda

Lara Pizzorno
Lara Pizzorno

Hi Linda,
You are so welcome! Delighted you are working with a receptive physician! You are most likely an ambassador of new information for your doctor, and hopefully, what will be learned will get passed on to help other patients as well.
Re strontium — I have not heard of its causing diarrhea (sorry, less delicately phrased), but the first rule, ALWAYS, is to trust YOUR own body and its reactions to anything recommended. Absolutely, cut back to 1 capsule of strontium and see how that works for you. It’s possible you reacted to something else you ate or were exposed to (environmental chemicals, bacteria, etc.) and not the strontium citrate. Just go very slowly and see what happens. If you tolerate 1 capsule, after several days of taking just 1, take 2, and see how you do. Taking 1 capsule several times a day will be a bit of a hassle as you must take strontium several hours before or after consuming calcium, so it would be easier to take 2-3 at once. But remember, YOUR body may prefer a lesser dose, period. Even 1 capsule per day is going to be doing some good for your bones.
Let me know how your personal clinical trial turns out, and Be well!

PS–if you are eating gluten-containing grains, I urge you to consider eliminating them (wheat, barley, rye). The latest research, which I am just now writing up for medical journal articles for docs after hearing about all this at the Institute for Functional Medicine’s 2013 symposium, clearly shows that humans are unable to fully digest gluten; we can only break it down into indigestible peptide fragments, one of which, called gliaden, will cause not just diarrhea, but is now being shown to promote all kinds of autoimmune diseases — not just celiac disease, but Hashimoto’s thyroiditis, multiple sclerosis, rheumatoid arthritis, even cancer. Modern wheat has been greatly hybridized over the last 50 years and contains WAY more gluten (gliaden) than wheat used to, and the food industry now also “deanimates” wheat to make it water-soluble, and thus easier to use in producing products. The end result of all this is that wheat has become much more harmful for us. It will definitely be causing inflammation for you, and as you know after reading Your Bones, chronic low grade inflammation actives osteoclasts and causes excessive bone loss. If you want to read more about all this, the head of the research team primarily involved (now at Harvard) is Alessio Fassano, MD. You can look him up on Google — much is now being written about this, and not just in the medical journals, but also for the public at large.

Charlotte
Charlotte

Hi Lara,

Thank you so much for all the information and support you have given us! I just finished your book and it confirmed that what I have been doing for four years is indeed working. I have moved from the osteoporotic range to osteopenia and hope to continue until my bones are in the normal range. Thanks for your thorough research and thoughtful insights in writing Your Bones!

My question is this (and I apologize if it’s been asked before):
Some have said that strontium replaces calcium in the bones. I know that we take them separately so they won’t compete for absorption because calcium will win. But in taking them separately, does strontium replace calcium in the bones? I always thought it just added to the calcium and helped strengthen. If it does replace calcium, where does the 1200 mg of calcium go? K2 is supposed to direct it to the bones and teeth and not the arteries. If strontium is replacing calcium in the bones, where is it going?

This is a subtle distinction, but I’m wondering if people are misinterpreting the instruction to take strontium separately. Please clear this up and let us know whether taking the two minerals separately just allows both to remineralize bones, or causes strontium to replace the calcium in bones.

Thanks again for all you do, and especially your prompt and informative responses on this blog!
Charlotte

Lara Pizzorno
Lara Pizzorno

Hi Charlotte,

So delighted you have been helped by the information in Your Bones! YOU are the reason I wrote the book.

Actually, no one has asked whether strontium “replaces” calcium in our bones. A great question. You are correct that, taken in recommended amounts — no more than half as much strontium as calcium — strontium adds to the bone matrix and helps not only strengthen bone but improves bone quality and ability to resist fractures. If strontium is taken in excess of calcium, more strontium than calcium will be available in the body to be used in bone, so more strontium than calcium will be incorporated into the bones, and at least in baby rats, whose skeletons were rapidly developing and who were given no calcium and lots of strontium, ricket-like bone abnormalities developed. This is why you want to be sure to be consuming twice as much calcium (from diet and supplements combined) as strontium. Your bones are quite capable of using both the 1,500 mg of calcium AND 680 mg of elemental strontium recommended for daily intake for postmenopausal women not on bio-identical hormone replacement (I say only BHRT here as conventional HRT is a very bad idea for many reasons!)

Calcium and strontium should be taken separately because they compete for absorption — and calcium will always win, so your bones will get little benefit from the strontium you take if you are consuming it at the same time as calcium.

One other bit of information about calcium — this mineral plays MANY essential-to-life roles in our bodies besides its use in our bones and teeth. Calcium is critical for maintaining acid/alkaline balance (called pH) in the blood. When blood pH begins to drop too low (down to 7.35 from a baseline of 7.4), calcium is immediately withdrawn from our bones to restore proper pH in our blood — because proper pH is essential for numerous critical life functions, including processes as varied as breathing rate and the ability to transport oxygen throughout our bodies via red blood cells. Calcium is also required for our nerves and muscles (including our cardiac muscle, the heart) to function properly. Proper calcium balance inside and outside of nerve cells is required for sodium to flow in and out of these cells, and this flow of sodium is the way in which nerves conduct signals to and from the brain. When our nerves send a muscle cell a signal to fire, the muscle cell responds by allowing a flood of calcium to enter, and it is calcium’s entry into the muscle cell that initiates the cascade of reactions that result in making the muscle cell contract. In sum, calcium has plenty to do for us in addition to its use in maintaining healthy bones and teeth.

Shaine
Shaine

Hi Lara:
I recently had a DEXA scan which showed some improvement in my bone density. This test was measured against a Dexa Scan from 2011 when I had also been taking strontium citrate. I am still, however, in the osteopenia range (but at 85%-89% of normal). I I have been using algae cal for about 8 months and I also use Drs. Best Strontium Citrate. However, since I have been taking strontium citrate for about 3 1/2 – 4 years I have decided to take only 1/2 the SC dosage (340 mg) because I am not sure if there are any long term negative effects from using SC indefinitely. I would like to hear your opinion regarding how long you feel one can take Strontium Citrate.
In addition, rather than take the full 4 tablets of algae cal, I am increasing my calcium consumption from food and plan on reducing the algae cal to 3 tablets daily. What is you opinion of this?
Looking forward to your response.
Shaine

Lara Pizzorno
Lara Pizzorno

Hi Shaine,
Wonderful that your bone density is improving! A number of medical experts now recommend that, once bone density has moved out of osteoporotic and into osteopenic range (which you now are), the dose of strontium citrate can be cut in half. I agree with you that long-term use of strontium citrate at the full dosage may not be optimal, and why risk it? You are supporting your bone health by taking AlgaeCal Plus along with ensuring your diet is providing adequate calcium — from healthful, organic whole foods, such as leafy greens, organic dairy products from grass-fed cows, organic GMO-free soyfoods — correct? If so, then I think your plan is excellent. Stay well, Lara

John McDonald
John McDonald

Hi Lara

Many thanks once again for all your answers to the questions on this blog and also for the

wealth of information in your books. I have a question re. the time interval between the

servings of Calcium. It feels more comfortable for digestive purposes to take the Strontium

with other food rather than, for example, late at night before lying down in bed. Also

breakfast time seems to be the meal which is most easily controlled for Calcium intake and

therefore Strontium is taken at this time. The first serving of the Calcium supplement is then taken

around lunchtime which also includes dietary Calcium and then the second serving some six

hours later at evening meal which again includes dietary Calcium. I wonder if the interval

between Calcium intakes is too short. Should the Calcium supplement be taken morning then

evening for better absorption or is the schedule of Strontium – Calcium – Calcium, with the

three meals of the day, equally effective. Your advice would be much appreciated.

John M

Shaine
Shaine

Lara:
I attempted to send this email last evening but I don’t think it sent.
An individual on the osteoporosis Inspire site wrote about elevated blood serum levels due to her consumption of the supplement strontium. She had test results from a strontium/serum/plasma/urine test that far exceeded the normal ranges. Normal range per her information is 10.0 to 45.0 ng/ml. Her range was almost 2,000 ng/ml ( which she indicated was over 4,000 higher than normal).
Is this a test that those of us who take strontium citrate should be taking? Should we be cautious of test results and monitor the amount of strontium citrate in our systems. Are high levels indeed toxic?
PLEASE comment about this. Many of us do take strontium citrate and do rely on much of the information that you provide.
Thanks, Shaine

Lara Pizzorno
Lara Pizzorno

Hi Shaine,
A number of people contacted me about this discussion group on the NOF. I sent the following reply to one of them to share there:

I found the discussion and have been looking – and looking and looking – for any research showing strontium citrate is toxic. I could find nothing. Only beneficial effects for strontium citrate. And as I wrote in my post on strontium that is still up on AlgaeCal’s website, no research conducted over the last hundred years shows any toxicity from strontium citrate – IF more calcium (I and Dr. Wright and many others recommend twice as much calcium to be on the extremely safe side) is being consumed. Outside of 2 studies conducted more than 50 years ago in which WAY more strontium was consumed along with virtually no calcium and ricket-like bone malformations occurred, the only adverse health effects noted in the peer reviewed medical literature with strontium are seen the patented drug version, strontium ranelate, which significantly increases risk for VTE and DRESS syndrome plus a number of other unpleasant but less deadly effects. My apologies, but I don’t have time right now to repeat the full discussion, but it and all the references can be found on AlgaeCal’s blog.

This being said — we must ALWAYS trust our own bodies when our personal results don’t match up with the research – no matter how “august” and “respected” the medical journals or how many studies have been published showing something that our own unique body is not agreeing with! I cannot emphasize this enough. We are each UNIQUE. I think arrowsp’s suggestion that for SCW strontium absorption may take more time than is “average” so abnormally high levels might have still been present in her blood when the test was run is certainly worth considering.

Some other things SCW might consider and discuss with her doctor:

I am wondering, “how much calcium is SCW taking?” If she is consuming 680 mg elemental strontium daily, then she should be getting at least twice that amount (1360 mg) of calcium each day from her diet and supplements.

Were her blood calcium levels also measured? Is she able to absorb calcium effectively? Or is there some issue with her ability to absorb calcium as well? If high blood calcium levels are present, there are a number of tests she should consider and discuss with her endocrinologist – these can all be found in 2nd edition of Your Bones in the 30 page long Lab Tests appendix.

How much vitamin D3 (I hope she takes D3 as it is significantly more effective for us than D2) is she taking? What are her vitamin D levels — her (25(OH)D blood levels? Optimal is 60-80 ng/mL; the 30 ng/mL level, which many docs still refer to as just dandy, is barely above frank deficiency.

Calcium and strontium compete for absorption and calcium will always win, which is why it is recommended that strontium supplements be taken apart from when calcium is consumed. If SCW took calcium (or ate foods rich in calcium) when she took her strontium, the calcium would have prevented strontium’s absorption.

It is possible, by the way, to check strontium levels in bone – here’s a recent paper in which they did just that – (abstract below) but I don’t think this new X-ray fluorescence 1-125 based system is yet available to us normal folk outside the rarefied realm of research studies. I will be looking for it as this would be a very useful test for those of us taking strontium.

This study was done to see how much strontium this osteoporotic woman’s bones were absorbing from a strontium citrate supplement (680 mg elemental strontium per day) and whether the beneficial effect continued after 800 days– it did.

Bone. 2012 Jul;51(1):93-7. doi: 10.1016/j.bone.2012.04.008. Epub 2012 Apr 23.

Monitoring bone strontium levels of an osteoporotic subject due to self-administration of strontium citrate with a novel diagnostic tool, in vivo XRF: a case study.

Moise H, Adachi JD, Chettle DR, Pejović-Milić A.

Source

Department of Physics, Ryerson University, Toronto, Canada.

Abstract
A previously developed in vivo X-ray fluorescence (IVXRF) I-125 based system was used to measure bone strontium levels non-invasively in an osteoporotic female volunteer. The volunteer was recruited in December 2008, as part of the Ryerson and McMaster University Strontium in Bone Research Study and measured at twice weekly, weekly and monthly intervals. Thirty minute measurements were taken at the finger and ankle bone sites, representing primarily cortical and trabecular bone, respectively and the strontium K-alpha X-ray peak at 14.16 keV was used in the analysis. Since the volunteer had no prior history of strontium based medications or supplementation, baseline natural strontium levels were obtained followed by a 24h measurement of first intake of strontium citrate supplements (680 mg Sr/day). While the baseline levels of 0.38 ± 0.05 and 0.39 ± 0.10 for the finger and ankle, respectively, were on par with those previously reported in Caucasians among twenty-two healthy non-supplementing strontium individuals by our group, an increase began to be seen after 24 hrs of 0.62 ± 0.14 and 0.45 ± 0.12 for the finger and ankle, respectively. By 120 h, the increase was statistically significant at 0.68 ± 0.07 and 0.93 ± 0.05, respectively. Further increases occurred within an interval of 90-180 days, with the most recent, after 800 days, at the finger and ankle being 7 and 15 times higher than the initial baseline reading. The intriguing results show bone strontium incorporation and retention follow a pattern, suggesting strontium levels, at least in the ankle, do not plateau within two to three years and will continue to increase over time, as an individual takes strontium supplements. The ability of this IVXRF system to monitor and measure bone strontium levels over time provides a useful diagnostic tool to help gain insight into strontium bone kinetics.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID: 22549020

Be well, Lara

Shaine
Shaine

Hello again Lara:
In addition to reading your blog I also read a blog from an osteoporosis site. One person wrote in regarding strontium. This individual had a strontium/serum/plasma/urine blood test administered. Normal results from this test range from 10.0 – 45.0 ng/ml. This individual had results that were slightly under 2,000 ng/ml which, in her assessment, is over 4,000 % higher than the upper normal limit of 45.0 ng/ml.
Is this a test that those of us taking strontium citrate should request of our doctors? Is a high blood level dangerous?
Please comment about this particular test and what we should be aware of with the results.
Thanks
Shaine

Shaine
Shaine

Lara:
Thanks for responding so quickly regarding dosage for strontium citrate and Algae Cal Plus once I achieve good DEXA results. I do plan on continuing the algae cal plus but question if I need 4 capsules each day or if I can cut the dosage. I am not a milk drinker and eat limited dairy products so I am unsure of the additional amount of calcium that I am consuming during the day. Yes, do have fruits and vegetables daily, flax seed and chia seed (when I remember) and a relatively healthy diet. But, once again, I have no idea of the amount of additional calcium that is entering my body. (I have a copy of your last book and have read it from cover to cover.)
Many thanks again to you for your continued research. Let me know about the algae cal. To all our good health…
Shaine

Lara Pizzorno
Lara Pizzorno

Hi Shane,
The best way for you to determine how much supplemental calcium (magnesium, boron, etc) YOU require, is to keep the food diary I suggest in Your Bones for 5-7 days and then use the charts in the book to see how much calcium, etc. YOU are typically getting from your diet. Once you know this, subtract this amount from 1,500 mg (if you are postmenopausal and not on bio-identical hormone replacement) or 1,200 if you are pre-menopause or postmenopausal and on BHRT. This is how much calcium YOU need to get from supplements. I realize keeping the food diary is a bit of a nuisance, but this is the only way to see what YOU actually need, so it truly is well worth the effort — and you only have to do it once unless your eating habits change dramatically. Most of us eat the same foods over and over and do not vary what we eat all that much. Also, keeping the food diary will let you see whether your diet (and your bones as a result of it) could benefit from a wee bit of dietary tweaking.
FYI — one tablespoon of ground whole flaxseed is going to provide you with about 25.5 milligrams of calcium. One ounce of chia seeds — about 3 tablespoons — will give you 176.68 milligrams of calcium. I did not put flaxseed or chia on my chart in Your Bones b/c these are not as commonly eaten, but I obviously should have done so! I did include the top commonly eaten sources of calcium — you’ll see that many vegetables are good sources of calcium, especially leafy greens, broccoli, etc., as are sesame seeds and tofu. Bottom line — you can get plenty of calcium cow-free! One important consideration regarding AlgaeCal is that it is supplying calcium within the naturally absorbed matrix of all the other trace minerals the sea algae used to create its bony structure — if you look at Appendix B in which I summarized all the vitamins and minerals healthy bones require, you will see that MANY trace minerals play important roles in our bones. If you find that your diet is supplying you with a fair amount of calcium, I would still consider taking at least some AlgaeCal as it will provide you with insurance that you are receiving these trace minerals in amounts in which they work together naturally. Bottom line here — truly worth keeping a food diary to see how much calcium your diet is giving you.

Shaine
Shaine

Hi Lara:
I will be having a DEXA scan next month to determine if the strontium citrate and algae cal plus that I presently take have been effective in increasing my bone density. Presently I take 680 mg stontium citrate daily and 2 algae cal plus twice daily.
Assuming that I have improved, what is the suggested dosage for each of these nutrients? Should strontium citrate be taken indefinitely?
Shaine

Lara Pizzorno
Lara Pizzorno

Hi Shaine,
Once you are in osteopenic range, you can cut your dose of strontium in half. I’m barely osteopenic now, but continue to take 340 mg of strontium most days (I sometimes forget as I take mine with lunch, or I realize that I just ate a cup of yogurt — so the calcium, which competes with strontium for absorption and will always win out over strontium, most likely blocked much benefit from the strontium that day). Strontium is a very helpful mineral — it lessens osteoclast activity AND boosts osteoblast activity, so I will continue to take some even after I am no longer even osteopenic, which I expect to happen within a year or two at most. I may drop down to 1/4 the dosage though. Re AlgaeCal Plus — your bones, which are continually remodeling throughout your life, will always need the calcium, magnesium, boron, K2, D3 and trace minerals this supplement provides. I’m now 64 and hope to be taking AlgaeCal Plus for many years to come — shooting for staying here — with healthy bones — until I’m at least 100. Hope your DXA results are stellar — keep me posted, Lara

Peter
Peter

Hi Lara, you have mentioned your improved BMD DEXA results after taking Algaecal products including strontium. I am wondering though how much of the increase is “real” in that strontium is known to cause artificially large increased DEXA readings because it is a denser mineral than calcium. So how can the real amount, if any, of increase in strength and quality of bone be known or determined? It is only real increases in strength and quality of bone that can reduce fracture risk, rather than numbers produced by a scan that has known shortcomings, even without considering strontium. Maybe animal studies?

Lara Pizzorno
Lara Pizzorno

Hi Peter,
Well, I have to admit that I often forgot to take my strontium (and still often forget to take it as I try to take it at lunch time and am frequently working or out then) — so it was the AlgaeCal Plus that made the difference for me. However, I believe my gains in BMD would have been even greater had I been consistently taking the strontium. Researchers have looked at strontium’s effects on bone quality in animal and human studies, and it has been found to improve bone quality as well as density. Below, I’ve copied in for you two abstracts of recent papers discussing this. The first is a review paper looking at animal (monkey) and human studies and the second is an animal (rat) study.

Osteoporos Int. 2003;14 Suppl 3:S19-24. Epub 2003 Mar 18.

The mineralization of bone tissue: a forgotten dimension in osteoporosis research.

Boivin G, Meunier PJ.

Source

Laboratoire d’Histodynamique Osseuse, Faculté de Médecine R. Laennec, 69372, Lyon Cedex 08, France. [email protected]

Abstract

Osteoporosis treatment should not only prevent the loss of bone tissue, not interfere with apatite and avoid bone mineral changes at the crystal level, but should also increase the mechanical resistance of bone and thus protect the skeleton against new fractures. Mineral substance is crystallized as nonstoichiometric carbonated apatite ionic crystals of small size and extended specific surface. Consequently, they have a very large interface with extracellular fluids, and numerous interactions between ions from the extracellular fluid and ions constituting apatite crystals are thus possible. It is generally agreed that bone strength depends on the bone matrix volume and the microarchitectural distribution of this volume, while the degree of mineralization of bone tissue is almost never mentioned as a determinant of bone strength. We now have evidence that the degree of mineralization of bone tissue strongly influences not only the mechanical resistance of bones but also the bone mineral density. In adult bone, our model is based on the impact of changes in the bone remodeling rate on the degree of mineralization of bone tissue. The purpose of this paper is to report the main results concerning the interactions of strontium (Sr) with bone mineral in animals and in osteoporotic women treated with strontium ranelate (SR). These studies aimed to evaluate using X-ray microanalysis, X-ray diffraction and computerized quantitative contact microradiography: (1) the relative calcium and Sr bone content, (2) the distribution of Sr in compact and cancellous bone, (3) the dose dependence of the deposition of Sr in bone, (4) the interactions between Sr and mineral at the crystal level (in monkeys), (5) the influence of Sr on the mean degree of mineralization of bone tissue and on the distribution of the degree of mineralization of bone tissue, and (6) the bone clearance of Sr over short periods of time (6 and 10 weeks) after cessation of SR administration (monkeys treated for 13 and 52 weeks, respectively). In monkeys killed at the end of exposure (13 or 52 weeks), Sr was taken up in a dose-dependent manner into compact and cancellous bone, with a higher content in new bone than in old bone. The Sr content greatly decreased (about 2-fold) in animals killed 6 or 10 weeks after the end of treatment but this affected new bone almost exclusively. After SR treatment, there were no significant changes in crystal characteristics. Easily exchangeable in bone mineral, Sr was slightly linked to crystals by ionic substitution (generally 1 calcium ion substituted by 1 Sr ion in each unit cell). The degree of bone mineralization was not significantly different in the various groups of monkeys. Thus, at the end of long-term SR treatment and after a period of withdrawal, Sr was taken up in a dose-dependent manner into new bone without alteration of the degree of bone mineralization and with no major modification of bone mineral at the crystal level. In postmenopausal osteoporotic women treated with SR (0.5, 1 and 2 g/day) for 2 years, Sr was dose-dependently deposited into new bone without changes in the degree of mineralization of bone tissue. These findings could reflect dose-dependent stimulation of bone formation and are of potential value for the use of SR in the treatment of osteoporosis. In conclusion, the different studies performed on bone samples from monkeys and humans treated with various doses of SR showed that Sr was heterogeneously distributed between new and old bone but in a dose-dependent manner without alteration of the crystal characteristics and the degree of mineralization of bone tissue, even after long-term administration of often high doses of SR (the highest therapeutic dose used in humans is 4-fold lower than the lowest experimental dose administered to monkeys). This emphasizes the value, as antiosteoporotic treatment, of SR, which is safe at the bone mineral level.

PMID: 12730799

Here is an animal (rat) study showing strontium improves bone quality as well as BMD:

J Bone Miner Res. 2004 Dec;19(12):2012-20. Epub 2004 Sep 13.

Strontium ranelate improves bone resistance by increasing bone mass and improving architecture in intact female rats.

Ammann P, Shen V, Robin B, Mauras Y, Bonjour JP, Rizzoli R.

Source

Service of Bone Diseases, World Health Organization Collaborating Center for Osteoporosis Prevention, Geneva 14 CH-1211, Switzerland. [email protected]

Erratum in
J Bone Miner Res. 2005 Mar;20(3):548.

Abstract

Strontium ranelate given to intact rats at doses up to 900 mg/kg/day increases bone resistance, cortical and trabecular bone volume, micro-architecture, bone mass, and total ALP activity, thus indicating a bone-forming activity and an improvement of overall bone tissue quality.

INTRODUCTION:

Various anti-osteoporotic agents are available for clinical use; however, there is still a need for drugs able to positively influence the coupling between bone formation and bone resorption to increase bone mass and bone strength. Strontium ranelate (PROTELOS), a new chemical entity containing stable strontium (Sr), was tested for its capacity to influence bone quality and quantity.

RESULTS:

In female rats treated with strontium ranelate over 2 years, dose-dependent increases of bone strength and bone mass of the vertebral body (containing a large proportion of trabecular bone) and of the midshaft femur (containing mainly cortical bone) were detected without change in bone stiffness. Similar effects were observed in males at the level of the vertebra. This increase in mechanical properties was associated with improvements of the micro-architecture as assessed by increases of trabecular and cortical bone volumes and trabecular number and thickness. Finally, plasma total ALP activity and IGF-I were also increased in treated animals, compatible with a bone-forming activity of strontium ranelate.

CONCLUSION:

A long-term treatment with strontium ranelate in intact rats is very safe for bone and improves bone resistance by increasing bone mass and improving architecture while maintaining bone stiffness.

PMID: 15537445

Audrey
Audrey

Hi Lara,
Thank you for your wonderful advice. I bought your book and I use it as a reference It has been so informative. I take more vitamin D now. And I am trying to be patient with myself. I read all your information to other women and I try to learn what is best for me too. Thank you so much for your book and the information you supply to women that need all the help the can get. Because doctors do not tell you the truth when it comes to improving your bone density. And you do. Thank you again…Audrey

sue
sue

just wondering if you got my email?

Linda Wilkins
Linda Wilkins

My doctor just started me on strontium citrate. I also take bioidentical estrogen. I’ve read that estrogens might decrease how fast the body gets rid of strontium and cause side effects. Is this a safe combination?

Lara Pizzorno
Lara Pizzorno

Hi Linda,
Both strontium citrate and bio-identical estrogen (likely bi-est) replacement will improve the health of your bones.
Where did you read that estrogens might decrease strontium metabolism? The PubMed research indicates just the opposite is true. In fact, in the one and only study on PubMed I could find suggesing even a remote connection between estrogen and strontium — a rat study involving ovariectomized rats (an animal model for human postmenopausal women) that were given estrogen, the rats’ metabolism of strontium normalized. When the animals were not given the estrogen, their metabolism of strontium was greatly slowed down. In other words, estrogen improved the rats’ ability to normally metabolize strontium; it did not decrease it. Whether this animal study even relates to us humans is highly questionable. But if it does, it shows that estrogen helps us metabolize strontium at a normal, healthy rate. (Here is the reference for this study: Ma B, Zhang Q, Wang G, et al. Synthesis and pharmacokinetics of strontium fructose 1,6-diphosphate (Sr-FDP) as a potential anti-osteoporosis agent in intact and ovariectomized rats. J Inorg Biochem. 2011 Apr;105(4):563-8. doi: 10.1016/j.jinorgbio.2011.01.001. Epub 2011 Jan 11.)
Hope this helps, Lara

John
John

Hi Lara,
I will run a DXA on Monday . I have been taking Strontium citrate since Aug. 30. and it seems I read somewhere that the Strontium exaggerates the results. I can’t seem to find where I read it or how you correct for it. Could you please tell me how to read these DXA results when on strontium.
John

Barbara
Barbara

Hi Lara:
I will be getting a dexa scan in a couple of months. I am on your bone building plan from your book and taking Algae Cal and Strontium. Do you have any recommendations before getting the scan as far as discontinuing either the algae cal or strontium or any other minerals or vitamins?

Thank you,
Barbara

Lara Pizzorno
Lara Pizzorno

Hi Barbara — delighted you are getting well informed and taking the best care of your bones (and all the rest of you if you are eating the healthy diet and following the exercise recommendations in Your Bones). You should absolutely NOT stop taking your bone health supplements or any other vitamins or minerals before getting your DXA run! These nutrients are FOOD for your bones. Continue to nourish your bones and your entire body well — every day for the rest of your long, and healthy life! Be gloriously well, Lara

Dennis Radecky
Dennis Radecky

My wife has been following the AlgaeCal Plus program for just over 1 month. Today 2/27/13, I took her to the ER. She had a Kidney Stone. Could this stone have been caused by the AlgaeCall supplement?

Lara Pizzorno
Lara Pizzorno

Hi Dennis,
Highly unlikely that her kidney stone is due to taking a calcium supplement. Kidney stone formation is almost certainly due to insufficient vitamin D (please have your wife’s levels of 25(OH)D checked ASAP–optimal levels are 60-80 ng/mL, and vitamin K2. Vitamin D increases our body’s ability to absorb calcium; vitamin K2 activates the proteins responsible for putting calcium into bone (osteocalcin) and keeping it OUT of arteries, kidneys, breasts. Few labs at this time are checking levels of unOC (uncarbocxylated osteocalcin) — you want these levels to be low as uncarboxylated osteocalcin is the form in which osteocalcin is NOT activated to pull calcium into bone). Your wife should be getting at least 120 mcg of MK-7 form of K-2 daily. Is she taking this anticoagulant?

Pam
Pam

I was taking 680 strontium citrate, 1130 calcium and 450 magnesium citrate. My hair started falling out and I read it might be the strontium so I cut back to 380 strontium. Now I’m reading that I might need more magnesium with so much calcium and wonder if you figure-in the strontium AND calcium to balance the magnesium. What are your thoughts on the amount of magnesium to calcium/strontium? (also, my blood pressure was rising significantly – enough that my Dr put me on blood pressure meds)

Lara Pizzorno
Lara Pizzorno

Hi Pam,
You should not be consuming more than 1,200 mg of calcium TOTAL daily from BOTH the foods you eat AND supplements. You should be consuming at least 600 mg/day of magnesium (from both food and supplements) for the 1,200 mg of calcium. Calcium and magnesium balance one another in many, many activities in our bodies. I think the ratio should be 2/3 as much magnesium as calcium rather than 1/2 as much — and this is what I take myself – 2/3 as much magnesium as calcium. If you have a copy of Your Bones, please read the sections on both calcium and magnesium. Also those on vitamin D and vitamin K2, both of which are essential for ensuring proper absorption and utilization of calcium and magnesium. If you don’t have a copy, please check it out from your library if you don’t wish to buy it. PLEASE read up! From what you write, it is apparent that you are not meeting your needs for magnesium, unless you are eating a diet VERY rich in magnesium AND your digestion and absorption are excellent. Magnesium needs are increased by stress. Hair loss can also be the result of chronic stress. I remember when my mother was dying from hip fracture + congestive heart failure — along with my 23 year old cat, who we were giving fluids several times a day because of her kidney failure — I was so stressed out and sad that I lost TONS of hair. It took several years for my hair to fill back in. It did though.
I have never seen anything suggesting strontium causes hair loss. Still, cutting back to 380 mg elemental strontium per day is reasonable — at this amount, it will still be helpful for your bones. Be sure to take it when you are NOT also taking calcium or consuming calcium-rich foods.
Be well! Lara

amanda
amanda

Hi so glad i found this site , my mom has exstensive bone marrow edema in 234and 5th matataresial bones in her foot also in the landrum of the foot shes 52 her bone density test came back low we are doing more blood work now the injury happened in october not sure how she has no fractures pain has now gone to her knees and she cant walk at all she always has poor eating habits smked and drinked most of her life nothing was helping the pain shes been on high calcium and vitamins for about a month now i started useing bone growth formula for her which she takes a strontium on an empty stomach so we tried Giving her a little more then 1000mg of it and its really gave her pain relief where no pain killer did we also started adding milk thistle and colostrum on an empty stomach first thing in the morning her insurance does not start till may 1st the problem is her xray on 11/19/12 the foot bones were all white next xray on 1/17/13 the bones seem to be turning black or OSTEONECEROIS MAYBE, ALMOST 90 DAYS TO GO IS IT TO RISKY TO WAIT? PLEASE ANY IFO WOULD BE GREAT SHES SCARED AND HEARTBOKEN

Lara Pizzorno
Lara Pizzorno

Hello Amanda,
Please do not wait! I urge you to call your mother’s doctor and make an appointment to be seen ASAP! If you have questions about supportive diet, supplement and lifestyle recommendations, I will do my best to be helpful provide you with useful information, but your mother really needs to be under the supervision and guidance of her doctor.
Let me know how she is doing, Lara

Kathy Graham
Kathy Graham

Great article.

Is there interference with iron or magnesium absorption if taken with strontium?

Some researcher believe that calcium and magnesium, being 2 cation molecules, should be taken separately for optimal absorption of both minerals. Your article clearly shows that strontium and calcium should be taken separately. What about iron and magnesium regarding strontium?

Thanks

Lara Pizzorno
Lara Pizzorno

Hi Kathy,
Great question! I have seen nothing in the recent research to indicate competition for absorption between strontium and iron or magnesium. However, I did find one paper, a rat study published in 1963, that considered competition between strontium and magnesium as well as calcium, and results suggest that competition does occur:
HENDRIX ZJ, ALCOCK NW, ARCHIBALD RM. COMPETITION BETWEEN CALCIUM, STRONTIUM, AND MAGNESIUM FOR ABSORPTION IN THE ISOLATED RAT INTESTINE.Clin Chem. 1963 Dec;12:734-44.
PMID: 14099733
As you likely know, rat and human absorption mechanisms are similar, albeit not equivalent. Here’s a recent paper on this:

Pharm Res. 2006 Aug;23(8):1675-86.
Why is it challenging to predict intestinal drug absorption and oral bioavailability in human using rat model.
Cao X, Gibbs ST, Fang L, Miller HA, Landowski CP, Shin HC, Lennernas H, Zhong Y, Amidon GL, Yu LX, Sun D.

Source: Division of Pharmaceutics, College of Pharmacy, The Ohio State University, Columbus, Ohio 43210, USA.

Abstract

PURPOSE: To study the correlation of intestinal absorption for drugs with various absorption routes between human and rat, and to explore the underlying molecular mechanisms for the similarity in drug intestinal absorption and the differences in oral bioavailability between human and rat.

MATERIALS AND METHODS: The intestinal permeabilities of 14 drugs and three drug-like compounds with different absorption mechanisms in rat and human jejunum were determined by in situ intestinal perfusion. A total of 48 drugs were selected for oral bioavailability comparison. Expression profiles of transporters and metabolizing enzymes in both rat and human intestines (duodenum and colon) were measured using GeneChip analysis.

RESULTS: No correlation (r(2) = 0.29) was found in oral drug bioavailability between rat and human, while a correlation (r(2) = 0.8) was observed for drug intestinal permeability with both carrier-mediated absorption and passive diffusion mechanisms between human and rat small intestine. Moderate correlation (with r(2) > 0.56) was also found for the expression levels of transporters in the duodenum of human and rat, which provides the molecular mechanisms for the similarity and correlation of drug absorption between two species. In contrast, no correlation was found for the expressions of metabolizing enzymes between rat and human intestine, which indicates the difference in drug metabolism and oral bioavailability in two species. Detailed analysis indicates that many transporters (such as PepT1, SGLT-1, GLUT5, MRP2, NT2, and high affinity glutamate transporter) share similar expression levels in both human and rat with regional dependent expression patterns, which have high expression in the small intestine and low expression in the colon. However, discrepancy was also observed for several other transporters (such as MDR1, MRP3, GLUT1, and GLUT3) in both the duodenum and colon of human and rat. In addition, the expressions of metabolizing enzymes (CYP3A4/CYP3A9 and UDPG) showed 12 to 193-fold difference between human and rat intestine with distinct regional dependent expression patterns.

CONCLUSIONS: The data indicate that rat and human show similar drug intestinal absorption profiles and similar transporter expression patterns in the small intestine, while the two species exhibit distinct expression levels and patterns for metabolizing enzymes in the intestine. Therefore, a rat model can be used to predict oral drug absorption in the small intestine of human, but not to predict drug metabolism or oral bioavailability in human.

PMID: 16841194

Bottom Line — for best absorption, take strontium separately from other minerals. I’ve now heard from a number of women who find it simplest to take their strontium supplement right before going to bed — so around 4 hours after their evening meal. This would avoid any competition and promote optimal bone benefit from strontium.
Hope this helps, Lara

Vimal
Vimal

Dear Lara,

I have just found out that a dear friend has a rare bone cancer Osteasarcoom. She is only 18 years of age, also it is secondary cancer not the primary.

Could you please explain the differences between Osteasarcoom and Osteaporosis as they both are located in the bone.

Is their anyway to keep the bones healthy or even cure Osteasarcoom, as the doctors have said it is uncurable.

Will Algaecal help fight the Osteasarcoom and keep the bones strong.

Could you please give detailed information about this, I would really appricate this.

Thanks,

Vimal

Lara Pizzorno
Lara Pizzorno

Hi Vimal, I am so sorry to hear this and wish I could offer you something helpful to try, but osteosarcoma, a cancer of the bone, is not at all related to osteoporosis, which is bone becoming thin and porous due to an imbalance in bone remodeling (break down and renewal) caused by numerous contributing factors (which I write about in Your Bones in detail). I do have one suggestion for you — you might get in touch with Cancer Treatment Centers of America. This medical group utilizes integrative medicine to support health while treating cancer. Here is a link to their main website: http://www.cancercenter.com/?source=GOOGLEBR&channel=paid%20search&c=paid%20search:Google:Google%20-%20National%20Branded:Branded+Test:cancer+treatment+centers+of+america:Exact&OVMTC=Exact&site=&creative=1144020265&OVKEY=cancer%20treatment%20centers%20of%20america&url_id=129386665&adpos=1t1&gclid=CImHytX1iLUCFexxQgodlngA4g AND another link to their contact page: http://www.cancercenter.com/contact-us.cfm

Farah Kamal
Farah Kamal

Lara, where can I order this book Your Bones. F

Lara Pizzorno
Lara Pizzorno

Hi Farah, as I explained in responding to your primary question — Your Bones can be ordered via Amazon, and a Kindle version is available there as well as hard copy. In the U.S., Your Bones was approved by our library book review system and is available in our public libraries as well.

Farah Kamal
Farah Kamal

Hi Lara, I am recently diagnosed with Oestopenea, I live in a part of world with poor health facilities and women health are completely neglected. I went with my BMD report to a bone doctor which prescribed me with Strontium Renalate suspension. However he asked me to stop taking the Calcium supplement (Caltrate 600D) I thought I heard it wrong but he was quiet sure I dont take any calcium supplement. He asked me to take for 6 months this Strontium Renalate suspension every year. Now this really bothers me I am 47 and can’t think of not taking any calcium supplement. I am so so worried and keep awake the whole night. I need your views. Please help me. Farah

Lara Pizzorno
Lara Pizzorno

Hi Farah,
So glad you wrote in — your doctor is likely concerned about the fact that calcium competes with strontium for absorption — and calcium ALWAYS wins, which translates to less strontium being absorbed when calcium is also consumed AT THE SAME TIME. What you want to do is take your strontium at a time of day when you are NOT consuming any calcium. I take my supplemental calcium when I brush my teeth in the morning and at night; I take my strontium with lunch, and try to be careful not to consume foods rich in calcium for lunch. Other women have written me that they find it easier to take their strontium at night, right before bed, so several hours after they have eaten dinner. You’ll know what will work best for you — just find a time of day when you can take your strontium several hours (3 – 4 hours would be ideal) apart from consuming calcium.
Your bones do need calcium! Please do continue to consume calcium — the recommended daily intake is 1,200 mg. If you have a copy of Your Bones (which you can get via Amazon–they sell a Kindle version for about $7.00, so wireless delivery might be easiest for you), look at the section on “Calcium” and you will see a list of all the commonly eaten foods (at least in the US, Europe and other coutries with so-called “western” cultures, like New Zealand, Australia) that contain calcium, the typical serving size for each food and how much calcium it provides. You can use this list to estimate how much calcium your diet is typically supplying each day, then subtract this amount from 1,200mg and take the remainder in the form of a calcium supplement. For example, if your diet is giving you 400 mg of calcium each day, then you need to take 800 mg of calcium in the form of a supplement.
I expect it may not be possible for you to ask for strontium in its natural form of strontium citrate, rather than the drug form, strontium ranelate? If you do have a choice, PLEASE use the natural form of strontium. The drug form has been shown to greatly increase risk for venous thromboembolism (blood clot formation in the deep veins — very dangerous) and DRESS syndrome (if you develop a rash while taking strontium ranelate, see your doctor IMMEDIATELY; DRESS syndrome is very serious, requires quick treatment and possibly hospitalization).
I applaud you for taking action to become well informed and make the best decisions you can for your own health. You are a brave and intelligent woman! Hopefully, you can share what you learn and help others in your country as well. Don’t hesitate to write if I can be of further help, Lara

Farah Kamal
Farah Kamal

Dear Dr. Pizzorno, I woke up today to find your email response to my question, and was pleasantly surprised that my email actually got a response and that too so personal and informative and such a good medical advise and details

I immediately started with my Calcium this morning at breakfast, I take Strontium 2 hrs after lunch everyday.
Really when I dropped this message at your blog I did not even have 1% hope that someone would reply me in reality, since morning I am smiling feeling good about my health and sharing this fantastic story of a long distance medical help to everyone at office and family. Doctors in our part of the world usually wont talk and discuss the issues much with their patients or bother to reply to their questions even after massive fee that they charge. So to me you are like an angel.
Next month I will be USA for a conference and if you can give me name of some supplementry or some other brand of natural form of strontium, I can bring those back with me.
Many many thanks for your help once again.

Farah

Thanks once again.

Lara Pizzorno
Lara Pizzorno

Good morning Farah,
SO delighted to have been able to give you helpful information! What you are now doing sounds just fine, although a number of other nutrients are required for optimal bone health — you should also be getting adequate vitamin D3, vitamin K2, boron, magnesium and vitamin C — plus a wide range of trace minerals. I have discussed all of the nutrients bone requires and how to determine how much you need of each in Your Bones. If possible, please try to get a copy. I have also discussed many things that contribute to bone loss that you may not be aware of, and which you can avoid once you know about them. Here in the US, Your Bones is available in our public libraries. If you do not wish to own a copy, you might be able to have a friend here check it out for you to read while you are visiting.
I am happy to suggest some choices of natural strontium supplements for you. I, personally, use AlgaeCal’s strontium supplement; I know AlgaeCal has the highest standards for its’ supplements purity and potency, but other companies here also offer strontium citrate. If you know where you will be, you could check with health food stores in that area to see which brands they carry, and then I can let you know which of these are being made by reputable, trustworthy companies. I am not a physician. My husband is — Dr. Joseph Pizzorno. I am a medical writer and have been a member of the AMWA (American Medical Writers Association) and have been writing medical journal articles and medical books for doctors and for the public for 30+ years now, so I am very well educated, and I also work with my husband, but I am not a doctor. I do have 2 graduate degrees — one in Philosophy/Theolgy from Yale University and a second master’s in English from University of Washington. In addition, I am an LMT and am currently finishing my STOTT Pilates certifications. You can Google us if you want our full resumes.

GM
GM

Dear Lara,

I have just found out that a dear friend has a rare bone cancer Osteasarcoom. She is only 18 years of age, also it is secondary cancer not the primary.

Could you please explain the differences between Osteasarcoom and Osteaporosis as they both are located in the bone.

Is their anyway to keep the bones healthy, as the doctors have said it is uncurable.

Will Algaecal help fight the Osteasarcoom and keep the bones strong.

Could you please give detailed information about this, I would really appricate this.

Thanks,

GM

Esther
Esther

I am 22 weeks pregnant and started taking Garden of life grow bone after 16 weeks. I just noticed the warning on the label 🙁 . Does anyone have any information about the dangers to my baby?

Lara Pizzorno
Lara Pizzorno

Hi Esther,
I am not familiar with the Garden of Life product — what are they saying may be harmful to a growing fetus?

Ann
Ann

Hi Lara –

Could you comment on the possibility that strontium citrate can promote hair loss? I’ve seen this mentioned in comments on several websites.

Thank you

Lara Pizzorno
Lara Pizzorno

Hi Ann,
I have not seen this in any of the peer-reviewed published medical research, and I have now looked at all the major papers on strontium published in the last 100 years. I suggest you ask the folks making these claims for references in the medical journals in which research has been published confirming them, and if they cannot supply you with any, do not give them any credence. And this applies to ANYTHING you see on the web. Ridiculous rumors spread like wild fire, and I all too often hear from people frightened by the latest rumor scare tactics. Rely on Science, not rumor. If strontium promoted hair loss, don’t you think it would have been noted in the last 100 years in the many thousands of subjects taking strontium in numerous clinical trials?

Gail
Gail

Dear Lara:

Thanks for your prompt and thoughtful response. I will check out the digestion issue.
Who can I ask about the optimal frequency of DEXA tests so I am properly monitoring my bone density? At this point every 2 years does not make sense. Thanks again and I intend to get a copy of your book, especially since Gary Null cites you and your book.
Happy Thanksgiving ! Gail

Lara Pizzorno
Lara Pizzorno

Hi Gail,
You’re so welcome! DXA (they are now using the acronym DXA instead of DEXA) scans should be run once yearly — it takes time for bone to rebuild, so running this scan sooner will not provide good information for you. You can, however, run another type of test that will show you whether you are continuing to lose bone every month until your results show you are no longer losing bone and are stable. Bone resorption (“medspeak” for bone breakdown) tests measure the amount of certain bone proteins in the urine or blood (serum) that have been released from bone as a result of osteoclast activity. There are currently three such tests available: NTx, CTX and Dpd. The current research indicates that the serum CTX is the most reliable of the three, but the NTx is also good and is used frequently. Dpd testing is less used nowadays.
Happy Thanksgiving to you, too. I’m taking off a good part of today to be in the kitchen cooking pumpkins to make soup and custards, and making rice stuffing (we are gluten-free folks) to fill a kamboucha squash that will be our “centerpiece” this year. (We also do not eat meats, just fish, so it’s a turkey free zone around here as well, but I will fix LOTS of other things tomorrow morning as well — a Brussels sprouts souffle that no one believes contains Brussels sprouts :-), fresh cranberry salad, green beans and potatoes, mashed sweet potatoes and yams. I love this holiday! SO MUCH to be grateful for this year, as always, Lara

Debbie
Debbie

Oh my…so sorry I didn’t read the fine print….it was right there! I appreciate your patience! Thanks for responding!!!

Lara Pizzorno
Lara Pizzorno

No worries — it took me months to figure this out. I started out taking just 1 capsule not because I wanted to take less than 680 mg of strontium but b/c I did not carefully read the label. As I am still osteopenic (though just barely so now), I continue to take the full 680 mg dose. My next DXA is due to be run May 2013 — I expect I will no longer be even barely osteopenic.. If so, I will drop down to 1 capsule then.

Lara Pizzorno
Lara Pizzorno

Hi Debbie — the info on the Strontium Boost label is confusing, I know, but what it says is that 3 capsules provide 680 mg of elemental strontium. The 2230 mg amount is the milligrams of strontium plus citrate. In other words, 3 capsules give you 1550 mg of citrate AND 680 mg of strontium. So, each capsule provides 226 mg of strontium.

Debbie
Debbie

Ms. Pizzorno,
I have just been skimming through the above blogs and I may have missed it…how much of the Stronium Boost do you take daily? I have been taking the 3 capsules at bedtime (2230 mg) which is recommended on the bottle but I also take medications for hypothyroidism. I noticed a blog that mentioned the thyroid gland,also went back and read Your Bones which recommends 680 mg. Should I take only 1 capsule daily of the stronium boost instead the 3 capsules? I don’t want to do something that would cause other problems. I also take 4 capsules of the Algaecal Plus daily(lunch/dinner). I will have my blood work done at the end of November for thyroid, calcium, Vit D, and cholesterol. Thanks so much!

John
John

Lara,

Firstly sincere thanks and appreciation for the contents of this blog. The time, effort, and knowledge which you apply to answering questions is amazing. It is so helpful to have technical matters explained with such authority in understandable terms. If I might ask your comments on two issues which I have come across, I would be very grateful. I have your excellent book so I will not ask you to repeat anything from there. I would be interested to learn of any further research on Lactoferrin and its positive effects on bone building. Also, if used, would there be any conflict issues with strontium and its effect of bone building or in the same way as there are with strontium/calcium. It seems that the many benefits of lactoferrin are well known, but its effect on bone building are not so well documented.

Secondly I have recently found reference to Pulsed Signal Therapy which appears to be a recent development of older techniques. It seems that positive effects on bone building were only noticed as a complementary event to pain relief and healing. Again research seems to be quite limited but is apparently on-going and seems to be promising. http://pstvet.com/pst/clinicalnew.htm and http://pst-global.com/images/1-22.pdf. Any information which you possess would be very much appreciated.

Many Thanks

Lara Pizzorno
Lara Pizzorno

Hi John,
Thanks, delighted you have found the blogs and Your Bones helpful.
Re lactoferrin, it looks quite promising. The study to which you sent me a link is the only human study I could find, but recent papers indicate lactoferrin may be quite helpful. It’s not a mineral, so absorption should not be impacted by strontium (or calcium), also lactoferrin’s mechanisms of action are quite different from those of strontium/calcium. In sum, it should be fine to use lactoferrin along with strontium. Here are the two most recent papers I found most interesting and helpful:

Hou JM, Xue Y, Lin QM. Bovine lactoferrin improves bone mass and microstructure in ovariectomized rats via OPG/RANKL/RANK pathway.
Acta Pharmacol Sin. 2012 Oct;33(10):1277-84. doi: 10.1038/aps.2012.83. Epub 2012 Aug 20. PMID: 22902986

Cornish J, Naot D. Lactoferrin as an effector molecule in the skeleton. Biometals. 2010 Jun;23(3):425-30. Epub 2010 Mar 16. Review. PMID: 20232111

Re pulsed signal therapy — this also looks both safe and helpful. The link you sent me goes to a website basing their claims on research conducted no later than 1993, so I checked PubMed to see if more recent papers had been published (which one would assume they would be if this therapy was helpful). I found a number of recent papers. Here are a couple of the most recent:

Angle SR, Sena K, Sumner DR, Virdi AS. Osteogenic differentiation of rat bone marrow stromal cells by various intensities of low-intensity pulsed ultrasound.
Ultrasonics. 2011 Apr;51(3):281-8. Epub 2010 Sep 26. PMID: 20965537

Ferreri SL, Talish R, Trandafir T, Qin YX. Mitigation of bone loss with ultrasound induced dynamic mechanical signals in an OVX induced rat model of osteopenia.
Bone. 2011 May 1;48(5):1095-102. Epub 2011 Jan 15. PMID: 21241838

Schofer MD, Block JE, Aigner J, Schmelz A. Improved healing response in delayed unions of the tibia with low-intensity pulsed ultrasound: results of a randomized sham-controlled trial. BMC Musculoskelet Disord. 2010 Oct 8;11:229. PMID: 20932272

This last paper is of especial importance since it shows low intensity pulsed ultrasound therapy does not promote cancer — here is a quote from the conclusion of this paper:
“LIPUS stimulation on metastatic bone tumors induces differentiation of osteoblasts without proliferation of tumor cells. Our study suggests that LIPUS may be a new method of treatment without surgery for metastatic bone tumors.”
Sawai Y, Murata H, Koto K, Matsui T, Horie N, Ashihara E, Maekawa T, Fushiki S, Kubo T. Effects of low-intensity pulsed ultrasound on osteosarcoma and cancer cells.
Oncol Rep. 2012 Aug;28(2):481-6. doi: 10.3892/or.2012.1816. Epub 2012 May 17. PMID: 22614439

Hope this helps answer your really great questions, Lara

Shaine
Shaine

Hi Lara:
(I am resubmitting my questions hoping to get some answers regarding the length of time to take strontium.)
Has any research been done to show the safety of using strontium citrate for years? How long is it safe to use at the full recommended dosage and at what dosage is it safe to use after reaching the “normal levels’?

Lara Pizzorno
Lara Pizzorno

Dr. Wright and I both believe that once bone mineral density has been significantly improved using the dose shown in the research to be effective (680 mg elemental strontium/day) should be reduced to half this amount (340 mg elemental strontium/day)for long term bone health. Again, most important is that you take at least twice as much calcium as strontium. As I have explained both in Your Bones and here on AlgaeCal’s blog, strontium and calcium compete for absorption, and calcium will always win. Thus, you want to (1) consume more calcium (from diet and supplements) than strontium, (2) take these 2 minerals at different times of day to get the most bone health benefit from strontium citrate. Hope this helps.

Mary
Mary

What is a suitable no calcium snack to have with the Strontium Citrate? I have been having it alone and away from the Algaecal. Thanks Mary

Antigone
Antigone

Re; Robert Gouterman January 17, 2012 at 8:31 am [i.e second post above]
In Laura Pizzorno’s blog , she refers to the excretion of ranelic acid , and questions the non excreted portion. What is the excretion of strontium citrate?

What is the answer to Gouterman’s question…? It remains unanswered in response above!

Lara Pizzorno
Lara Pizzorno

Hi Antigone,
Both strontium and citrate are natural substances that are highly beneficial to and are utilized within the body — ideally, the majority of the strontium in strontium citrate supplements is absorbed into bone, increasing bone mass and strength. The citrate portion is both an alkalinizer (so helps prevent an acidic body pH, which promotes calcium withdrawal from bone / bone loss) and is also used in the Krebs cycle (a key part of the energy production cycle in our cells). Ranelic acid is a new to nature compound, synthesized in a lab by a pharmaceutical company so they could combine it with strontium and thus patent the result — the purpose of this is to make money, no other reason. Ranelic acid’s only claim to fame is that it is SUPPOSED to be inert. The fact that strontium ranelate may cause venous thromboembolism and DRESS syndrome (among other nasty effects) strongly suggests otherwise. Hope this answers your question, Lara

sml
sml

Hi Lara:
Has any research been done to show the safety of using strontium citrate for years? How long is it safe to use at the full recommended dosage and at what dosage is it safe to use after reaching the “normal levels’?

sml
sml

Lara:
Re: Life Extension K2 – There are two available K2 products from them. The Advanced Super K contains all three of the Vitamin K (to total 2100 mcg of K activity) per tablet, the Low Dose K2 has 45 mcg of the MK7. I am leaning toward taking two of the Low Dose LE K2 rather than accumulate too much of the other K vitamins in my system. Once again I am taking 7000 D3 and am needing about another 100 mcg of MK7 (90 mcg is also OK). Which of the LE products do you recommend?
Again, thanks for all your prompt responses and your amazing insight!

Lara Pizzorno
Lara Pizzorno

Hi SML,
Either product will be fine. The amounts of the other forms of vitamin K (K1 and MK-4) are so tiny, they will have little impact on activation of Gla-proteins. Actually, the K1 will have no impact on Gla protein activation — it will be used for clotting factors and also has anti-inflammatory effects (so good to help prevent excessive activation of osteoclasts, which is triggered by chronic inflammation). MK-4 requires 15 milligrams 3x daily for efficacy. What you really want is about another 100 mcg of MK-7 — so you could take 2 capsules of the Low Dose K2 formula or 1 capsule of the Advanced Super K. I’d check costs and go with whichever one is least expensive. I expect you are consuming plenty of leafy greens and other vegetables rich in K1, right?

sml
sml

Hello again Lara:
I take about 6000 iu’s of D3 daily and will be increasing to 7000 iu’s in order to get me blood level above 60 nG. (at 6,000 iu’s my levvel was at 55 nG.) Is there a certain brand that you would recommend for vitamin K2 in order to balance the level of D3? I will be getting about 100 mg of K2 (MK7) from my other supplements. Based on your previous response to me I should probably add to my K2 amount. What amount would you suggest? Is there a toxic level for K2 (MK7)?
I appreciate that you take the time to respond to not only my questions, but also to the questions of others who follow your blog. Your advise and expertise is very much apppreciated.
Thanks

Lara Pizzorno
Lara Pizzorno

Hi sml,
If you take AlgaeCal Plus, the full daily dosage will be giving you 90 mcg of K2 (MK-7). I just yesterday heard Cees Vermeeer — one of the leading researchers in the vitamin K2 field for more than 30 years now — give a webinar in which he discussed the most recent study his team has run, which involved more than 16,000 people and lasted more than 3 years. They found 180 mcg was an effective dose, even for those whose initial levels of unOC were severely depressed. Since you are getting 100 mcg from your other supplements, if you just took the full dose of AlgaeCal Plus, you would be getting 190 mcg/day. If you are taking 7,000 IU vit D3, then this amount of MK-7 should be adequate. If you end up finding your vit D3 needs run even higher — to 10,000 IU/day — you could check out Life Extension’s vitamin K supplement, which is what I use for my additional K2 since I must take 10,000 IU/day of D3. The LEF supplement provides 100 mcg of MK-7. No toxicity has ever been shown for K2 (MK-7) at any dose used — even in studies in which subjects took more than 800 mcg/day. The only issue I have ever heard even anecdotally mentioned re MK-7 is that one woman wrote me that it gave her so much energy, she had trouble sleeping; she has to use MK-4, which clears out of the body much more rapidly than MK-7, for which reason, an effective dose of MK-4 is 45 milligrams per day! And you have to take this in divided doses of 15 mg / 3 times a day as MK-4 is cleared by almost everyone within 4-6 hours. This woman does better with MK-4. A couple of months ago I saw new research suggesting that some people (a VERY few of us, obviously including the woman who wrote me) may be able to get by with less K2 — these are persons with some rare SNPs that result in their keeping K2 around longer than the vast majority of us. I’ve written up all this research for inclusion in the 2nd edition of my book, Your Bones, which will be out in March 2013 — it’s very interesting! YOUR best solution is highly likely to be around 180 mcg of K2 as MK-7.

sml
sml

One additional question (I just finished posting my prior questions to you.) Is there enough K2 in the AlgaeCal Plus or should I supplement (and if so by how much?)

sml
sml

Lara:
Thanks for your response about New Chapter. However, my confusion now lies in the amount of calcium in the two tablets of AlgaeCal Plus. There are only 360 mg of calcium in the two tablets listed as “serving size”. Even taking 3 tablets only increases the calcium intake to 540 mg. This is not nearly enough to take in conjunction with the amount of suggested strontium. (We should take more calcium than strontium in order for both to be effective.) Please let me know what you suggest in order to take the AlgaeCal Plus to ingest a healthy amount of calcium.
Additionally I have been using Doctor’s Best Strontium. Do you have any information regarding this product?
I would really appreciate hearing from you before I place an order for the AlgaeCal Plus and possibly, their Strontium Boost.
Thanks

Lara Pizzorno
Lara Pizzorno

Hi sml,
Yes, the label is confusing. Full day’s serving of AlgaeCal Plus is 4 capsules — 2 capsules twice daily. When I first started taking AlgaeCal, I didn’t realize this for several months. So, amount of calcium provided by AlgaeCal Plus is 720 mg/day, plus you need to look at your diet to see how much calcium you are typically getting from the foods you eat. Most people get somewhere around 400 mg/day or more of calcium from their normal diet (e.g., milk, yogurt, cheese, leafy greens, soymilks and yogurts, etc., also enriched with calcium — in Your Bones, I provide a full listing of the foods rich in calcium, how much is in a typical serving, so you can figure out what YOU are getting). I don’t know how much strontium is in Drs Best (am currently in Toronto airport with just a few minutes before my connecting flight to Washington DC, so no time to look), but most supplements providing strontium citrate (which is what you want — you do NOT want the patented drug form, strontium ranelate!) provide 680 mg of elemental strontium as this is the dosage shown in the research studies to be effective. AlgaeCal Plus provides more calcium than this amount of strontium and surely with your dietary intake of calcium, you will be getting quite a bit more than 680 mg. Re Drs Best strontium — if it is strontium citrate, it should be fine. I am not familiar with the quality control standards held by Drs Best — you might want to check with them to learn what tests are run to ensure their products are free of contaminants, etc.
Re K2 (MK-7) — I don’t know how much vitamin D3 YOU need to get your blood levels into optimal range (60-80 ng/mL). If you need the amount of vitamin D3 required by the “average” person (for whom 2,000 IU/day is often sufficient), then 100 mcg of K2 (MK-7) should be fine. If you need 5,000 to 10,000 IU of D3/day, then you will need more K2. D3 and K2 must be in balance. Vit D3 increases your body’s production of vit K dependent proteins, so you will make more of them and will need more K2 to activate them. For example, I personally need 10,000IU of D3/day to get my blood levels into good range, so I need at least 300 mcg of MK-7. I try to get around 400 mcg/day of MK-7 from supplements plus my diet. Hope this helps, Lara

sml
sml

Lara:
I have read your recommendation for taking AlgaeCal . I am presently taking New Chapter Bone Strength Take Care. The calcium source from this brand is also algae as is the source for all the nutrients listed. Are you familiar with this brand? How does it compare to the AlgaeCal that you recommend?

Lara Pizzorno
Lara Pizzorno

Hi smlhealth,
There are a number of important to me differences between the algae used in New Chapter Bone Strength Take Care (Aquamin) and that which is used for AlgaeCal (Algas calcareus). Aquamin is a different species of algae from Algas Calcareas. Aquamin (used in New Chapter) has no published studies supporting its efficacy in promoting increases in bone density. AlgaeCal has 2 in vitro and 2 human clinical trials proving its effectiveness. New Chapter’s algae is sourced by dredging in the North Atlantic; dredging is harmful to the coral and the sea floor environment, and the dredging equipment has a huge nozzle so picks up a LOT more than just sea algae. AlgaeCal is gathered carefully by hand from the shoreline off the coast of South America (where it washes up) or from the sea floor by divers. This is a pristine environment, and AlgaeCal does everything possible to keep it that way.

Aquamin costs less than AlgaeCal –Why? Here are a number of reasons:

AlgaeCal is a tropical species / Aquamin is a North Atlantic species
AlgaeCal is live and phyto-nutrient rich / Aquamin is dead and decaying
AlgaeCal has a US FDA issued NDIN (dietary ingredient notification) / Aquamin has no NDIN, is not legally for sale in USA
AlgaeCal has done and published six safety studies / Aquamin has one unpublished safety study
AlgaeCal is USDA Certified Organic / Aquamin is not organic
AlageCal is harvested sustainably as evidenced by IBD and IBAMA / Aquamin is not sustainable as evidenced by their move from Ireland to Iceland for harvesting
AlgaeCal is ecologically Harvested by hand / Aquamin is harvested via dredging, which silts flora and fauna
AlgaeCal is a pure algae product / for Aquamin, *80% of material brought on to the large dredgeing ship is discarded as impure
AlgaeCal is untreated as it is clean and pure / Aquamin is bleached with Hydrogen Peroxide
AlgaeCal is clinically Supported for bone health:
•the only Ca complex to increase bone density in adults!
Health Canada claim pending.
•better absorption than CaCO3
•2X better mineralization of Osteoblasts than CaCO3 and Ca Citrate
•3X better proliferation of Osteoblasts than CaCO3 and Ca Citrate

Aquamin has no valid studies on bone health. Aquamin has done one “absorption study” where PTH response is measured. Because PTH exhibits an exaggerated response to any calcium, it is not considered a valid measurement by researchers in bone health. This is the only study Aquamin offer’s on bone health.

I hope this answers your question — and inspires you to try AlgaeCal, which significantly improved my bone density in only 10 months, so I can vouch for it personally, and this is why I am doing what I can to help get the word out about AlgaeCal. I know it works, Lara

Carol
Carol

Thanks, Laura, for your prompt and very detailed reply. In August 2011, my T score was -2.6 hip, -2.1 spine. I am 57-years-old. I had a partial esophagectomy/gastrectomy 16 years ago due to esophageal cancer and, therefore, need to get a lot of my nutrients from supplements. It is overwhelming me to find the right combination of products that will give me the amount of vitamins and minerals recommended to maintain my health, as well as improve my bone density and bone health. In addition, Algaecal suggests taking Strontium Boost along with Algaecal Plus. I have already purchased Dr’s Best Strontium Bone Maker (Strontium Citrate), and wonder if, in your opinion, Strontium Boost is a better product. Thanks again for your help.

Lara Pizzorno
Lara Pizzorno

Hi Carol,
You’re so welcome! Yes, very challenging to work out the optimal amounts of vitamins and minerals we each need, and especially with all you have gone through, even more so.
In Your Bones, I’ve laid out how you can figure out what you are getting from your diet and then what the supplement options are, so you can better determine what you need. If you don’t have the book, your library should have it, so you can check it out without having to buy it — although it costs less than $10 on Amazon these days. Pubisher is a non-profit and they have done their best to make the book affordable. If you haven’t read it, please consider doing so.
Re strontium –any strontium citrate supplement should be good. I do not personally know anything about Dr’s Best quality control, so I cannot vouch for this company. You could contact them and ask them what they do to ensure their products are free of heavy metals and other contaminants. If they have good independent quality control assurances, then their strontium citrate product should be fine. I do know about AlgaeCal and can personally tell you their quality control is excellent.
Be well! Lara

Sylvia Ross
Sylvia Ross

Hi Lara –
I just found this forum – thanks for all of the very interesting replies you have so kindly written. I have “Your Bones” on my Kindle now so I am reading (but must admit at my age I do forget rather quickly …so sometimes need to re-read..) How did your DEXA tests turn out after being on AlgaeCal?
I am Canadian and the BMD test shows lumbar spine T-score of -2.8 and Femoral neck T-score of – 1.8 – I took Calcitonin Nasal spray for two years and apparently my bone loss has continued…now I have stopped Calcitonin altogether and I am looking for something else. Your indepth info on Strontium Citrate has me leaning that direction….. but when I came across this info from you about AlgaeCal I thought it was worth considering…so my dear, I am asking how are your bones now?
What do you recommend for me – age 74 with fine bones…and osteoporosis with the above BMD results? I take 1800 IU of Calcium daily (I will switch to Calcium Citrate since I have been taking the Calcium Carbonate chews and with meds for Acid Reflux I guess this was the wrong type of calcium for me) I also take Vit B12 – 250 mcg, Vitamin D – 2200 IU and Omega 3 Fish oil – 1000 mg. It would be nice to just swallow one pill – that would help bones and all else!
Many thanks Lara and any suggestions would be appreciated.
Sylvia

Lara Pizzorno
Lara Pizzorno

Hi Sylvia,
Delighted you are finding the information in Your Bones annd here on AlgaeCal’s blog helpful. As you work your way through Your Bones, I hope you will use it to figure out how much your diet is providing for you of the nutrients essential for building healthy bones and what and how much you will need to get from supplements.
Don’t know where you live in Canada, but if anywhere near Vancouver, BC, I will be giving 5 “Wellness Series” lectures for Factors Group discussing bone health in Vancouver Oct 22-24. I believe these are open to the public. Would love to meet you if you live anywhere near.
Personally, I take a good high-potency multiple (6 capsules is the daily dose), AlgaeCal Plus (for additional supplemental calcium, magnesium, D3 and K2) and Strontium Boost. Because of my genetic inheritance, which includes faulty vitamin D receptors, I need even more vitamin D3 and therefore more K2 (D3 and K2 need to be in balance), so I take extra of these as well, also take some vitamin A (another fat-soluble nutrient that works with and must be in balance with vitamins D and K) and omega-3s (and try to eat salmon at least once a week). I sure wish I could just take 1 pill, but reality is that this would not do the job for me. Every woman in my family whom I know about for many generations back died from osteoporosis — I am the poster child for risk for this disease, but have managed to beat it by learning what my bones need and supplying it. And if I can beat it, truly, anyone can!
I began taking AlgaeCal after coming across the research — 2 in vitro trials and 2 human trials — conducted on their products and published in the peer-reviewed medical literature about 2 years ago now. As a medical editor/writer, I typically spend 3-4 hours every day scanning the research and bone health is my special interest, so that’s how I learned about AlgaeCal. My results have been excellent — after 10 months of using AlgaeCal as my source of supplemental calcium, I had my DXA run. BMD in my hip/femur had gone up 3.5% and was up 6% in my spine. Prior to using AlgaeCal, I had been rebuilding bone, but SLOWLY. Now I am barely osteopenic and expect my next DXA will show I am fully in the healthy “normal” range. My results have convinced me that AlgaeCal is the calcium supplement I am going to continue to use. Why is it so much more effective? My guess is related to the research I am now seeing indicating how important a variety of trace minerals are to healthy bone remodeling — and these trace minerals are supplied naturally in AlgaeCal. It is NOT just calcium, but calcium within the matrix of all the trace minerals required by the sea algae to build its bony structure.
I hope this information is helpful to you and encourages you to give AlgaeCal a try. FYI — I am NOT paid by AlgaeCal to promote its products. I am not being paid to respond to questions here on this blog. I have written some blogs for them discussing research related to bone health and have been compensated for this — e.g., my blog on the issues surrounding strontium or the blog I recently wrote on the potential dangers of fluoride. But let me reiterate, I am NOT paid to be a sales person for AlgaeCal. I use it because it works.

Carol
Carol

Hi Laura, You recommended calcium citrate, malate, gluconate, aspartate, or hydroxyapatite over calcium carbonate in calcium supplements, yet calcium carbonate appears to be the major form of calcium found in the algae used in Algaecal. What is your your opinion on the effectiveness of this supplement over calcium carbonate? The information on Algaecal sounds good, but I would like to hear a recommendation fom someone besides the people selling the product. Thanks!

Lara Pizzorno
Lara Pizzorno

Hi Carol,
AlgaeCal actually contains several forms of calcium — calcium hydroxide, chloride, phosphate and sulfate in addition to carbonate. I’ve seen the independent lab analysis. Why do I believe AlgaeCal is more effective than plain calcium carbonate? I read the research. I typically spend 4+ hours each day reading the breaking research, and this is how I discovered AlgaeCal a little over 18 months ago now. Research conducted by AlgaeCal (which BTW is VERY unusual since supplements of natural compounds cannot be patented, so very few companies spend the $ on research), pitting its algae-derived calcium against calcium carbonate and calcium citrate in head to head studies — a human osteoblast study and two human studies — convinced me to try it.
In the in vitro research, AlgaeCal produced 200 – 400% greater proliferation and mineralization of osteoblasts (bone building cells) than did calcium carbonate or citrate. In AlgaeCal-treated cells, levels of PCNA (proliferating cell nuclear antigen, a protein involved in DNA synthesis and repair) and DNA synthesis were also much greater (4.0-fold greater than control, 3.0-fold greater than calcium carbonate, and 4.0-fold greater than calcium citrate). The end result was that more calcium (Ca2+) was deposited in AlgaeCal treated cells (2.0-fold more than controls, 1.0-fold more than calcium carbonate, and 4.0-fold more than calcium citrate-treated cells). When vitamin D3 was also added to the treated osteoblasts, the results were even better.
AlgaeCal was also found to significantly reduce oxidative stress in the osteoblasts after just 24 hours. (Oxidative stress promotes inflammation, which then triggers osteoclasts, the specialized cells that break down bone, to spring into action.) AlgaeCal reduced oxidative stress in human osteoblasts by 4-fold compared to controls (untreated cells), 2-fold compared to calcium carbonate, and 2.5-fold compared to calcium citrate.
These promising results led to 2 human trials, in which results were excellent. 2 versions of AlgaeCal supplements were used– AlgaeCal 1 and AlgaeCal 2. To put these results into perspective, you should know that the “conservative” (least) expected drop in BMD for women aged 41-55 is a loss of -0.5%/year, for women 56 and older, a loss of -1.0%/year, and for men, a loss of half these amounts. However, population-based longitudinal studies suggest that these loss estimates are not high enough. Minor bone loss starts at age 40, increasing to 0.5% to 0.9% a year in peri-menopausal women and to above 1% after menopause, after which the yearly loss in BMD remains about 1%. Other studies suggest that after midlife, in men as well as women, there is an age-related yearly loss of bone of 1%, which, for women, accelerates to 2% for up to 14 years around the age of menopause (which typically occurs around age 52). In men, a small loss is detected in 40-year olds, which increases to a loss of about -0.8% per year into old age.
Compared to the most conservative estimate for annual bone loss given above, AlgaeCal 1 had a positive mean annualized percent change (MAPC) in BMD of a gain of +1.15%. AlgaeCal 2 had a positive MAPC of +2.79%. With no negative side effects. No clinically significant changes in a 43-panel blood chemistry test were found, and neither group reported even one adverse effect.
Upon completion of this initial study, a second study was done to look at the effects of three different versions of an AlgaeCal bone-health supplement program. In this study, 176 women over 40 years of age followed one of three different bone-health programs: Plan 1 used a bone-health supplement with vitamin D3 (800 IU), AlgaeCal’s plant-sourced form of calcium (720 mg), and vitamin K as MK-4 (1.5 mg) for one year. The other two Plans also used AlgaeCal’s plant calcium, but in differing amounts (750 mg in Plan 2, 756 mg in Plan 3), and with differing amounts of vitamin D3 ( 1,000 IU in Plan 2; 1,600 IU in Plan 3) and other bone health ingredients. Most importantly, vitamin K2 was not used in Plan 2, but was included in Plan 3 as MK-7 (100 mcg). Upon completion of this initial study, a second study was done to look at the effects of three different versions of an AlgaeCal bone-health supplement program.
After this, a second human trial was run. In this study, 176 women over 40 years of age followed one of three different bone-health programs: Plan 1 used a bone-health supplement with vitamin D3 (800 IU), AlgaeCal’s plant-sourced form of calcium (720 mg), and vitamin K as MK-4 (1.5 mg) for one year. The other two Plans also used AlgaeCal’s plant calcium, but in differing amounts (750 mg in Plan 2, 756 mg in Plan 3), and with differing amounts of vitamin D3 ( 1,000 IU in Plan 2; 1,600 IU in Plan 3) and other bone health ingredients. Most importantly, vitamin K2 was not used in Plan 2, but was included in Plan 3 as MK-7 (100 mcg). All three AlgaeCal Plans tested produced increases in BMD — a marked improvement over just slowing the rate of age-related bone loss. In all three treatment groups, study participants with above average compliance had significantly greater increases in BMD compared to the losses seen in the two expected-change reference groups. Women in the Plan 3 group, the group receiving the most nutritionally comprehensive supplement program (the one now available at https://www.algaecal.com/, gained significantly more BMD than the other two groups. Subjects in all three plans had an increase in BMD: Plan 1= +1.20%, Plan 2= + 0.33%, and Plan 3= +2.5%. Again, no adverse effects were reported nor were any seen in the comprehensive blood chemistry tests run on study participants.
After reading these papers (which were published in the peer-reivewed medical literature and are accessible on PubMed), I decided to try AlgaeCal. My results have been excellent — after 10 months of using AlgaeCal as my source of supplemental calcium, I had my DXA run. BMD in my hip/femur had gone up 3.5% and was up 6% in my spine. Prior to using AlgaeCal, I had been rebuilding bone, but SLOWLY. Now I am barely osteopenic and expect my next DXA will show I am fully in the healthy “normal” range. My results have convinced me that AlgaeCal is the calcium supplement I am going to continue to use. Why is it so much more effective? My guess is related to the research I am now seeing indicating how important a variety of trace minerals are to healthy bone remodeling — and these trace minerals are supplied naturally in AlgaeCal. It is NOT just calcium, but calcium within the matrix of all the trace minerals required by the sea algae to build its bony structure.
I hope this information is helpful to you and encourages you to give AlgaeCal a try. I am NOT paid by AlgaeCal to promote its products. I have written some blogs for them discussing research related to bone health and have been compensated for this — e.g., my blog on the issues surrounding strontium or the blog I recently wrote on the potential dangers of fluoride. But let me reiterate, I am NOT paid to be a sales person for AlgaeCal. I use it because it works.

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Derek O'Brien
Derek O’Brien

Lara, Thanks for the extra git you gave, much appreciated.

We are lucky here in Australia, our dairy is virtually all green-grass grazing, much of our beef is too, especially when obtained from the local butcher and not the supermarket; can get free-range chickens cooked to perfection locally, lamb is always green-grass grazed, but pork is a mystery due to production methods, and if I choose to eat seasonal fruit and vegetables organic, I am happy as a lark. Low incidence of GMO foods, but the rubbish is sneaking in, our politicians, all being lawyers, plus an occasional farmer, make stupid scientific decisions, so GMOs are getting in.

Items left from my list of meds: Super Ubiquinol CoQ10 from LEF, Zinc 22 mgm, Chromium 50 mcg, daily and copper 2mg twice a week; manganese is picked up from CA/Mg supplement. Waiting for delivery of Vanadium.

Yes, all dairy is full cream, yogurt and NZ Cheddar cheese; unfortunately milk is homo/pasteurised and fresh is unobtainable. And basically following a low carb diet otherwise. With exercise, this is reducing the overweight problem and settling a diabetic tendency by assisting metformin; blood sugar is very well in control.

I will look into the Algaecal when my stock of Ca/Mg supps gets down to reorder level.

Take care.

DEXA rescheduled, machine was out of action this morning.

Lara Pizzorno
Lara Pizzorno

Australia — truly one of the loveliest places on Earth. You are so lucky to live there! We’ve visited a couple of times — we have friends at Southern Cross University and my husband, Dr. Joe Pizzorno, has lectured there. We fell in love with Australia, both the land and the wonderful people. Still hoping to get back for another visit to Brampton Island where we swam in lagoons and were surrounded by clouds of electric blue butterflies–am I remembering how to spell this correctly?
Sounds like you are doing lots of good things for not only your bones, but your health overall. Hope you will let me know how your DXA turns out. Expect results will be good. Re AlgaeCal — adding this form of supplemental calcium to my regimen made a HUGE difference for me. I had been rebuilding bone, but slowly. Within 10 months of using AlgaeCal Plus, my 2012 DXA showed BMD ↑3.2% in my hip, and ↑6% in my spine from 2011. Since switching to AlgaeCal was the ONLY thing I changed in what I had been doing, I am now a believer. I hope you will give AlgaeCal a try when you need to reorder you calcium supps.
Stay gloriously well, Lara

JoAnn Rice
JoAnn Rice

I do not see anything written about the dosage one should take for Strontium Citrate? and how many times a day? I was thinking of ordering mine from Vita Cost but see brands. Any thought?? Thank you JoAnn Rice

Tyler
Tyler

Thanks Lara,

I have asked questions on a number of different blogs or emails to companies and it seems like my posts/emails usually get rejected/or no response, probably because I asked questions that couldn’t be accurately answered and thus demonstrated the fallaciousness of the product/marketing claims. Luckily, strontium has science to back it up and someone (i.e. you) knowledgeable to answer questions concerning it.

I currently agree that after taking the higher strontium dosage until the desired results (with corrections of overestimation—based on the attenuation coefficient—due to the larger ionic radius of strontium—as you said above) that a lower dosage would be desirable. As already mentioned, we know that lower doses are still effective just not as effective, so taking the lower doses would be advisable after the temporary period of higher doses. I think this is good advice especially if the patient has impaired renal function and thus subsequent decrease in its clearance by the kidney.

Thanks again!

Tyler
Tyler

Hi Lara,

Thanks so much for looking into all that. You have been so nice, I actually feel kind of bad for giving you a headache over the above contested quotation from Li’s thesis paper. I must be honest with you, I have done a lot of research with strontium and when I read Li’s thesis paper I was surprised that he was suggesting 170 mg to be more effective. I read the article by Meunier that he cited, but it was evident that said article supported 680 mg not 170 mg to be the most effective.

I then searched a series of database/citation indexes (e.g. PubMed, Web of Science, Scopus, HighWire and Google scholar) for all the articles by Meunier and found over 150 articles relating to strontium in which he was involved. None of the articles however, showed 170 mg to be more effective than 680 mg.

I then came across Dr. Keith Scott Mumby’s article which said 170 mg is more effective. I also came across Dr. Don Colbert’s article which also said that 170 mg is more effective and he cited Meunier (same reference that Li gave) for the information.

This made me go back through all the articles and recheck them more punctiliously; I also did some stoichiometry based on the molar masses of strontium and the various anions to see if the discrepancy could be reconciled by various methods used to report dosage (i.e. elemental vs. compound). Indeed the 500 mg of strontium ranelate (used in Meunier study) is equivalent to 170 mg of elemental strontium, and 2 grams of the compound equates to 680 mg of strontium. I searched the literature again for equivalent doses of 170 mg elemental strontium, in every case the higher dose was shown to be more efficacious.

However, I did come across one article using what they called “low dose” strontium phosphate, that may lend support. But the article was not clear on the elemental dosage of strontium because they only gave the molecular weight in compound form. It was impossible to calculate the elemental dosage because they didn’t provide the molar-mas of the compound. So I made the assumption that the formula was strontium di-calcium phosphate (in which case the molar mass=357.7 g/mole). I couldn’t know for sure if this is the correct molar mass, because there is nowhere for an extra divalent ion (i.e. strontium) to bind to Ca3(PO4)2. (So it could have been di-Sr, a mixture or something else.) With that assumption the results indicated that around 400 mg of strontium was very effective, but this is still higher than 170 mg.

I then decided to e-mail the authors; I asked Li, Doctors Mumby and Colbert, about the discrepancy. I also e-mailed Meunier and asked if his cited study (or any he knew of) suggested 170 mg to be more effective than 680 mg—as the above people are citing him as demonstrating that.

In waiting for their reply, I came across this blog and noticed you not only had done an extensive amount of research on strontium, but you were answering everyone’s questions. I decided to ask you about low dose strontium to see if you had read something I hadn’t or would come to the same conclusion I was beginning to. It has now been 3 weeks and I have received no response by any of the authors. I am surprised that Meuiner didn’t get back to me—his actual email address is different than the one given in the articles, in fact the one given doesn’t even work, luckily I found his actual contact info.

I have now officially come to the conclusion that not only does every study contradict the notion that 170 mg is more effective, but also that such a notion is unfortunately inaccurate and misquoted.

Again, Lara sorry for giving you a headache with this strontium dosage, and thanks so much for your help in investigating this matter with me, if any of those authors emails me back I will let you know.

-Tyler

Lara Pizzorno
Lara Pizzorno

Hey Tyler,
What a great insight of yours! Of course, the elemental vs. compound difference can explain the seeming dosage discrepancy. Nonetheless, from the papers I have read, 170 mg of elemental strontium has not been shown to be more effective in rebuilding bone — although even the longer studies looked at no more than 2 years if I remember correctly. So, they were looking at short term (in comparison to the rest of a postmenopausal woman’s life span) outcomes. The question I have is — would this lower dosage be a better long-term choice after initial improvements? As you know, our bones continue to remodel throughout our lives, so the therapies used to support healthy bones must be ones we can rely on long-term. I have discussed this isssue now with a number of physicians — docs whom I feel are among the smartest on the planet — and all are in agreement that 680 mg may not be the best long-term choice. So, the issue you bring up is an imporant and valid one.

Personally, I expect to no longer be even borderline osteopenic by my next DXA (about 9 months from now)– and as soon as that happens, I am going to run an n=1 trial, cut my strontium dosage in half and see how that works for me.

Please don’t apologize for asking such interesting questions, especially since the answers to them could have very significant practical relevance for human health. Our correspondence has been a total delight for me. Don’t be discouraged not to have heard back yet from Li, Mumby or Colbert — I expect all have many demands on their time. I have corresponded with a number of leading researchers. In both the review articles I have written on a variety of topics on Longevity Medicine Review and as I was writing Your Bones, I have had quite a few questions for which I could not find answers in the published research, so I wrote the people whose published work indicated they were the seminal researchers involved. Some responded quickly;others took several months to get back to me — but all responded eventually and have been most helpful.

Keep asking questions! And stay gloriously well,
Lara

Mary Bomford
Mary Bomford

Hi Lara
I want to share my new way to eat natto as it is not an easy food for westerners to eat! Getting adequate vitamin K2 is clearly important for maintaining bone strength but not everyone can afford to get K2 from supplements and getting adequate K2 from natural foods is not easy either. Japanese Natto (fermented soybeans) has extremely high concentrations of vitamin K2 and packets of frozen natto are available at low cost from Asian food shops. But natto has a very strong smell and a slimy texture and most westerners don’t like it. I bought some and was determined to eat it regularly. But I really struggled with smell and the slimy coating. So now I have a new way of eating it which does not have this problem. I eat it frozen!!! I just break off bite size frozen pieces, crunch them up in my mouth quickly and swallow them with a mouthful of hot tea. I actually enjoy eating natto this way and look forward to it. I’m going to go and eat some now as I am determined to keep my bones strong!!!
Mary

Tyler
Tyler

Hi Lara,

For that quotation out of Li’s thesis article he cites Meunier as the author of the study, and cites him twice :

This is the 2004 article
Meunier, P. J., Roux, C., Seeman, E., Ortolani, S., Badurski, J. E., Spector, T. D.,
Cannata, J., Balogh, A., Lemmel, E. M., Pors-Nielsen, S., Rizzoli, R., Genant, H.
K., and Reginster, J. Y. (2004). The effects of strontium ranelate on the risk of
vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med
350, 459-468.
Here is the link: http://orbi.ulg.ac.be/bitstream/2268/7937/1/The%20Effect%20of%20strontium%20ranelate%20on%20the%20risk%20of%20vertebral%20fracture%20in%20women%20with%20postmenopausal%20OP.pdf

Here is his 2002 article which is the one being cited. And already you posted the abstract above.
Meunier, P. J., Slosman, D. O., Delmas, P. D., Sebert, J. L., Brandi, M. L.,
Albanese, C., Lorenc, R., Pors-Nielsen, S., De Vernejoul, M. C., Roces, A., and
Reginster, J. Y. (2002). Strontium ranelate: dose-dependent effects in established
postmenopausal vertebral osteoporosis–a 2-year randomized placebo controlled
trial. J Clin Endocrinol Metab 87, 2060-2066.
Here is the link: http://jcem.endojournals.org/content/87/5/2060.full.pdf

Which one did you get in French? Perhaps the information in Li’s thesis article was cited inaccurately? as this happens from time to time.

Lara Pizzorno
Lara Pizzorno

Hi Tyler,
Here’s the 2004 paper that came up when I ran a PubMed search for Meunier PJ:

Med Sci (Paris). 2004 Jun-Jul;20(6-7):631-3.

[Strontium ranelate: new therapeutic agent for postmenopausal osteoporosis].

[Article in French]

Meunier PJ.

PMID: 15329809 [PubMed – indexed for MEDLINE] Free full text

I just ran a PubMed search for Meunier PJ 2002 again, and the article appeared — I have no idea why it did not come up for me when I checked earlier. WEIRD!
So, I have finally read the paper — but I found no mention of a 170 mg dose of strontium being used. I ran a search within the paper to be sure, and nothing came up for 170 mg. The dosages given in the 2002 paper were 0.5 gram, 1 gram or 2 grams/day for 2 years, and best results were seen with 2 gram dose.

Regardless, I still think you are correct in suggesting a lower than 680 mg/day dose of strontium citrate may be helpful. In those with osteoporosis or osteopenia, I would suggest 6 months to a year at the 680 mg dose, then once benefit has been verified with DXA, discussing with their physician the possibility of lowering the dose and rechecking in 6 – 8 months.

One other thought — have you considered trying to contact Li and asking him for a link to the research in which 170 mg of strontium was used successfully? I looked again at his thesis, but could find no contact information there. Would you have access to a means of contacting Li through the HKU Scholars Hub?

Tyler
Tyler

Hi Lara,
Thanks for the info on Vitamin D. That’s interesting that it was advised to only state 100%, but in some ways isn’t surprising.

Re-low dose strontium the statement:

“Interestingly, according to one study, 170 mg of strontium per day was more effective than 680 mg per day for reducing fracture risk (Meunier et al., 2002), which raises the possibility that even lower doses might be as effective as, or more effective than, the dosages that have been studied.”

Is a direct quotation from Li’s thesis paper cited above on page 41 of the document or page 59 in the PDF format, if you just scroll down to page 41 or type in page 59 or search “more effective than” you will find it.

Also Dr. Keith Scott Mumby, is saying the same thing, http://www.healthiertalk.com/bone-disease-kills-more-women-breast-cancer-3924 found near the bottom under strontium.

Hope that helps thanks again!

Lara Pizzorno
Lara Pizzorno

Hi Tyler,
Thanks, I found the reference to this study in Li’s thesis — unfortunately, Li does not provide us with a footnote on it, just one for the 2004 paper by Meunier et al. I read French, so read this paper; it says nothing about strontium dosages. I looked at Dr. Mumby’s article — he also provides no references (and I sure wish he had specified the type of vitamin K2 he is referring to when suggesting a 10 milligram daily dose is MK-4! And also that the effective dose for MK-4 in the research is 45 mg/day [actually 15 mg taken 3 times daily]. You do NOT want to take 10 milligrams of MK-7 daily! Just 100 micrograms of MK-7 is effective.) Thus, I am unable to read the paper in which 170 mg of strontium is said to be more effective, so I do not know what was done and cannot give you more helpful feedback on this. If you can locate this paper, please do let me know. Sorry that I have not been able to find it on PubMed.

Tyler
Tyler

Hi Lara,
Thanks again for your response. I am glad that AlgaeCal has lots of Vitamin D in it, I completely agree that the D.V of 400 and the DRI of 600 is way too low. I have seen a number of studies showing that unless the subjects took at least 800 IU’s of vitamin D there was no improvement in the measured parameters. I was just thinking that because AlgaeCal provides more than the DV, it should be reflected in the percentage given. Just as it gives the appropriate % of calcium and magnesium, I would think it would do the same for vitamin D. However, as mentioned the labels on both, the plain and plus, state they each contain 100% of the DV when in reality they contain 200% and 250% of the DV. Shouldn’t the label reflect the actual percentage?

I agree with your assumptions on thyroid and iodine—great article by the way, I hope others reading these posts will check it out—I felt the same way, but I wanted to ask you because I could see that you had already done an extensive amount of research and willing to answer peoples questions/concerns. I like it when people reach the same conclusions I have.

I mentioned this earlier, what are your thoughts on the following statement given in Li’s thesis paper (cited above):

“Interestingly, according to one study, 170 mg of strontium per day was more effective than 680 mg per day for reducing fracture risk (Meunier et al., 2002), which raises the possibility that even lower doses might be as effective as, or more effective than, the dosages that have been studied.”

Thanks again for your insights.

Lara Pizzorno
Lara Pizzorno

Hi Tyler,
I asked AlgaeCal for a response to your question and it appears that the reason is a legal issue. Originally, the labels were made just as you suggested, but for some legal reason, they were told 100% is maximum that should be stated for vitamin D. Also as I am sure you know, some “experts” are still saying 600-800 IU of vitamin D is the recommended amount – despite years of research and literally hundreds of studies now showing this is not the case. Bottom line here for practical purposes — i.e, YOUR HEALTH, it is not best to simply now rely on the RDI % to determine whether a supplement is providing what YOU need – particularly in the case of vitamin D, a blood test to check your levels of 25(OH)D is essential and should be run every 3-6 months for at least a year to get an indication of how the seasons affect YOUR vit D levels depending upon where YOU live, YOUR lifestyle, diet, genetics, etc.

RE strontium at a lower dose – I agree with you, and so does Dr. Wright. He is now telling his patients that once positive effects have been noted (say 3-6 months of 680 mg dose shown to be effective in the research) that they should drop this dose down to half this amount or even less.
However, no research that I know of specifically shows that 170 mg of strontium /day is more effective in preventing fracture risk, and the only PubMed article I can find for Meunier et al in 2002 concludes a 2 gram/day dose is most effective – here is the abstract:
(Is the sentence you quoted somewhere in the full paper? After reading the abstract, I did not pull the full article.)

J Clin Endocrinol Metab. 2002 May;87(5):2060-6.

Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis–a 2-year randomized placebo controlled trial.

Meunier PJ, Slosman DO, Delmas PD, Sebert JL, Brandi ML, Albanese C, Lorenc R, Pors-Nielsen S, De Vernejoul MC, Roces A, Reginster JY.

Source

Hôpital Edouard Herriot, 69437 Lyon, France. [email protected]

Abstract

The aim of the strontium ranelate (SR) for treatment of osteoporosis (STRATOS) trial was to investigate the efficacy and safety of different doses of SR, a novel agent in the treatment of postmenopausal osteoporosis. A randomized, multicenter, double-blind, placebo-controlled trial was undertaken in 353 osteoporotic women with at least one previous vertebral fracture and a lumbar T-score <-2.4. Patients were randomized to receive placebo, 0.5 g, 1 g, or 2 g SR/d for 2 yr. The primary efficacy endpoint was lumbar bone mineral density (BMD), assessed by dual-energy x-ray absorptiometry. Secondary outcome measures included femoral BMD, incidence of new vertebral deformities, and biochemical markers of bone metabolism. Lumbar BMD, adjusted for bone strontium content, increased in a dose-dependent manner in the intention-to-treat population: mean annual slope increased from 1.4% with 0.5 g/d SR to 3.0% with 2 g/d SR, which was significantly higher than placebo (P < 0.01). There was a significant reduction in the number of patients experiencing new vertebral deformities in the second year of treatment with 2 g/d SR [relative risk 0.56; 95% confidence interval (0.35; 0.89)]. In the 2 g/d group, there was a significant increase in serum levels of bone alkaline phosphatase, whereas urinary excretion of cross-linked N-telopeptide, a marker of bone resorption, was lower with SR than with placebo. All tested doses were well tolerated; the 2 g/d dose was considered to offer the best combination of efficacy and safety. In conclusion, SR therapy increased vertebral BMD and reduced the incidence of vertebral fractures.

PMID: 11994341

Tyler
Tyler

Hi Lara,

Thanks again for your reply. That makes sense about the calcium dosage; the online label didn’t say how often to take it. I did notice something interesting on the label though. The D.V. for vitamin D is 400 IUs and the plain and plus give 1000 IUs and 800 IUs respectively, but they both say they deliver 100% of the D.V., shouldn’t it say 250% and 200% correspondingly? Or does it have something to do with calculated equivalences?

The information on the strontium/thyroid is found in the Li’s thesis paper cited above. It states the following:

“Strontium supplementation also increased thyroid-gland weight and decreased pituitary weight in rats, with a “no-observed-adverse-effect-level” roughly equivalent to 41 mg per day for humans”

Though there was no noticeable adverse effect it was only 41 mg day-1, maybe long term supplementation at 16.6 times that much could pose an issue.

I found the referenced study, with its PMID #, for you.
Kroes, R., et al. Short-term toxicity of strontium chloride in rats. Toxicology 7, 11-21. PMID: 841579

-Tyler

Lara Pizzorno
Lara Pizzorno

Hi Tyler,
In answer to your first question regarding the labeling on AlgaeCal’s calcium products, yes, they supply a little bit more than the DRI, but the DRI is considered insufficient by virtually all the experts in the field of vitamin D research.
DRIs for vitamin D are:
Children 1-13 years: 15 micrograms (600 IU)
Teenagers 14-18 years: 15 micrograms (600 IU)
Adults 19-70 years: 15 micrograms (600 IU)
Adults above 70 years: 20 micrograms (800 IU)
Pregnant and lactating women: 15 micrograms (600 IU)
Most medical authorities in the field of vitamin D research, e.g., Dr Michael Holick, also check the Vitamin D Council, recommend at least 2,000 IU/day. We have found the majority of patients we have screened need 5,000 IU /day or even more. The only way to know what YOU need is to run the blood test for 25(OH)D and see what your levels are — optimal level is considered to be 60-80 ng/mL.

Regarding strontium/thyroid — Thanks for sending me the PMID. I took a look at the study — this is one short term (90 day) rat study done back in 1977. I looked but could find no other study that has replicated these findings or reported similar findings since. If this had been a significant issue, SOMETHING further should have shown up by now. It has not. Even strontium ranelate (the drug version of strontium supplelmentation, which greatly increases risk for a variety of life-threatening side effects including DRESS syndrome and venous thromboemoblism) has not been linked to adverse effects on thyroid function. But I would strongly advise you NOT to use any dosage of this abnormal form of strontium!
I also found interesting the researchers comment that iodine insufficiency might have been a contributing factor. MANY people are deficient in iodine for a variety of reasons I summarized in a 2 part review paper I wrote on iodine for Longevity Medicine Review (here is a link to Part I –http://www.lmreview.com/articles/view/iodine-the-next-vitamin-d-part-I/) As I expect you know, our bodies cannot produce thyroid hormone without sufficient iodine (T4 requires 4 iodine molecules, T3 requires 3 of them). Many factors in our current environment prevent us from getting sufficient iodine for optimal thyroid function.
Still, none of the research that I have seen has ever mentioned any adverse effect on thyroid function from natural forms of strontium at a dosage level of 680 mg/day. Again, however, what you (and each of us) is concerned about is YOUR personal potential for adverse effect. If you have reason to believe YOUR thyroid function might be affected (e.g., you have had other issues with thyroid function prior or currently), why not use a lower dose of strontium for yourself and check its efficacy in YOU after 3-6 months?

Barbara
Barbara

Hi Lara:
Thank you so much for your response. I am very appreciative for all the information. I am doing many of the things you mentioned and have one more quick question. Will the trace minerals in AlgaeCal be enough on a daily basis or do I need to supplement?

Thank you again.

Lara Pizzorno
Lara Pizzorno

Hi Barbara,
Very glad to hear you are doing many of the things I noted that are essential for healthy bones. AlgaeCal’s content of trace minerals is excellent, however, no supplement can make up for lack of a healthy diet. Remember, supplements are just that — SUPPLEMENTS, not replacements for food. If you are consuming a Mediterranean-style diet rich in organically grown vegetables (esp leafy greens, whole grains, nuts [eg Brazil nuts are an excellent source of selenium — so good that you don’t want to consume more than 2 Brazil nuts a day]), then this combined with AlgaeCal Plus will be providing you with a good supply of trace minerals. Conventionally grown vegetables have been shown to contain far less of many minerals, so if you are not eating organic, all bets are off here. Hope this helps, Lara

Tyler
Tyler

Hi Lara,

That makes sense about the calcium dosage. The label online didn’t say how often to take it. I did notice something interesting though; the D.V. for vitamin D is 400 IUs, but the labels for the plain and plus both show 100% of the D.V. when they have 1000 IUs and 800 IUs respectively? Shouldn’t it be 250% and 200% correspondingly, or does it have something to do with calculated equivalences?

The strontium and increase in thyroid weight, that I had reference to, can be found in the thesis paper (cited above) in one of the literature review portions. States the following:
“Strontium supplementation also increased thyroid-gland weight and decreased pituitary weight in rats, with a “no-observed-adverse-effect-level” roughly equivalent to 41 mg per day for humans.”

I found the study, with the PMID # for you that was referenced in the above dissertation.
Kroes, R., et al. Short-term toxicity of strontium chloride in rats. (1977) Toxicology V.7 p. 11-21. PMID:
841579

What are your thoughts about the following quotation mentioned earlier from Li’s thesis paper? “Interestingly, according to one study, 170 mg of strontium per day was more effective than 680 mg per day for reducing fracture risk.”

As always thanks again for your insights.

-Tyler

Tyler
Tyler

Hi Lara,

Below are the citations of the studies I referenced above.

M.E.J. Curzon, P.C. Spector. “An association between strontium in drinking water supplies and low caries prevalence in man” Arch Oral Biol. 1978; 23(4):317-21. PMID: 278570 http://dx.doi.org/10.1016/0003-9969(78)90025-0

Li, Zhaoyang. “Novel strontium fortified calcium salt for enhancing bone formation As in vitro and in vivo large animal model study”. This is a 2007 dissertation paper I found on Europe PubMed Central. You can get it at the following link. http://ukpmc.ac.uk/theses/ETH/2476

Also I find the lower dosage of calcium in “AlgaeCal Plus” to be more appealing than the plain (360 mg compared to 750 mg); however, I do wonder why does it contain so little calcium relative to the given dosage of strontium; it appears, from the studies and recommendations given on this website, that calcium intake should be greater than that of strontium intake?

Thanks again for your help.

Lara Pizzorno
Lara Pizzorno

Hi Todd,
Calcium dosage in AlgaeCal Plus is actually 2x 360 or 720 mg/day as recommended daily dose of this supplement is 2 capsules, twice daily. EASY to miss this — I did for the first several months after I began taking AlgaeCal Plus.
THANK YOU for the links to these papers! So interesting! (I realize you have read these papers, but wanted to include a couple of quotes from them for others who may be interested and have not.)
Curzon study — especially interesting to me was “This effect seems to reach its optimum when concentrations of Sr at 5 to 10 mg/l with 1 mg/l of F are present in the drinking water for man.” As you probably know, fluoride in excess is damaging to teeth and to bone. I recently wrote a blog on this, which is posted in the blog section of AlgaeCal’s website, so I would not recommmend taking fluoride, but given how much of our water in the US is fluoridated, we are surely getting this much (probably more, which may not be good). In terms of this small an amount of strontium having beneficial effects on bone as well as teeth — I have not seen any research indicating this low a dose would be beneficial in bone.
Could you let me know what research you have seen suggesting effects on thyroid at 41 mg/day? I thought this might be in one of the two papers you kindly provided links to, but I could not find anything re thyroid in these, and I have seen nothing suggesting this in any of the papers on natural forms of strontium that I have read. Would very much appreciate any references you have on this issue and will follow up and get back to you.
Li’s thesis also very nifty — I am assuming this was animal research, so results would need to be confirmed in human trials, but his suggestion that “calcium will supply nutrition for bone while strontium will display synergistic effects for enhancing bone formation activity” and confirmation via the finding that “Oral administration of strontium fortified calcium compound significantly increased expression of IGF-I and Runx2 in bone matrix. Both IGF-I and Runx2 levels were positively associated with the bone mineral apposition rate (MAR).” is really stellar. If there is a synergistic effect here, that might help explain the exceptional results seen when strontium is added to a bone building regimen.
Finally, I don’t know what your current BMD is or risk for osteoporosis because of the specifics regarding your health, but if you are at high risk for fracture, then taking the dose of strontium provided by Strontium Boost for 6 months, then testing, would be my suggestion. Once improvement has been made then dropping down to a lower dose, say half to one-quarter this amount, may be sufficient. Again, you would need to use the lower dose for 6 months and then recheck. As the daily dose of Strontium Boost is 4 capsules, it would be easy to cut down to half (2 caps) or 1/4 (1 capsule).

Lara Pizzorno
Lara Pizzorno

Hi Tyler — can you send me the PMID #s for this study, so I can pull the full paper and see what exactly was done and the full results?
Dr. Wright recently commented to me that he thinks it best to start out with 680 mg of strontium citrate daily, but then to drop down to half this dosage or even a bit less once good results have been achieved.
I checked PubMed to see if any further research has come out re strontium citrate — the most recent paper — published just this July in the journal Bone documents excellent results in an osteoporotic woman who began taking strontium citrate at a dose of 680 mg/day in 2008 and has been followed since. Her BMD has continually increased, and after 800 days (the most recent check before the paper was submitted to Bone) strontium retention at her finger and ankle were 7 and 15 times higher than the initial baseline reading. No adverse effects. (Moise H, Adachi JD, Chettle DR, et al. Monitoring bone strontium levels of an osteoporotic subject due to self-administration of strontium citrate with a novel diagnostic tool, in vivo XRF: a case study. Bone. 2012 Jul;51(1):93-7. ) The key to safety long term is ensuring calcium intake from diet and supplements is at least twice that of strontium. And, of course, you also want to be sure to be providing adequate vitamin D to boost calcium absorption from the intestines and adequate vitamin K2 to activate the proteins that then ensure calcium is deposited in bone and not in arteries, kidneys or breasts.

Tyler
Tyler

Hi Lara,

Thank you for all the research you have done on this subject and for answering our questions. I am wondering if we whould be taking less stontium. One paper (Novel strontium fortified calcium salt for enhancing bone formation As in vitro and in vivo large animal model study.) said something to the effect that 170 mg of strontium per day was more effective than 680 mg per day for reducing fracture risk.

Safety does come first for me, and if at 41 mg/day they saw changes in thyroid I would like to take less. Futhermore if bones follow the pattern of teeth ,then according to the study, “An association between strontium in drinking water supplies and low caries prevalence in man”, maybe I should take 5-10 mg/day . The study found that caries followed a quadratic curve with strontium concentrations on the X-axis; the lowest prevalence of caries was seen with strontium concentrations of approximately 5-6 mg/L.

Audrey
Audrey

Hi Lara,
I had a small fracture in the pelvic area. I was taking Fasomac for three years with the doctor’s advice. I heard it was not good to take it so long. I came off and just took calcium supplements. I am now taking Algaecal for about a month. I had a bone density test done and found out I have low bone density which I know is not good. I can only have a bone density test done every two to three years. Can you give me some advice as to the best course I can take to prevent another fracture. I appreciate your knowledge and insight into women”s bone health. Also can you tell me where I can buy your book…Thank you so very much. I live alone and lost my family. So I need all the help I can get now…… God Bless you …….Audra

Lara Pizzorno
Lara Pizzorno

Hi Sandy,

THANKS for catching my misspelling of Dr. Genuis — although “Genius” would be more appropriate for his insights and accomplishments with the COMB research, and more fun (have you ever noticed the synchronicity between peoples’ names and their professions or accomplishments? Our dentist is Dr. Carie, and the lead author of a recent paper on men’s fish consumption, omega-3 levels and sperm count and activity is named Attaman. Such occurences add smiles to our days 🙂 )
OK — to your questions:
Re their recommendation of impact exercise for the participants in this study, I believe it was reasonable and helpful — here are the reasons why.
(1) Key point in the COMB paper is the “where possible” in this quote from the paper:”Patients were also instructed to commence and maintain a regimen of daily impact exercises such as jumping jacks or skipping where possible as impact has been associated with prevention of bone density loss.”
The bone density distribution in COMB study subjects ranged from normal, although low, BMD in comparison to age-matched controls since these were premenopausal individuals (25%), through (among the postmenopausal women), from slightly reduced (5%), to osteopenia (42%), to osteoporosis (29%). Thus, for 71% of the participants in this study, a short daily period of exercise, a few minutes of which was high impact exercise, was a reasonable and safe recommendation. Subjects with osteoporosis were not told to go home and do 300 jumping jacks.

(2) The first study cited by Genuis et al. as the basis for the exercise recommendations used brief (10-15 minute) periods of exercise, and these included several minutes for warming up and several for cooling down, so time spent at the ‘high impact” level was around 5 minutes per session. As you can see from the references listed below, in the Niu et al. study, the exercises were conducted during short breaks from work at the office.
The other study cited (Korpelainen et al.) used a more aggressive exercise program. Subjects were 160 postmenopausal women, mean age 73 years, with a hip BMD value of more than 2 standard deviations below the reference value, so clearly well into the osteopenic / osteoporotic range. The women in the exercise group were asked to attend hour-long training sessions, supervised by a qualified physiotherapist, for a 6-month period each year (this was a 30-month study) and were also asked to train 20 min daily at home following a program of similar exercises to those in the supervised sessions. For the remaining 6 months, the women just exercised at home. Both the supervised and home exercise programs were updated every 2 weeks to ensure progression and versatility.
The supervised exercise sessions were undertaken as group activities. Approximately 45 min of each session was devoted to jumping and balance exercises, including walking, knee bends, leg lifts, heel rises and drops, dancing, stamping, stair climbing and stepping up and down from benches. Each session included a 15-min warm-up period.
Problems were minor and did not prevent any of the women from continuing to exercise – although for a few of these women, their program were modified to meet the individual’s needs. Three women in the exercise group experienced musculoskeletal problems that required minor modifications in their training regimen. All of these women completed the exercise program without further problems. Two women had to suspend training for a few weeks due to knee arthroplasty, six women due to neurological or cardiovascular problems and six women due to glaucoma surgery. None because of adverse effects on bone. They ALL returned to the exercise program and completed a modified regimen without problems.
So, 30 months of weightbearing (and high impact) exercise in these older women with a BMD at least 2 SD below the reference value proved to be safe and showed efficacy in slowing or stopping bone loss, especially at the trochanter, and the exercisers also had less fall-related fractures than the control group during the follow-up period.

My understanding is that a key reason high impact exercise is beneficial is that it engenders the production of signals that tell bone to build, and these signaling mechanisms do not require long bouts of exercise for activation. A little daily high impact exercise by women in the mildly osteopenic range should be safe and may go a long way towards maintaining healthier bones.

Here are the citations for the studies upon which the COMB researchers based the study’s exercise recommendations:
K. Niu, R. Ahola, H. Guo et al., “Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women: the Sendai Bone Health Concept Study,” Journal of Bone and Mineral Metabolism, vol. 28, no. 5, pp.568–577, 2010.
R. Korpelainen, S. Keinänen-Kiukaanniemi, J. Heikkinen, et al. “Effect of impact exercise on bone mineral density in elderly women with low BMD: a population-based randomized controlled 30-month intervention,” Osteoporosis International, vol. 17, no. 1, pp. 109–118,2006.

Other studies — a number of which are cited in the above 2 papers — have also shown that weight-bearing and high impact exercise prevents bone loss and helps prevent fractures, both by maintaining and/or improving BMD and by improving balance, thus preventing falls.
The most current research looking into the use of “high velocity progressive resistance training” is just underway and will, hopefully, give us more insight into the best exercise protocols to prevent bone loss and rebuild osteopenic, osteoporotic bone. I’ll be following this research and will report the results. (Here’s the citation for this study: Gianoudis J, Bailey CA, Sanders KM, et al. ‘Osteo-cise: Strong Bones for Life’: Protocol for a Community-based Randomised Controlled Trial of a Multi-modal Exercise and Osteoporosis Education Program for Older Adults at Risk of Falls and Fractures.BMC Musculoskelet Disord. 2012 May 28;13(1):78. [Epub ahead of print]PMID: 22640372)

My personal thoughts overall:
Clearly, anyone with severe osteoporosis should work with a well qualified physiotherapist, and my preference would be the use of a highly supportive and very safe exercise regimen like Pilates — which has also been shown to be able to target and help build specific areas of bone — until bone density was restored to the osteopenic level. Then I’d recommend something like Zumba because it can not only be high impact (you can always modify the steps to be low impact), but is so much fun that compliance is a delight. We’re not wanting to have healthy bones just to stay above ground on the planet; as the song lyric says, “Girls just want to have fun!”

In regards to your question about strontium being taken as a single dose in the COMB study, this is not unusual. Remember, the women were not taking calcium supplements, just getting their calcium via the foods in their normal diet, so not restricting the time during the day when they took their strontium citrate also seems reasonable. It is true that calcium and strontium compete for absorption –and calcium will win out in this competition, so maximum benefit from stontium will occur when large doses of calcium are not being ingested at the same time. However, unless these women were consistently taking their 680 mg strontium supplements with meals providing comparably large doses of calcium — an unlikely situation — they would receive some benefit from the strontium. Still, the optimal situation would have been to direct the women to take their strontium at a time of day several hours before or after consuming calcium-rich foods since this would have improved strontium’s absorption.

Thanks again for catching my misspelling of Dr. Genuis name and for your really great questions, Lara

Sandy
Sandy

Hi Lara, Note that the COMB study was conducted by Dr. GenUIs (not Genius)…I have contacted his office regarding the type of exercise that was used by patients in the study and was surprised to learn that he recommends “jumping, running, or jogging” (exercises that are typically contraindicated for osteoporotic patients), working up to 300 repetitions. I also questioned the administration of the strontium citrate and was told that “the strontium is taken as a single dose and no restriction is provided as to when the supplements are taken.” What are your thoughts about these recommendations?

Lara Pizzorno
Lara Pizzorno

Hi sml,
I suggest you ask your doctor about getting a “Vertebral Deformity Assessment” — this is done on DEXA machines using special software that takes a side (lateral) view of the spine and provides an image of each vertebra to see if there are any deformities or fractures. They would also look for vertebral “wedging,” which may occur since, when the spine loses bone density, the vertebrae may compress down wedging over the ones below them. This would explain your loss of height. I don’t know what type of exercise regimen you follow, but in both exercises and your daily activities, it is very important NOT to do movements that flex your spine forward into a big “C” curve. You want to do exercises that strengthen the muscles running up your back along both sides of your spine — these are called the “multifidi” and “erector spinae”. Pilates exercises with an instructor who has been trained to work specifically with people with bone loss may be very helpful for you. These exercises can help you strengthen the muscles that support your spine, so can help you to decompress and re-elongate your spine. The great people at AlgaeCal were kind enough to tape a number of video clips in which I demonstrate some of these exercises, and I also provided some copy describing them and briefly explaining why Pilates is so helpful for those of us with osteoporosis. I believe these will be posted on AlgaeCal’s website soon.
Hope this helps, Lara

sml
sml

Hi Lara:
I have a dilemma. I have been taking strontium citrate for two years. am presently in my third year taking it. My last dexa scan (summer of 2011) indicated that there had not been any decline in my bone density. (This was a very positive result since I had bone loss for other prior dexa scans.) My dilemma,however, is that I have been losing height. In the past two years I have been measured to be one inch shorter. I cannot understand this. What is your input regarding this?
sml

Lara Pizzorno
Lara Pizzorno

Hi AJ,
I just had my DXA run May 1st. My results have TOTALLY convinced me. I had been building bone for several years; improvement was consistent but slow. Last summer (July 2011), I switched to AlgaeCal Plus as my source of supplemental calcium and to Strontium Boost for my strontium supplement. This is the only change I made to what I had been doing. BMD in my spine is up 6%; BMD in my hip/femur is up 3.2%. I am barely osteopenic now; my T-score went from -1.9 to -1.5. Since I made no other changes, I believe AlgaeCal is a major contributing factor to these improvements.

AJ
AJ

Just curious- did you get your DXA in April? Did the results convince you that this regimen is beneficial? Or, not?

Lara Pizzorno
Lara Pizzorno

Hi Audrey,
Any supplement providing 680 mg of elemental strontium in the form of strontium citrate will be fine. My only consideration would be the quality control level of the company selling the product. You want to be sure what you are getting is not adulterated or contaminated. Pure Encapsulations and AlgaeCal are two brands you can trust, and so are a number of other brands. If you can send me the names of the companies from which you are able to purchase stronium where you are, I will look at their quality control standards and let you know which I would feel comfortable trusting.

Audrey Yzaguirre
Audrey Yzaguirre

I have been taking Pure Encapsulations Strontium as per doctor’s suggestion, but have run out of it. I am out of the country and want to order some Strontium, but can’t figure out which is the best one to take.

Thanks for your help.

Lara Pizzorno
Lara Pizzorno

Hi Barb,
In the research on postmenopausal women, the amount of strontium shown to be effective in helping to increase BMD is 680 milligrams per day. Is your inflammation under control now that you have eliminated dairy and nightshade vegetables from your diet? If not, is there anything else that might be contributing to it that you could change to lessen inflammation? Are you getting sufficient omega-3 fatty acids? Are you able to eat omega-3 rich fish like wild caught salmon or would you consider taking a DHA/EPA supplement? Are you aware of the research on glutathione (given via nebulizer) for COPD — it is VERY helpful!

Barb Blonsky
Barb Blonsky

Hi Lara. The strontium I take is 1000 mcg. Yes, my inflammation is under control. I’m also taking an EPA supplement that has 1536 mg. I’m also thankful I can and I love salmon! My COPD isn’t an issue any longer, since Dec. ’09. I have a lot less coughing for no apparent reason. I quit all meds. for it at that time.

Barb

Lara Pizzorno
Lara Pizzorno

Hi Barb — wow, that’s wonderful!
Just be sure to have wild caught rather than farm-raised salmon. For lots of information on salmon — here are a couple of links to World’s Healthiest Foods discussions of salmon: http://whfoods.org/genpage.php?tname=foodspice&dbid=104
(I helped create the content on WHF and continue to help maintain it)
Re strontium — the amount you are currently taking is very low! 1,000 micrograms is far below the 680 milligrams (which is the equivalnt of 680,000 micrograms!) shown in the research to be helpful. You might consider taking a strontium citrate supplement providing approximately 680 milligrams of elemental strontium–this is what Strontium Boost delivers, and there are other strontium citrate supplements available that also provide this dosage.

Barb Blonsky
Barb Blonsky

Hi Lara. I take a 1000 mcg. strontium supplement. What is an adequate amount is for post-menopausal women to take? I have severe osteoporosis at age 56. I’m thin and have trouble gaining weight. I don’t eat dairy or Night Shade vegetables (I’m on an anti-inflammatory diet which has helped both the beginnings of arthritis and COPD diagnoses about 4-5 years ago). I do eat nut butters, avocados, and meat to get my fats.

Barb

Lara Pizzorno
Lara Pizzorno

Hi Sara,
I’m sorry, but I do not know the details about the Save our Bones program, so I won’t comment on that. Also, I don’t know what “raw calcium” is. What I can offer you are some suggestions in response to what I see in your note to me — this will sound like an advertisement, but I urge you to get a copy of Your Bones and read it! Your library should have it if you don’t wish to buy it. Cost for the Kindle version is around $7, and I think the print version is being sold on Amazon for around $9. In this book, I go over all the many factors that can contribute to bone loss that you may not be aware of, every nutrient your bones need to build, how to determine if you are getting enough from your diet and how to choose a supplement if you need more. I also discuss bone building exercises and diet. It’s way too much to try to share with you in a response here — and I don’t know what, in particular, will be most important for YOU, only you can determine this by reading the material yourself and thinking about it in relation to YOU.
That being said, your note suggests to me that if you have not already had your vitamin D levels checked, you should do so! The test you want run is for 25(OH)D– this is the circulating form of vit D and the best indicator of body stores. Optimal levels are now considered to be 60-80 ng/mL.
If you are not consuming any dairy products, your diet is most likely providing very little if any vitamin K2, for which the best source in the western diet is cheese, particularly Jarlsberg and Emmenthaler. (And I disagree that dairy is necessarily bad. The issues are (1) allergies to the proteins in dairy (2)non-organic dairy — don’t have this!many reasons too many to go into here (3) a diet excessively high in protein will produce an acidic body chemistry. Since your diet is vegetarian/pescatarian, this should not be an issue for you. In Your Bones, I explain how to determine if your diet is too high in protein for YOU.
At any rate, you will certainly need to supplement with K2. I discuss the research on K2 and the 2 forms available as supplements in Your Bones. I recommend (and use myself) the MK-7 form of K2 for a number of reasons — too many to go into in any meaningful way here. If you would like to learn more about K2, I’ve written a review for physicians of the latest research on this nutrient; you’ll understand the key points despite the medical jargon — it’s available via this link:
http://www.lmreview.com/articles/view/Vitamin-K2-Essential-for-Prevention-of-Age-Associated-Chronic-Disease/
My third suggestion for you is to have your doctor order a 24 Hour Urine test to check all your hormone levels — best lab for this is Meridian Valley Labs. Here’s a link: http://meridianvalleylab.com/
You do not have to be suffering from 1/2 hourly hot flushes! Once you are tested and find out where your imbalances are (and this will be clearly shown on the 24 Hour Urine test for all the estrogens, progesterone, DHEA, testosterone, your adrenal hormones — and more), you can restore balance. Bio-identical hormone replacement –formulated specifically for YOUR needs by a compounding pharmacist–will take care of this in a month or less (and protect your bones, your heart and your brain). I’ve written quite a bit about BHRT (which I am on and have been on for more than 10 years now) — you can read many these articles on Smart Publications website.

If you would like to read up about hormone testing — and the 24 Hour Urine, I wrote an article for physicians about all this that is available at Longevity Medicine Review — here’s a link:
http://www.lmreview.com/articles/view/select-the-right-hormone-test-for-your-patient-using-bio-identical-hormone-/
Lastly, regarding strontium citrate — it has been shown in MANY studies, thousands of women, to be safe and effective. You just need to take it at a different time of day from when you take calcium (as I have written in the blog and in response to questions here, calcium and strontium compete for absorption, and calcium is better absorbed, so if you take them at the same time, you will receive less benefit from the strontium.) Also, you want to consume approximately twice as much calcium (from food and supplements) as strontium. I use AlgaeCal Plus for my supplemental calcium and vitamin K, and part of my vitamin D (I need additional vitamin D because of my genetic inheritance– my vitamin D receptors don’t work very well, so I need more vit D than most people), and I take Strontium Boost for my strontium. It works best for me to take AlgaeCal Plus in the morning and evening and Strontium Boost with lunch. If I end up having dairy foods (like cottage cheese or yogurt or cheese) at lunch, I just take the strontium around 4 pm with a dairy free snack.
http://www.lmreview.com/articles/view/select-the-right-hormone-test-for-your-patient-using-bio-identical-hormone-/
Most importantly, I want to encourage you NOT to put up with bone loss and twice hourly hot flushes — both are completely fixable! Obviously, what you are currently doing is not meeting YOUR needs. This is what your body is telling you! It’s going to take some work — I very much hope you will read the articles and Your Bones for solid, research-backed information and get the appropriate tests run (I also discuss a number of tests in the book–when you read the sections in which they are mentioned, you will know if they are ones you should consider), but you absolutely can figure out what YOU need. When you have more questions — which I expect you will as you travel down this road of self-discovery (a challenge, I know, but also you will soon discover that YOU can take control of your health!) — just let me know. I will do my best to help you.

Lara Pizzorno
Lara Pizzorno

Hi SML,
Yes, as you will have noted in my blog on strontium, the patented/drug version of strontium, strontium ranelate has now been conclusively shown to produce numerous side effects, at least two of which, VTE and DRESS syndrome can be fatal. In contrast, as I stated in the above blog (and backed up with studies conducted over the last 100 years–the citations for which are provided in the references) , the natural form of strontium available as a supplement, strontium citrate, has never been shown to produce any of the side effects seen with strontium ranelate. The only issues with strontium citrate (or any form of strontium) are that to err on the side of safety, you should be consuming twice as much calcium (from both diet and supplements) as strontium AND you should take your strontium supplement several hours before or after consuming calcium. This is because the two minerals compete for absorption, and calcium will win out, so you will get less benefit from strontium consumed at the same time.
Regarding taking 1/2 the recommended dosage — I have not seen anything in the research to indicate this would be better. However, as I hope I keep repeating, each of us is UNIQUE. You must observe your body’s reactions to anything you do — and respect them. I project that in another 20 years (maybe even sooner), we will be able to have genetic tests run that will clearly indicate for each of us our specific needs and susceptibilities. We already can get this information for some things — for example, my genetic inheritance includes a SNP that makes my vitamin D receptors less able to latch on to vitamin D, so I need much more vitamin D than the “average” person to get my levels into a healthy range. Eventually, I expect we will be able to get our full “genetic template”. We don’t have it yet though. So we must experiment. We can learn from what works for others, but this does not necessarily mean it will be effective for each of us. What we can do is see how our body appears to be reacting — in other words, how do you feel? And we can check, in terms of our bones, what’s happening with NTx and DXA tests, also our vitamin D levels, and I’m hoping soon the test for vitamin K levels (it’s called unOC, which stands for uncarboxylated osteocalin) will be widely available. I wish it were less complicated, and we could all just do exactly the same thing, and it would be just right for each of us — but this is not how it is. We can help guide each other towards what is highly likely to be beneficial — we cannot be each other. And truly, isn’t this wonderful? We are, each of us, special, unique and irreplacable.

sml
sml

Lara:
Could you please comment about this article re: strontium ranelate. For those of us taking strontium citrate I personally find this article to be somewhat disturbing. Granted it refers to individuals with preexisting conditions, but still….
Thanks for all the time that you take to answer our many questions.
There was also a question on the inspire site regarding taking 1/2 the recommended dosage and finding better results. I look forward to your response on this as well.

Sara
Sara

Hi Lara,
so interested to read you and your incredible store of information especially about Strontium Citrate. Since being diagnosed with osteoporosis [-3.5 spine, -2.7 L. femoral neck] and Osteopenia [2.1 L. hip, 2.2 Rt hip. -2.4 rt. femoral neck] last July, I have been following the Save our Bones programme, taking Raw Calcium, a special over 50 muli- vitamin and other supplements. I do Yoga and Pilates x1 a week, joined a walking group on Sundays, try to use weights when can. Watch acid/alkali balance. Drastically reduced milk as they say it becomes acidic in the body switching to rice milk, hemp and now almond. have soya yogurts [ I’ve suffered from 1/2 hourly hot flushes for 5 years]. I am a fish vegetarian so eat healthily catch the sun and walk whenever I can. I have lived with a lot of stress at home and at work but try to meditate when poss. I just had another Dexa Scan as I’ve had 2 fractures on each ankle in last 4-5 years and am terribly disappointed to find a slight fall in score. I thought I was doing everything right. I have been scared to take Strontium but am now wondering if should, I would be so grateful for your advice and suggestions,
many thanks, Sara

sml
sml

I am constantly on the lookout for additional information regarding strontium citrate. I, therefore, thank you for all this valuable information. I have two questions..one regarding your recommended daily dosage for strontium and the second regarding your recommended daily dosage for Vitamin K4. Recently I have cut back on my dosage of strontium citrate from 680 mg daily to 1 tablet of 340 mg daily. In addition I take 5 mg of Vitamin K4 (menatetrenone). Also (I guess this is a 3rd question) how long do you recommend that someone should stay on these two vitamins (i.e. how many years)?
I’m not sure where I should look for a response. I hope that it would come to my email account listed.
Thanks again.

Lara Pizzorno
Lara Pizzorno

Hi Shaine,

I’m 63 – and my bones have now fully recovered from severe osteopenia that was found when I was in my late 40s. I promise you, you can completely restore the full health of your bones! You just need to provide your bones with the nutrients they require to rebuild, stop doing any of the things I discuss in Your Bones that you might be doing that promote inflammation, and get a little weight bearing exercise. And following these recommendations is not only going to give you strong bones, but vibrant health overall. Definitely a win on all fronts!

Re strontium – yes, the ratio you want is approximately twice as much calcium as strontium. Remember, however, that you are most likely getting calcium from your diet, too – this counts! In Your Bones, I provide a listing of the common foods richest in calcium, so you can take a look and estimate about how much calcium your diet is providing you. For most of us, it’s at least 400 mg /day. Even if you are not eating dairy foods (cheese, yogurt, cottage cheese, milk), plenty of other foods are great sources of calcium – e.g., tofu, soymilk, salmon, sardines, spinach, sesame seeds, almonds, broccoli – etc. You may be surprised to see how much calcium your diet is providing when you add it up.

For my MK-7 needs, I use AlgaeCal’s AlgaeCal Plus – it provides me with not only K2 (as MK-7) at a dose of 100 mcg –an amount shown in the research to be effective – but a highly bioavailable and effective form of calcium, also magnesium, boron, and a whole mix of trace minerals – all of which play a role in bone health. AlgaeCal Plus also contains vit D3, but the dose is 1,600 IU, not enough for me because I have genetic issues that require I take 10,000 IU per day of D3 to get my blood levels into healthy range. You will need to get your blood levels of 25(OH)D [this is the circulating form of vit D and the best indicator of body levels] checked to see where you are, optimal range is 60-80 ng/mL. If you find you are below this range, increase the amount of D3 you are taking and retest in 3 months. We have found in the more than 6,000 patients we have now tested in a health promotion project we have been involved in up in Calgary that virtually everyone needs at least 2,000 IU per day, many need 5,000 IU per day or even more.)
Here’s a link to AlgaeCal’s product:
https://www.algaecal.com/products/
I also use their strontium boost product – it’s less expensive for me since I order 6 months of both at a time and get a good discount on the price, and also don’t have to think about having to order something more than twice a year.

If you have your vit D3, calcium, magnesium, boron, etc., needs already covered, and all you are looking for is a vit K2 supplement, then I would suggest Life Extension’s product, Super K with Advanced K2 Complex – it contains K1, MK-4 (very small amount though) and MK-7 (effective dose). All 3 forms of vitamin K are beneficial – K1, which you can get in abundance from green leafy vegetables, is highly anti-inflammatory as well as being required for normal blood clotting, so you don’t bleed to death from even a tiny cut. I just eat lots of greens – they are a great source of so many minerals and phytonutrients that are good for us as well as K1! MK-4, even at such a low dose, can’t hurt and may help. You can get this small amount of MK-4 from foods though – a list of food sources is in my vit K2 review on LMR. Cheese is one of the best food sources of MK-4; Jarlsberg and Emmenthaler cheeses are the richest in K2. I love both, and try to have an ounce regularly – great for a snack with an apple, in omelets, and my family’s all time favorite – wonderful in tuna melts (I make tuna fish salad with canned tuna, omega-3 rich mayonnaise, lemon juice and a tablespoon of capers or jalapenos, spread it on whole wheat bread, top with a slice of Jarlsberg, spray the top of the sandwich with an organic olive oil version of PAM, put it on a cookie sheet and toast it the oven at 350 degrees for about 20 minutes. One caveat here –if you eat tuna PLEASE purchase tuna that has been checked for mercury content! I get ours on-line from Oregon’s Choice – it tastes so much better than StarKist, absolutely no comparison, and while the cost per can is higher, the cans are several ounces bigger.

Hope this helps you,
Lara

Lara Pizzorno
Lara Pizzorno

Hi Patricia,
Yes, your email arrived, although I don’t see it posted here in the Comments section yet, so I will copy in and respond to your questions here. Your English is very good!:

” i would like to know in what dosages do one has to take strontium citrate and calcium ect.. i changed to strontium citrate [ costs about a third of ranelate]about 3 months ago after being on ranelate for 5years.. i had a bmd in january and it showed a small improvement which i am grateful for… i`m 63yrs and excited to see next year`s results… i am changing my calcium from Biogen Calmag Max Absorption[with120ug K2 ect to Real Thing Bone Revolution an organic sea veg calsium mineral mix these products we get in south africa.. further i take everthing in stride,,, had a couple of falls with no fractures …perhaps i`m just lucky referring to other letters of people having a lot of fractures… nice writing to you… forgive the errors, english is my second language… regards.. patricia”

Here’s my reply:
The research indicates a daily supplemental doses of 680 mg of strontium citrate and 1,200 mg of calcium are effective. Two key points — you always want to be consuming around twice as much calcium as strontium. If you are not allergic to dairy foods, then I expect you are likely getting at least several hundred milligrams of calcium from milk, cheese, yogurt, kefir, etc. Even if you are avoiding dairy products, if you are eating lots of dark green leafy vegetables you will be getting calcium from these as well. ( I hope you are eating lots of these vegetables — like spinach, kale, Swiss chard, broccoli — because they contain not only calcium but other minerals and vitamins essential for building healthy bones (e.g., vitamin K1, magnesium, boron). And they are very good sources of calcium — spinach, for example, contains 245 mg in a 1 cup serving!
Secondly, take your strontium at a different time of day from when you are consuming calcium. Strontium and calcium compete and calcium always wins — so to get the most benefit from your strontium, take it at least 2 hours before or after having calcium supplements or foods rich in calcium.

Delighted to learn you are taking an organic sea vegetable derived calcium-mineral mix and that this is available in South Africa! From the research I have seen on algae-derived calcium, it is more bioavailable and more effectively used in building bone than calcium derived from rock.

Regarding your falls — two things to consider — weight-bearing exercise and vitamin D3. Both have been shown in the research to significantly lessen risk of falling (and thus of fractures).
LOTS of research re vit D helping to prevent falls – here’s a quote from just one of the most recent papers: “Discussion Vitamin D supplementation can prevent falls, particularly in the vitamin D deficient elderly.” (Reference: Winzenberg T, van der Mei I, Mason RS, et al. Vitamin D and the musculoskeletal health of older adults.Aust Fam Physician. 2012 Mar;41(3):92-9.PMID: 22396920)
In fact, there has been so much research indicating vit D plays a very important role in our muscular stability that two very large trials are now in progress to sort out the best specific recommendations for how much vit D and how much calcium is optimal — here are two papers discussing these studies — one is being conducted in Spain, the other in Finland:
López-Torres Hidalgo J; ANVITAD Group.Prevention of falls and fractures in old people by administration of calcium and vitamin D. randomized clinical trial.BMC Public Health. 2011 Dec 9;11:910.PMID: 22151975
Uusi-Rasi K, Kannus P, Karinkanta S, et al. Study protocol for prevention of falls: A randomized controlled trial of effects of vitamin D and exercise on falls prevention.BMC Geriatr. 2012 Mar 26;12(1):12. [Epub ahead of print]PMID: 22448872
So, are you taking vitamin D3? If so, have you had your blood levels of 25(OH)D checked? This is the best indicator of body levels of vitamin D. Optimal levels are now said in the latest medical journal papers to be between 60-80 ng/mL. Many people need 5,000 IU of vit D3 daily to achieve these levels.

Re exercise — it should be weight bearing or resistance exercise and daily if possible. Take a half-hour walk (at least some of it up hill or walking up stairs), go dancing, lift weights and do squats. I do Pilates daily myself and also lift weights and take a dance type aerobic class called Zumba a couple of times each week. I keep trying to convince my husband to go dancing but no success — yet.
Here’s just one of many medical journal articles discussing the benefits of regular weight bearing exercise on preventing falls: Robitaille Y, Laforest S, Fournier M, et al. Moving forward in fall prevention: an intervention to improve balance among older adults in real-world settings. Am J Public Health. 2005 Nov;95(11):2049-56. Epub 2005 Sep 29.PMID: 16195514
I’m 63 years old, too — isn’t is great how much fun it is to be “all grown up” now that we can stay strong and healthy! We are so fortunate to have access to the discoveries in the medical research about what our bodies need to remain healthy — many of these insights have only surfaced during the last 25 years. We’ve come a very long way since vitamins were “discovered” 100 years ago!
My husband, Dr. Joe Pizzorno, and I have a great friend in South Africa, Dr. Myron Schultz, D.C.–he’s in Durbin at the University. We keep hoping to have a chance to come visit him and see your lovely country.
Stay well! Lara

patricia
patricia

hi lara… idont knowif my email will reach you… what does the website refers to? any way if it does and i hope it will i want to thank and congratulate you on the
excellent responses to queries… i would like to know in what dosages do one has to
take strontium citrate and calsium ect.. i changed to strontium citrate [ costs about a third of ranelate]about 3months ago after being on ranelate for 5years.. i had a bmd in january and it showed a small improvement which i am grateful for… i`m 63yrs and excited to see next year`s results… i am changing my calsium from Biogen Calmag Max Absorption[with120ug K2 ect to Real Thing Bone Revolution an organic sea veg calsium mineral mix these products we get in south africa.. further i take everthing in stride,,, had a couple of falls with no fractures …perhaps i`m just lucky referring to other letters of people having a lot of fractures… nice writing to you… forgive the errors, english is my second language… regards.. patricia

Lara Pizzorno
Lara Pizzorno

Hi Anne, what you are doing sounds great. No need to take strontium on an empty stomach. You just want to take strontium at a time when you are not also consuming calcium since the two minerals compete for absorption (and calcium always wins, so you will get little benefit from your strontium if you take it when also consuming calcium). But 3 hours afer eating a bit of yogurt as part of a fruit dessert should not be an issue. Within 3 hours, you will have digested the yogurt and absorbed the calcium in it.

Lara Pizzorno
Lara Pizzorno

Hello Carleen,

The form of strontium you should consider taking is strontium citrate — NOT strontium ranelate–this form has caused many adverse effects, which I have written about — at length — both in my book Your Bones, 2nd edition and on AlgaeCal’s blog.

You should be taking both AlgaeCal Plus and their strontium product, which is called Strontium Boost (and which is strontium citrate).

You can take either AlgaeCal Plus or Strontium Boost with a meal. However, you must take Strontium either without food or if with a meal, it should be a meal that does not contain calcium. Calcium and strontium compete for absorption, and calcium always wins, so you will not get benefit from the strontium if taken with calcium.
For the same reason. Do not take AlgaeCal Plus and Strontium Boost at the same time.

Hope this helps,
Lara

Lara Pizzorno
Lara Pizzorno

Hi Tammye,
Strontium ranelate was used in these trials. Medical research is VERY expensive, so the drug companies are not going to spend the money on something they cannot patent and make a big profit on. Because strontium ranelate, not strontium citrate or other natural strontium salt was used in SOTI and TROPOS, that’s why although BMD improved and fracture rates dropped, a few unfortunate individuals experienced a number of side effects, including very serious ones, i.e., venous thromboembolism and DRESS syndrome. Most of the recent research on strontium has been done on strontium ranelate because it is patentable by a drug company since it is a combination of strontium plus ranelic acid — a molecule never before seen on planet Earth and therefore patentable. Strontium is what is responsible for the bone-building effects. Ranelic acid was created to make it patentable. Since a significant amount of other research over the last 40 years has never shown any adverse effects from strontium combined with natural salts, like citrate (unless way more strontium was being consumed than calcium and then the adverse effect was rickets, not VTE or DRESS syndrome), it is only rational to conclude that the cause of the ADRs is the new-to-nature ranelic acid (ranelate in the combo). I hope this answers your question — I realize I sound like a broken record here, but the point is that even though SOTI and TROPOS showed beneficial effects on bone from strontium ranelate, we can have these benefits using a natural form of strontium (like strontium citrate) without the health risks (and high financial costs) of taking the patent medication.

Barbara
Barbara

Hi Lara,
I read your research about the strontium ranelate vs. sc.from a post in 2010. It was very informative. However, I’ve been curious about taking calcium microcrystailine hydroxiapetite as a calcium source to increase my BMD .Everything I read is good about this form of calcium, and that it is the closest to the calcium we use to produce bone. I was diagnosed with osteoporosis in July of 2009. I’m leery of the strontium “replacing” calcium in my bones, where calcium is what is supposed to be forming bones, not strontium. I have not added the MCHC to my regimen yet.

Tammye Herring
Tammye Herring

Hi Lara,

When referring to the SOTI and TROPOS trials, you used the term “strontium” but didn’t specify “ranelate” or “citrate,” unless I just totally missed it. Can you clarify which type of strontium was used in these trials?

Thanks much,
Tammye

Marilyn Pinkerton
Marilyn Pinkerton

Lara, Thank you seems so inadequate. Thank Dr. Joe also for his recommendation. Reading your book and following all your posts has really helped me. God Bless, Marilyn

Lara Pizzorno
Lara Pizzorno

Hi Marilyn,
No worries! Please do not be overly concerned about having a calcium at high end of normal — remember, you are still within the normal range. Everyone is different, so high end of normal may be normal for your body. Nonethelss, I believe this may indicate suboptimal vitamin K2 status, plus many studies have now demonstrated that vitamin K (and specifically K2) is needed for healthy bones and to prevent calcification of arteries and other soft tissues. So, yes, I would take more vitamin K2. Vitamin K2 (MK-7) at a dose of 120 mcg/day or even 240 mcg/day is extremely safe. No studies have shown any adverse effects. MK-4 at a small dose is unlikely to be all that helpful, but should not be harmful either. The only caveat here is if you are on an older anticoagulant medication, in which case you need to work with your doctor to stablize your INR when taking vitamin K.
Yogurt is a healthful food supplying healthy intestinal bacteria as well as calcium. Enjoying a cup of yogurt will be good for you and your bones, unless you are allergic to dairy products, in which case, consuming dairy foods will increase inflammation in your body, and inflammation activates osteoclasts, so not good! You could try soy yogurt instead.
Strontium citrate is also very safe, again, no adverse effects have been seen with natural forms of strontium (ie strontium citrate) if more calcium is being consumed than strontium. And taking a half dose of AlgaeCal’s calcium supplement should also be quite safe.
Yes, DHEA supplementation is a very good idea. The decline in DHEA, which is produced by our adrenals & thus not related to menopause at all, can start as early as the late 20s, and research has proven that our levels of DHEA correlate with BMD — in both pre- and postmenopausal women. Dr. Wright discusses this in Stay Young & Sexy with BHRT. In one of the studies he notes, women with the lowest levels of DHEA had double the risk of fracture as women with the highest levels. (Garnero P et al. J Bone Miner Res 2000;15:1526-36.) I took a look on PubMed to check for the most recent papers found a number of others confirming this association. The most recent study showed higher levels of DHEA were associated with 0.49% less bone loss at the neck of the femur (Ghebre MA, Hart DJ, Hakim AJ, et al. Association between DHEAS and bone loss in postmenopausal women: a 15-year longitudinal population-based study. Calcif Tissue Int. 2011 Oct;89(4):295-302.PMID: 21789637) The only potential issue here is that DHEA is an androgen and a precursor to testosterone, so taking too much DHEA (for YOU) can cause the appearance of secondary male sexual characteristics in women – e.g., acne, growth of excess body and facial hair, loss of scalp hair. Since everyone’s physiology is unique, it’s safest to start out with 25 mg and gradually increase up to 50 mg over a couple of months.
Given your allergies, my best recommendation for you is to work with a knowledgeable physician who can run the tests needed to monitor precisely what is happening in YOUR body. Joe took a look to see who is in Arizona near Phoenix, and discovered that one of the contributors to the Textbook of Natural Medicine, Dr. Tom Kruzell, ND, is in Scottsdale! He’s not a Bastyr grad, but Joe recommends him; he is a very good doctor. His phone number is 480-767-7119. Keep me posted on how you are doing and don’t hesitate to get in touch if I can be helpful.

Marilyn Pinkerton
Marilyn Pinkerton

Sorry, used to the post preview at NOH, lots of booboos! M

Marilyn Pinkerton
Marilyn Pinkerton

Thanks Lara. I reread my post this morning before I read yours. I should have been
.8 in reference to the bone density drop, but sure you figured that out. I was concerned the 9.3 calcium was at the high end of normal, but am more concerned that you think it is high. Will definitely not eat any more yogurt as that was just a sugar splurge. So are you comfortable with me taking 2 of the AlgaeCal daily as I was hoping to up by strontium to 2 daily. With my steroid issues, do you think the strontium is my best hope. I had read about the doctor you mentioned, as I have searched high and low for someone. Would love to find a Bastry U. grad here that you guys knew. I do get MK-7 in the Algae-Cal, should I supplement 50mg more. The MK-4 that I take is such a small dose, that should be OK, right .
Sorry, do not mean to hammer on you with questions. Thank you for all your help, will run that info by the allergist, and also check with GYN-possibly DHEA could help. Making collards and beans today! As always, grateful to you! Marilyn

Lara Pizzorno
Lara Pizzorno

Hi Marilyn, wow–thanks so much for taking the time to send me such a complete picture of what’s going on with you! I am not a doctor, but I can at least give you some suggestions to look into and discuss with your physician. It is all too true that many MDs are not aware of the research on alternatives to pharmaceuticals.

Two issues seem the most important to me — your lung inflammation and, of course, the high calcium levels. Re the inflammation (which as you know promotes activation of osteoclasts, so we really need to get that down!), and your desire to get off Symbicort as quickly as possible (also a goood idea since glucocorticoids cause osteoporosis–here’s a very recent paper on this if your doctor is not already aware of it –den Uyl D, Bultink IE, Lems WF. Glucocorticoid-induced osteoporosis.Clin Exp Rheumatol. 2011 Sep-Oct;29(5 Suppl 68):S93-8. Epub 2011 Oct 21.) , you might benefit greatly from N-acetyl cysteine–especially if you can have your doctor order it as an inhalation solution of Glutathione [60 mg/mL] + NAC [125 mg/mL] to be taken with a nebulizer — only compounding pharmacies provide this. We use Key Pharmacy here in Washington state, and we have ordered nebulized NAC for patients with COPD as far away as FLA. It is extremely effective– truly close to miraculous in its healing effects. After a month or two using the nebulizer, many of our patients have been able to just take NAC orally; they are that much better!

Re the high blood calcium, my first thought would be that you need more vitamin K, specifically, K2 as MK-7. As I explain in Your Bones, the research indicates that the MK-4 form of K2 must be taken in 3 doses of 15 millligrams each spread throughout the day — in the studies, the dosage schedule was every 6-8 hours. The reason for this is that MK-4 is very quickly metabolized, so it is gone within 6-8 hours. In contrast, the MK-7 form remains bioactive in the body for about 3 days — this is one of the key reasons why you need so much less — just 120 mcg has been shown in the research to be effective — for MOST people. I, personally, am not one of them. I need more than this because I need more vitamin D3, so I take at least 240 mcg of MK-7 daily. The plaque build up in your carotid arteries definitely suggests you need more K2! I feel this is safe — unless a person is on an older anticoagulant medication in which case you must consult with your doctor to help you manage your drug dose so you can gradually increase your vit K without disturbing your INR — because studies have been done showing that even much higher doses of MK-7 (over 800 mcg/day) not only caused no adverse effects but resulted in higher levels of activated osteocalcin. Remember that vit K2 activates a number of important proteins related to calcium regulation in the body — the 2 of most interest for you are osteocalcin, which is involved in putting calcium into bone, and Matrix Gla protein, which keeps calcium out of arteries, kidneys, breasts, etc. There is a still cutting edge but available blood test to check to see how well you are doing at this — they can check your blood levels of uncarboxylated osteocalcin (ucOC). If they are high, this means you are not getting enough vit K2 to activate your osteocalcin and Matrix Gla protein. The test is pricey and will not be covered by your insurance, so I would suggest you look into simply taking additional MK-7 – I use Life Extension’s Super K with Advanced K2 Complex and take 1 capsule AM and 1 capsule PM. Plus I am getting MK-7 in my multiple as well. Here is a link to a review of the research I very recently wrote for Longevity Medicine Review (it’s written for physicians, but you will get the gist of it — and you may wish to suggest your doctor read it, so she or he will be aware of the latest findings in the peer-reviewed medical literature — http://www.lmreview.com/articles/view/Vitamin-K2-Essential-for-Prevention-of-Age-Associated-Chronic-Disease/

Re your vitamin D levels, which your last blood test showed were too low (you want to be between 60-80 ng/mL), since you are lucky enough to be living in the Phoenix area, — if you are not already doing this — please get outside for at least a half hour sometime between 12pm and 2pm and get some sunshine on your skin (no sunscreen!). You can wear a hat and put sunscreen on your face to prevent wrinkling and age spots, but leave at least your arms and legs bare and sunbathe. If even after taking 4,000 IU per day and getting some sun for a couple of months, you are still not in the 60-80 ng/mL range, your genetic inheritance may — like mine — have resulted in poor absorption of vitmain D, so that you need more than the typical person. Please have another blood test run to check you vitamin D levels in another 2 months.
I will look into recommendations for a good endocrinologist in Phoenix. You might check with Martha Grout, MD. She is in Scottsdale, here’s a link to her website. I do not know her personally, but she is a member of the Institute for Functional Medicine –a very good sign, the doctors involved with the IFM are both better informed and more open to integrative medicine. She may know of me, but will certainly know of my husband, Dr. Joe Pizzorno–he has been on the IFM board for 20+ years, is one of their Linus Pauling Award recipients, and served as Chair of the IFM Board for a number of years. Here s a link to Dr. Grout’s website: http://www.arizonaadvancedmedicine.com
Re being insurance poor – I am hoping that Dr. Grout will still be able to be helpful. I cannot know your financial situation, but nothing is as important as your health. Please consider investing in your health if you possibly can.
Lastly, re bio-identical hormone replacement. I am on BHRT myself–have been for about 10 years now — and I believe this would also be very helpful for you. Dr. Grout does offer BHRT. To learn more, you could read Dr. Wright’s excellent book about it — explains absolutely everything you need to know about BHRT. Has a horrible title, though – Stay Young & Sexy with BHRT.

Please keep me posted on how you are doing. And don’t hesitate to get in touch if I can be helpful.

Marilyn Pinkerton
Marilyn Pinkerton

Lara, I never wanted to tie you up while I was moderating the discussion on NOF, but feel free to ask here. My osteoporosis dexa showed a -2.5 in the hip. I take Symbicort 160 4xday, am working hard on trying to get it down to 160 2x day with 80 2x a day. Also take Synthroid (77). Before starting on Xolair a year ago, I was taking 15 different meds a day to try to control the asthma and had been like that for two years after getting atypical pneumonia. Now am much better, but lost 8 pts in my hips in that two year period and had a -2.5 in hip this last time. I have had 3 allergic reactions to antibiotics, so am careful about what I take. I switched to Algae-Cal after you recommended it. I have been taking only 2-3 a day, and one strontium tablet. I take about 350 mg of magnesium, and 3 tablets of ALTA silica a day, and Vit D3 is 3000, Omega 3 oil. Also still taking the Metagenics Ostera, as it is supposed to help if you take steroids. My PCP ran some blood tests in September at my request, Vit D, 25-Hydroxy was 35.4, my calcium and PCH was 9.3 and 58. Dr. said to increase VitD another 100o and I did. Interesting that my calcium was high and I have never taken calcium supplements until quite recently. (I had read Christopher C. Barr, and followed his advise – no calcium, only magnesium and silica). I found NOF, and actually they did a good job of alarming me. Then I read your book and totally tried to follow your advice. I was cautious about the calcium because of Mr. Barr, and was even more cautious when I found out I was in the higher range with no supplementation. That is troubling to me as do not want to end up with hyper-calcium. I have plaque in my carotid arteries, 20-40% range, I started getting the MK7 with the Algae-Cal, but was already taking some MK-4 drops (5-8 a day). MK-4 was the preferred way to go on NOF before you started posting. Still take at least 5 drops a day. I have read your posts to know you are much more aggressive than this. Am I being foolish to be so conservative – my next DEXA will be in about 4-5 months. I have considered asking my GYN for DHEA, all I take is Estrace internally. I will be 69 this year, and took my share of the old kind of Estrogen. She does the bio-est, but is expensive and scary. You have no fear, I envy that. I take a few protein shakes to get the lactoferrin, eat mostly vegetarian (loved your navy bean receipe), try to keep urine in alkaline range. No cheese, butter, only almond milk – and do take yogurt. Try to follow a plant based diet, not so easy to learn!! Am going to order the cod liver /butter oil unless you advise not to. I have a green smoothie at least 5 days a week with collards or kale. Also planted lettuce and do green salads. I live in Arizona, but lungs keep me inside mostly as air here is dry and very dusty. What should I change for the remaining 5 months. Thank you so much, you give an unbelievable amount of time freely to help people who cannot get this kind of help from their doctor. Am insurance poor, so have to go to conventional doctors. Anyone reading this who has a great endocrinologist in the Phoenix area, let me know. WHEW, sorry wanted to get it all in. Marilyn

Lara Pizzorno
Lara Pizzorno

Hi Robert,
I am so delighted you are here! I did return your call — did you get the message I left for you? Re your question above, best outcome would be if very little of either the strontium or the citrate were excreted. You want both of these to be used inside your body — the strontium, to build bone, and the citrate, to help make your overall pH more alkaline. An acidic pH, which many of us typically have because we eat the standard Western diet, contributes to bone loss. Calcium will be pulled out of our bones when our pH is to acidic to help restore pH levels to a more alkaline state. In contrast, ranelic acid is an unnatural, lately created in a lab, compound, which, the research indicates, increases your risk for venous thromboembolism and DRESS syndrome, among other unpleasant side effects. When it was created, it’s “claim to fame” was that it was supposed to be competely inert, and would just zip through our bodies without doing anything, and it was supposed to be completely excreted. Obviously, this is not the case.

Robert Gouterman
Robert Gouterman

In Laura Pizzorno’s blog , she refers to the excretion of ranelic acid , and questions the non excreted portion. What is the excretion of strontium citrate?

moyra earnshaw
moyra earnshaw

Thank you for these points but you say nothing about the risk of blood clots.

Lara Pizzorno
Lara Pizzorno

Hi Moyra,
Sorry, I should have explained that “venous thrombosis” is medical-speak for a blood clot (thrombus) that forms within a vein. “Thrombosis” is the medical term for a blood clot occurring inside any blood vessel. Venous thromboembolism (VTE) refers to life-threatening blood clots in deep veins. If the blood clot lodges in the lungs, it’s called “pulmonary embolism.”
In the section above with the subhead, Adverse Side-effects Are Seen ONLY with Strontium Ranelate – Natural Strontium Salts, Like Strontium Citrate are Safe, I explain that the latest research confirms that strontium ranelate increases risk for VTE. There’s a wee bit of disagreement as to how much — somewhere between 40% and 50%. Easiest if you could please take a look at this section above for the full discussion.

Sheila G.
Sheila G.

Hello Laura,

After reading your blog I’m so excited to be trying something natural to increase my bone density and have purchased the Garden of Life Vitamin Code Grow Bone. My concern is that if Strontium Citrate is a “salt” will it raise my blood pressure? I am on a low salt diet to control my blood pressure.

Thank you,

Sheila

Lara Pizzorno
Lara Pizzorno

Hi Sheila,
Strontium citrate is not the kind of “salt” that you are concerned about — this is sodium chloride, which does, if consumed in excess, cause an increase in blood pressure. Virtually all minerals must combine with another organic compound to be stable (e.g., citrate, malate, chloride) These stable compounds are referred to as “salts”. The biochemical reason for this is that minerals each have an ionic charge that must be balanced — in a “salt,” you have a cation and an anion– a positively charged and negatively charged atom or atoms in the mineral and the organic compound with which it combines, that balance each other, so that a stable compound is formed.
To help lower your blood pressure (and build healthy bones), eat lots of mineral (potassium, magnesium, calcium)-rich green leafy vegetables and avoid the unrefrigerated stuff (I refuse to call this “food”) in boxes and cans in the aisles of your grocery store — the processed food-like items. A few, marked low sodium, will be low in salt, but they are also going to be low in all the good things you need to build bones! Also avoid fast foods and most restaurant foods — these are typically loaded with sodium chloride. If you follow the dietary recommendations in Your Bones, you will lower your blood pressure along with your risks for virtually all chronic degenerative diseases, and build healthy bones along with overall good health. BE WELL! Lara

Johnf455
Johnf455

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