Strontium
Strontium (as citrate or ranelate salt)
TL;DR
Strontium increases measured bone density — but partly by replacing calcium in bone and distorting DEXA readings. The drug form (ranelate) cut fractures yet raised heart attack risk; OTC citrate has no fracture trials. Not recommended.
Avoid If
- Cardiovascular disease or risk factors
- Kidney disease
- History of blood clots
Frequently Asked Questions
Overview
Strontium sits directly below calcium in the periodic table and is incorporated into bone in its place. The prescription drug strontium ranelate reduced vertebral and hip fractures in large RCTs (SOTI, TROPOS), but was restricted and then withdrawn in Europe after post-marketing data showed increased myocardial infarction risk. Supplement strontium citrate has never been tested in fracture-outcome trials; its apparent bone-density gains are inflated because denser strontium atoms make bone look denser on DEXA scans without equivalent strength gains. Given the safety signal from the drug form and absence of benefit data for the supplement form, routine use is not recommended.
How It Works
- Incorporates into bone mineral, inflating DEXA density readings
- Activates calcium-sensing receptor to promote bone formation
- Drug form (ranelate) raised cardiovascular risk — withdrawn in EU
Quick Facts
- No fracture-outcome trials for OTC strontium citrate
- DEXA gains are partly an artifact of strontium's density
- Prescription ranelate withdrawn over heart attack risk
Benefits & Outcomes
No linked outcomes yet. Research is ongoing.
Supporting Research4 studies
The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis
Meunier PJ, Roux C, Seeman E +10 more
Strontium ranelate reduces vertebral fracture risk in postmenopausal osteoporosis.
Strontium ranelate for preventing and treating postmenopausal osteoporosis
O'Donnell S, Cranney A, Wells GA +2 more
Strontium ranelate reduces fractures but carries thromboembolic and gastrointestinal risks.
Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study
Reginster JY, Seeman E, De Vernejoul MC +10 more
Strontium ranelate reduces nonvertebral fracture risk in postmenopausal osteoporosis.
Nationwide registry-based analysis of cardiovascular risk factors and adverse outcomes in patients treated with strontium ranelate
Abrahamsen B, Grove EL, Vestergaard P
Cardiovascular safety concerns contributed to regulatory restriction of strontium ranelate.
Safety Information
Potential Side Effects
Nausea, diarrhea; possible increased cardiovascular and clotting risk based on ranelate data.
Contraindications
Cardiovascular disease or risk factors, kidney disease, history of blood clots, pregnancy.
Drug Interactions
- Calcium supplements (competitive absorption)
- Antacids
- Tetracycline and quinolone antibiotics (chelation)
Pregnancy & Breastfeeding
Pregnancy: unsafe
Breastfeeding: unsafe
Dosage Guidelines
Dosage Used in Studies
680-680 mg
Best Form
None recommended
Bioavailability
~25% absorbed, competing with calcium; take away from calcium and food.
Forms Compared
Common supplement form; unproven for fracture prevention
Prescription drug; withdrawn in Europe for cardiovascular risk
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.