The International Osteoporosis Foundation reports that an estimated 75 million people in the U.S., Europe and Japan suffer from osteoporosis, a condition that makes bones become porous, brittle and susceptible to fractures.1 Clinical studies are show that strontium supplementation could be an effective tool for reversing the devastating effects of osteoporosis.
Two large randomized controlled 5-year trials have shown a significant reduction in fractures and increases in bone density in postmenopausal women using strontium ranelate. The evidence also shows benefits for people over 80, which is something that no other anti-osteoporosis treatment has demonstrated.234
The clinical studies, SOTI (Spinal Osteoporosis Therapeutic Intervention) and TROPOS (Treatment of Peripheral Osteoporosis), were started in 2000 to investigate the efficacy of strontium ranelate in reducing vertebral and peripheral fractures, including hip fractures. The results showed that the patients who took strontium ranelate had a 41% reduction in vertebral fractures and 36% reduction in hip fractures compared with patients treated with placebo.2
A recent review of strontium ranelate in the April 2010 edition of the journal Drugs found that the drug provided protection against new fractures for up to 8 years for patients who continued to receive it during the 3 years following these two trials.5
What is strontium?
Strontium is a soft metal that is chemically similar to calcium. In fact, strontium lies directly below calcium on the periodic table of elements, which makes calcium, strontium and magnesium all in the same chemical family. They are all naturally occurring metals found in the soil, in foods and in your body.
In the 1950s strontium emerged as a potential osteoporosis drug because it shows a natural attraction to bone. But strontium is unpatentable because it is a natural element, and it was soon “forgotten.” In order for drug companies to profit from a natural substance they typically have to add something artificial to it. Once patent protection is granted, it becomes cost effective for a drug company to invest in large clinical studies.
What is strontium ranelate?
Ranelic acid is a synthetic molecule that a pharmaceutical company added to strontium to create a patentable form. Strontium ranelate is composed of two atoms of strontium and one molecule of ranelic acid. (Ranelic acid is excreted from the body via the kidneys.)
Strontium bonds easily with other materials to form stable salts like strontium citrate, strontium lactate, and strontium carbonate. These natural compounds are sold as dietary supplements. It’s important to note, however, that some forms, such as citrate, are gentler on the stomach and easier to absorb than others.
Although the drug strontium ranelate is prescribed in Europe under various names (Proteolos, Protos, etc.) as an alternative to bisphosphonates such as Boniva®, Fosamax® and Actonel®, it has not been FDA approved in the U.S. It is possible, however, to buy strontium as a dietary supplement in a natural and effective form such as strontium citrate for strontium supplementation. It is also included in bone support formulas. And remember, the ranelate in strontium ranelate is not responsible for the benefits. It’s the strontium that exerts its effects on the bones.
Strontium is unique because it has the dual effect on bone metabolism of increasing bone formation and decreasing bone resorption – something that bisphosphonates, which are anti-resportive only, cannot do. Of particular note, strontium slows bone resorption, but doesn’t kill osteoclast cells (the cells that resorb or remove the mineralized matrix of bone) as bisphosphonates do.6
A recent article published in the journal Osteoporosis International discusses strontium ranelate’s dual mode of action and how it is the first drug proven to protect against bone fracture in all age groups, including young postmenopausal women and those over 80 years. Evidence is now available to show that all women, including the elderly, can benefit from treatment to prevent further bone loss and restore lost bone to decrease the risk of further fractures.7
Although the news about strontium supplementation is encouraging to everyone concerned about maintaining bone mass and preventing fractures, it’s important to focus on a comprehensive bone health regimen. So make sure you get plenty of calcium, vitamin D, magnesium, vitamin K2, boron, phosphorous, vitamin B6, B12 and folic acid. Weight bearing exercise is also crucial for supporting bone health. Now get moving and bone up on your nutrients.
- International Osteoporosis Foundation.
- Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350:459-468.
- Blake GM, Fogelman I. Strontium ranelate: a novel treatment for postmenopausal osteoporosis: a review of safety and efficacy. Clin Interv Aging. 2006;1(4):367-75.
- O’Donnell S, Cranney A, Wells GA, Adachi JD, Reginster JY. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Database Syst Rev. 2006 Jul 19;3:CD005326.
- Deeks ED, Dhillon S. Strontium ranelate: a review of its use in the treatment of postmenopausal osteoporosis. Drugs. 2010 Apr 16;70(6):733-59. doi: 10.2165/10481900-000000000-00000.
- GillianSanson.com. “Strontium-A novel bone building treatment.”
- Boonen S. Addressing the age-related needs of osteoporotic patients with strontium ranelate. Osteoporos Int. 2010 Jun;21 Suppl 2:S415-23. Epub 2010 May 1