Most people think of strontium as a radioactive, toxic metal associated with nuclear fallout. It’s too bad they don’t also know about stable strontium, considering the important recent breakthroughs on strontium for natural osteoporosis treatment. While synthetic, radioactive, toxic isotopes of strontium do exist, stable (nonradioactive) strontium, element number 38 of the periodic table of elements, is a naturally occurring, alkaline mineral closely related to calcium.

As one of the most abundant elements on earth, stable strontium is  nontoxic  even when administered in large doses for prolonged periods.  And research has revealed it is uniquely effective in stimulating rapid bone formation thus making it critically important as a key component of a natural osteoporosis treatment plan. Nearly all the strontium in the human body is located in bone and connective tissue. Because of its similarity to calcium, strontium accumulates especially where active bone remodeling (bone formation) takes place. In fact, studies show that strontium is one of the most effective natural substances available for the prevention and treatment of osteoporosis. 

Strontium is Licensed in Europe as a Dual Action Osteoporosis Treatment 

Strontium (in the form of strontium ranelate, the strontium salt of ranelic acid) is even the first licensed osteoporosis treatment in Europe known to have a dual mode of action: it simultaneously increases the formation of new bone and decreases the breakdown of bone.[1] Because of this dual action it can switch the entire equilibrium of bone turnover to one of bone formation making it an excellent choice for natural osteoporosis treatment.

Even though strontium ranelate is considered a prescription medication and is not yet available in the United States, other salts of strontium, including strontium citrate, carbonate, and lactate are available as dietary supplements. The addition of strontium to the bone health supplement scene is a real breakthrough for natural osteoporosis treatment since it appears that the active ingredient is strontium, and whatever salt of strontium used is less important than the amount of strontium consumed.

Study Results Increasingly Verify Strontium’s Important Role in Bone Health

Studies show that when strontium replaces a small proportion of the calcium in hydroxyapatite crystals of calcified tissues such as bones and teeth it imparts additional strength to these tissues. Research on strontium for bones goes back as far as 1959, when researchers at the Mayo Clinic investigated the effect of strontium in 32 individuals suffering from osteoporosis.[2] Eighty-four percent of the patients who took 1.7 grams of strontium per day as strontium lactate reported marked relief of bone pain. The remaining 16 percent experienced moderate improvement. They experienced no significant side effects even with up to three years of supplementation. Although more sophisticated tests for bone density were not available, X-rays indicated increased bone mass.

Additional human studies in the 1980’s used 600 to 700 mg per day of strontium in the form of strontium carbonate in patients with osteoporosis.[3] Findings included the increased  rate of bone formation based on bone biopsy as well as diminished bone pain and increased ability to move. The research then stalled until the early 2000’s when strontium ranelate studies began. In the last ten years, many double-blind, randomized clinical trials of strontium ranelate have been conducted. Overall, they show a significant 31% decrease in fractures due to osteoporosis from treatment with strontium ranelate.[4] Some studies have shown up to a 50% decrease in hip fractures and a 45% decrease in fractures of the spine.[5,6] The pooled results of the largest studies to date indicate that strontium ranelate treatment is associated with sustained increases in bone mineral density and ability to prevent fractures over 10 years, with a good safety profile.[7]

Although clinical studies on other salts of strontium besides ranelate have not yet been conducted, many integrative and natural health care practitioners are recommending strontium supplementation to their patients with osteoporosis based on the idea that the active ingredient is strontium and whatever salt of strontium used is less important than the amount of strontium consumed. The dose of strontium ranelate found to be most effective in studies, 2 grams per day, provides 680 mg of actual strontium. Therefore, if taking strontium as a supplement, you should aim for a daily total of 680 mg strontium in whatever form of strontium salt you take.

How To Properly Take Strontium Supplements

For natural osteoporosis treatment, I typically recommend my patients follow a protocol similar to the FOOT protocol (Fully-Optimized Osteoporosis Therapy) pioneered by naturopathic physician Dr. Mark Swanson. As part of the protocol, Dr. Swanson recommends his osteoporosis patients take 680 mg strontium citrate at bedtime, 2 hours away from dairy foods or calcium supplements.[8] When his patients take night-time strontium along with calcium and potassium supplementation during the day, Dr. Swanson has stated that almost universally he sees positive influences on DEXA results in terms of impressive and rapid improvement in T-scores.  Dr. Swanson’s recommendations about night-time dosing of strontium adhere to the recommendations of strontium researchers who caution that co-administration of strontium with calcium appears to impair strontium absorption, so it is recommended that strontium be taken on an empty stomach and away from calcium, and not by patients with severe kidney disease. Is strontium supplementation a part of your own natural osteoporosis treatment program? All signs seem to point that it should be.

[1] Cesareo R, Napolitano C, Iozzino M. Strontium ranelate in postmenopausal osteoporosis treatment: a critical appraisal. Int J Womens Health. 2010 Aug 9;2:1-6.

[2]  McCaslin FE, Janes, JM. The effect of strontium lactate in the treatment of osteoporosis. Proc Staff Meetings Mayo Clin, 1959, 34:329-334.

[3] Marie PJ, Skoryna SC, Pivon RJ, et al. Histomorphometry of bone changes in stable strontium therapy. In: Trace substances in environmental health XIX, edited by D.D. Hemphill, University of Missouri, Columbia, Missouri, 1985, 193-208.

[4] Kanis JA, Johansson H, Oden A, McCloskey EV. A meta-analysis of the effect of strontium ranelate on the risk of vertebral and non-vertebral fracture in postmenopausal osteoporosis and the interaction with FRAX(®). Osteoporos Int. 2011 Aug;22(8):2347-55.

[5] Rabenda V, Reginster JY. Positive impact of compliance to strontium ranelate on the risk of nonvertebral osteoporotic fractures. Osteoporos Int. 2010 Dec;21(12):1993-2002.

[6] Ortolani S, Vai S. Strontium ranelate: an increased bone quality leading to vertebral antifracture efficacy at all stages. Bone. 2006 Feb;38(2 Suppl 1):19-22.

[7] Reginster JY, Kaufman JM, et al. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos Int. 2012 Mar;23(3):1115-22.

[8] Swanson M. The FOOT Protocol: Fully-Optimized Osteoporosis Therapy.