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Strontium And Bone Density Tests

Strontium and bone density test are connected. This includes DXA Scans, blood and urine tests.

Researchers have adjusted improvements in bone density tests by 50% (downwards) to account for the presence of strontium. This adjustment still allows for an approximate 8-14% increase in bone density after three years of osteoporosis treatment.

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STRONTIUM AND DXA SCANS

As strontium is heavier than calcium, it will show up in a bone scan and indicate that the bones are denser than they really are. Bone density tests (DXA) used to detect osteoporosis must be adjusted in order to get an accurate reading.

Unfortunately, the adjustment calculations suggested by the scientific community are difficult for a lay person to understand and apply. Here are a few sample arguments:

“... reliable DXA determinations of BMD may be carried out in the presence of selenium and may be interpreted in terms of calcium hydroxyapatite equivalent if the bone selenium content of the measured bone is known. The same adjustment factor (10% overestimation for 1 mol/mol% Sr) can be used for all presently available types of instrument and acquisition modes.”

(Meunier CR, Roux P, Cassin De B, Basse-Cathalinat OH, Sorensen D, Slosman SP, Nielsen, “Influence of strontium on bone mineral density and bone mineral content measurements by dual X-ray absorptiometry.”, Journal Clinical Densitom. 1999 Winter;2(4):371-9. (Department of Clinical Physiology, Hillerod Hospital, Hillerod, Denmark. spni@fa.dk)

A description of the clinical trials of the prescription drug Protelos (for osteoporosis treatment) suggests a fifty percent adjustment of improvements made in bone density:

“The combined effects of strontium distribution in bone (see section 5.2) and increased X-ray absorption of strontium as compared to calcium, leads to an amplification of bone mineral density (BMD) measurement by dual-photon X-ray absorptiometry (DXA). Available data indicate that these factors account for approximately 50% of the measured change in BMD over 3 years of treatment with Protelos 2 g/day.”

(This quote is taken from information posted on the electronic Medicines Compendium (eMC) regarding the strontium ranelate product-Protelos.)

To complicate things further, measurement of strontium will vary significantly between different manufacturers of DXA equipment.

STRONTIUM RETENTION

A 2009 study in Denmark found that there was significant retention of strontium after treatment was completed... especially if a person had taken strontium for eight years. It concluded its findings as follows:

“According to the power function model, the skeletal retention three and six months after stopping the treatment would average 66% and 58%, respectively after three years of treatment, and 76% and 70%, respectively after eight years of treatment. However, individual predictions are uncertain due to large inter-individual variations, and the values cannot be extrapolated to other bone sites.”
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Therefore, DXA results will not accurately reflect a person's true BMD after stopping strontium treatments because the mineral is retained in the bones for at least six months and probably longer.

(Bärenholdt O, Kolthoff N, Nielsen SP , “Effect of long-term treatment with strontium ranelate on bone strontium content.” Bone Unit, Department of Clinical Physiology, Hillerød Hospital, DK-3400 Hillerød, Denmark. Bone. 2009 Aug;45(2):200-6. Epub 2009 Apr 17) (PMID: 19376283)

STRONTIUM AND BLOOD CALCIUM TESTS

The pharmaceutical company Servier warns that strontium can interfere with tests for calcium in the blood and urine. These tests are used during the treatment of osteoporosis to measure how much bone is building up and how much it is breaking down and at what speed.

“Strontium ranelate interferes with colorimetric methods for the determination of blood and urinary calcium concentrations. Therefore, in medical practice, inductively coupled plasma atomic emission spectrometry or atomic absorption spectrometry methods should be used to ensure an accurate assessment of blood and urinary calcium concentrations.”

If you take strontium supplements, it is recommended that you inform your care provider prior to completing any blood and urine calcium tests... so that adjustments can be made to improve the accuracy of the test results.

A comprehensive osteoporosis treatment program can be purchased for less than $200 USD annually by combining Strontium Bone Maker (strontium citrate) with Puritan's Pride Bone Care which provides the calcium, vitamin D, magnesium and vitamin K needed to support a strontium treatment program.

To learn how strontium and bone density tests fit into an osteoporosis prevention program... visit Osteoporosis Treatment Guidelines.