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What Role Does Strontium Citrate Play In Natural Osteoporosis Treatment?

Strontium citrate is a natural source of strontium, a dual-action agent that both reduces bone resorption and increases high quality strong bone formation.

One pharmaceutical company claims that it could fundamentally change the treatment paradigm of patients with osteoporosis.

Puritan's Pride sells strontium at the most attractive price we could find on the internet... as well as the calcium, magnesium and vitamin D to support it.

To view visitor comments about strontium citrate, please visit our Strontium Citrate And Strontium Ranelate page.

Why The Excitement About Strontium Citrate?

Most current osteoporosis medications are antiresorptive. They prevent bone breakdown by osteoclasts, thereby allowing osteoblasts to form bone, which leads to a net increase in bone mineral density (BMD).

Strontium acts as a "dual-acting bone agent" by simultaneously increasing bone formation and reducing bone resorption. These two actions lead to a rebalance of bone turnover in favour of bone formation in the prevention and treatment of osteoporosis.

Research by pharmaceutical companies has shown that strontium can improve bone density by 8-14% when combined with daily supplements of 1,500 mg of calcium and 800 IUs of vitamin D.

Taking this full program of supplements requires a dedication and discipline which is not necessary with prescription drugs, which are usually taken daily or weekly.

Osteoporosis treatment with strontium citrate, therefore, will not be for everyone, although it is now being considered for the prevention of osteoarthritis in the knees as well.

Strontium Citrate As A Dietary Supplement

In the USA and Canada strontium citrate is available as a dietary supplement. Most manufacturers provide 300 to 350 mg per tablet of strontium and recommend two pills a day to provide a dose similar to that used in studies of prescription formulas.

Natural compounds of strontium were approved as supplements in the United States under the Dietary Supplements Health and Education Act of 1994... and are often recommended by health practitioners for the treatment of osteoporosis.

More About Strontium


The French pharmaceutical company Servier found that the bioavailability of strontium ranelate is about 25% (range 19-27%) after an oral dose of 2 g. The American company Osteologix claims to have superior absorption with its product strontium malonate.

Bone Quality

Strontium assists with the development of high quality bone tissue. Research found that strontium treatment increased bone mass, bone dimension, microarchitecture and intrinsic bone tissue quality.

Long-Term Effects

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."

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

As strontium is heavier than calcium and remains in the bones, it will indicate that the bones are denser than they really are in a bone scan. Bone density tests provided by DXA scans must be adjusted in order to get an accurate reading. Blood and urine tests for calcium must also be adjusted.

The studies on strontium ranelate took this into consideration and the reported improvements in bone density are net of the impact of strontium in the bones.

Strontium Safety

In the two European studies on strontium ranelate there was little difference in side effects between the patients receiving strontium ranelate and the placebo groups that were not receiving strontium.

The most common side effects included nausea, diarrhea, headaches and eczema but with only 2 to 4% increase compared with the placebo group.

Most of the side effects subsided in 3 months. This result is consistent with earlier research on strontium using natural supplements.

While 700 mg of strontium daily appears to be safe for most people, individuals with the following disorders should avoid both natural and prescription forms of the mineral:

  • Decreased kidney function
  • History of blood clots in the veins (venous thromboembolism, e.g., deep vein thrombosis or pulmonary embolism).
  • Blood disorders that increase the risk of blood clots in the veins, e.g. antiphospholipid syndrome, factor V Leiden. (Tests performed on strontium ranelate indicated that strontium may slightly increase the incidence of blood clots.)

Strontium for osteoporosis treatment should not be taken by:

  • Children
  • Pregnant and lactating women
  • people who are immobilized
  • People taking antibiotics such as quinolones or oral tetracyclines as strontium may reduce their absorption. (These drugs are commonly used for acne and rosacea but may also be used for chlamydia, typhus, syphilis, Rocky Mountain spotted fever, Lyme disease & Legionnaires' disease... among others)

Guidelines For Taking Strontium Citrate

Do not take strontium through a bone-building supplement that includes calcium, as calcium reduces the bioavailability of strontium by 60-70%.

Strontium citrate will only be effective if taken correctly.

  1. Allow at least two hours between a calcium supplement and strontium intake as calcium can reduce the bioavailability of strontium by 60-70%.
  2. The suggested time to take strontium citrate is on an empty stomach before going to bed-preferably three hours after a meal.
  3. Strontium has proven effective for the treatment of osteoporosis only when taken in combination with 1,500 mg calcium and 800 IU vitamin D supplements.
  4. An effective bone health program will also include vitamin K, magnesium and lots of exercise.
  5. Vitamin D does not interfere with strontium absorption.

This regimen is much more demanding than taking a single pill daily or weekly... and lack of compliance will undermine the effectiveness of the strontium.

Cost With Strontium Citrate

The annual cost of an osteopoosis treatment program that includes strontium citrate and the necessary calcium and vitamins is approximately as follows:

  • Strontium supplements (680 mg/day): $100 USD
  • Calcium,vitamin D, magnesium and vitamin K: $60 USD

This compares to the annual cost of osteoporosis medications as follows:

  • Alendronate (generic Fosamax):$400 USD
  • Risedronate (5 mg Actonel): $840 USD
  • Raloxifene (Evista): $670-$850 USD
  • Etidronate (generic Didronel): $150-200 USD (6 month supply)
  • Zoledronic Acid (Aclasta/Reclast): $984 USD

Health practitioners generally advise their patients to take adequate calcium and vitamin D to support their bone health and reinforce their medication.

Many people like to complement their strontium citrate with two tablets of inexpensive Puritan's Pride Bone Care to gain the necessary calcium, vitamin D, magnesium and vitamin K for optimal bone health. (Remember that calcium should be taken separately from the strontium.)