Strontium: A Better Drug for Osteoporosis?

As a kidney transplant patient, I take lot of drugs, which can result in bone density loss. My doctor prescribed Fosamax, but I stopped taking it because of the side effects. Recently, I read about strontium, which appears to be as effective as Fosamax in promoting bone density, but without the side effects. What do you think about strontium as an alternative to Fosamax?

– December 1, 2005

Since you’re a kidney transplant patient, I would advise against taking anything without the supervision and approval of your physician. Here’s the story about strontium:

The drug you no doubt read about is strontium ranelate, a combination of the mineral strontium with ranelic acid. It has been licensed for sale in the UK and elsewhere in Europe for treatment of osteoporosis in postmenopausal women. A number of studies have shown that it can strengthen bone and reduce the risk of fractures, even among women 74 years of age or older when risks are highest. Use of strontium ranelate to strengthen bone and prevent fractures has been escalating since the positive results of a three-year clinical trial were published in the January 29, 2004 issue of the New England Journal of Medicine. In that study, researchers in Europe and Australia randomly assigned 1,649 women age 50 and older who had at least one vertebral fracture due to osteoporosis to take calcium plus vitamin D and two grams of strontium ranelate or just calcium and vitamin D without the drug. The women who took the supplements and the drug had fewer new vertebral fractures and increased bone mineral density of the spine and hip to a greater degree than the women who took only the supplements. In fact, the supplement group actually showed a loss of bone mineral density. Since then at least one other study has shown that strontium ranelate reduces the risk of non-vertebral fractures, including hip fractures.

In Britain, the recommended dose is two grams daily taken at bedtime, at least two hours after eating (any type of food) or drinking (any liquid other than water), both of which can affect absorption.

Strontium ranelate is not yet approved by the FDA for treatment or prevention of osteoporosis in the United States. It remains under study.

Andrew Weil, M.D.

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