When you’re deciding which osteoporosis supplements to purchase, it’s imperative you read the labels and find out how much strontium the products contain. It literally could be a matter of life and death. Here’s why…
Maybe you’ve heard of, or have even taken, a prescription drug that used to be available in Europe called Protelos or Osseor? After the European Medicines Agency’s Pharmacovigilance Risk Assessment Committee (PRAC) recommended that the drug not be used for osteoporosis back in April 2013, the drug was finally pulled from the market in August 2017 due to an abundance of severe side effects including heart attacks, seizures, pulmonary embolisms and strokes!
Well guess what, this drug was nothing more than a form of strontium called strontium ranelate! It had somehow passed clinical trials and was prescribed to the public for years, injuring a number of people in the process. Maybe I’m just being a conspiracy theorist, but perhaps it had something to do with sales reaching $220M a year within just a few years of being released?
What is Strontium
Strontium is an alkaline metal that is heavier than calcium. It has been historically used in early television tubes because of it’s X-ray absorbing properties. Strontium in the television tubes absorbed the X-rays and prevented it’s watchers from being slowly radiated to death during evening shows of Johnny Carson. Luckily, it’s never been approved as a drug in the U.S.
Even though the risks are high, strontium is still used as a treatment for a few more serious diseases such as prostate and bone cancer, where the dangers of such side effects might be worth the risk. That form is a radioactive version called strontium-89 chloride (Metastron) and is administered intravenously in a clinical setting. Also, the form strontium chloride hexahydrate can sometimes be found as an additive in toothpaste to reduce tooth sensitivity. Not to worry, as you probably won’t be ingesting or absorbing enough from toothpaste to cause systemic damage.
Strontium is not thought to be an essential nutrient. However, we do get this naturally occurring metal in small amounts in our diets. We typically consume perhaps a few milligrams of it per day. According to the CDC, leafy greens grown in the U.S. have about 64 milligrams per 2.2 pounds of vegetables. The prescription form Protelos was given in doses of 2,000 milligrams per day, or about 1000 times the amount we naturally consume. Giving 1000 times the dose of a nonessential nutrient seems like a good idea, right?
Effects in the Body
Strontium is stored in the human body mostly in bone and teeth. This increases the appearance of bone density on DEXA scans. DEXA scans are used to measure bone density in osteoporosis patients (for more information on osteoporosis, see this article). The strontium basically gets stored in the bones just like calcium, but the problem is the bones are not supposed to have strontium in them. You are basically filling the voids with metal, like some real life Wolverine from the X-Men comic book movies, but in a bad way. The strontium continues to accumulate in the bones and the body and starts to cause all of the nasty side effects mentioned earlier.
It is similar to the old fluoride story. When orally swished or perhaps taken in very low natural doses, fluoride contributes positively to the tooth density and enamel, as it is also primarily stored in the teeth and bones. However, at doses in the 2-8 milligram per day range, toxic fluorosis occurs. What happens is the fluoride gets stored in bones, replacing calcium and other essential minerals and the structure of the bone becomes brittle and prone to stiffness and fracture. Humans tend to want shortcuts to health, but they rarely end up working.
In addition to the cardiovascular, blood clot, seizure and other risks associated with strontium, there was a paper published in 2013 identifying 47 cases of “drug rash with eosinophilia and systemic symptoms (DRESS)” in strontium patients. This is essentially a hypersensitivity reaction where the body breaks out in rashes, white blood cells increase causing swollen lymph nodes and there is systemic inflammation (heart, lungs, liver, kidney, etc.) that can eventually lead to death.
Populations at especially high risk of side effects from strontium include:
- Paget’s Disease- the bones of people with this disease will hold more strontium than usual
- Pregnant or nursing mothers- strontium has been detected in umbilical cord blood
- Kidney Disease- strontium is eliminated via the kidneys and it can accumulate and damage the kidneys
- Blood clotting disorders- strontium has a history of causing dangerous blood clots in higher doses
- Liver disease- strontium has a history of causing liver damage
- Seizures- strontium has a history of increasing seizures
If you have any of the above, please avoid all strontium supplements or speak to your doctor before taking strontium, and make sure they are educated on the risks of strontium.
My personal belief is to avoid all supplements with more than a few milligrams of strontium. There are several osteoporosis supplements out there that contain 2,000 milligrams (also on labels as 2g or 2 grams) of strontium per dose. It is usually in the form of strontium citrate, but there is no data that this form is any safer than the ranelate, as it’s the strontium that is actually doing the damage, not the ranelate. Anyone who tells you differently is giving out dangerous advice.
- PRAC recommends suspending use of Protelos/Osseor – European Medicines Agency. (2018). European Medicines Agency. Retrieved 29 July 2019, from https://www.ema.europa.eu/en/news/prac-recommends-suspending-use-protelososseor
- Cessation of strontium ranelate supply. (2019). The BMJ. Retrieved 29 July 2019, from https://www.bmj.com/content/354/bmj.i5109/rr-1
- Méar, F., Yot, P., Cambon, M., & Ribes, M. (2006). The characterization of waste cathode-ray tube glass. Waste Management, 26(12), 1468-1476. doi:10.1016/j.wasman.2005.11.017 https://www.sciencedirect.com/science/article/pii/S0956053X05003144?via%3Dihub
- Strontium: Health Benefits, Uses, Side Effects, Dosage & Interactions. (2019). RxList. Retrieved 29 July 2019, from https://www.rxlist.com/strontium/supplements.htm
- strontium-89, G., & Metastron, B. (2019). Metastron (Strontium-89): Side Effects, Interactions, Warning, Dosage & Uses. RxList. Retrieved 30 July 2019, from https://www.rxlist.com/metastron-drug.htm
- Price, C., Langford, J., & Liporace, F. (2012). Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet. The Open Orthopaedics Journal, 6(1), 143-149. doi:10.2174/1874325001206010143 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330619/
- ATSDR – Public Health Statement: Strontium. (2019). Atsdr.cdc.gov. Retrieved 30 July 2019, from https://www.atsdr.cdc.gov/PHS/PHS.asp?id=654&tid=120
- Dhar, V., & Bhatnagar, M. (2009). Physiology and toxicity of fluoride. Indian Journal Of Dental Research, 20(3), 350. doi:10.4103/0970-9290.57379 http://www.ijdr.in/article.asp?issn=0970-9290;year=2009;volume=20;issue=3;spage=350;epage=355;aulast=Dhar
- Cacoub, P., Descamps, V., Meyer, O., Speirs, C., Belissa-Mathiot, P., & Musette, P. (2013). Drug rash with eosinophilia and systemic symptoms (DRESS) in patients receiving strontium ranelate. Osteoporosis International, 24(5), 1751-1757. doi:10.1007/s00198-013-2265-1 https://link.springer.com/article/10.1007%2Fs00198-013-2265-1
- Sonal Choudhary, P. (2013). Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. The Journal Of Clinical And Aesthetic Dermatology, 6(6), 31. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718748/
- Silver, M., Arain, A., Shao, J., Chen, M., Xia, Y., Lozoff, B., & Meeker, J. (2018). Distribution and predictors of 20 toxic and essential metals in the umbilical cord blood of Chinese newborns. Chemosphere, 210, 1167-1175. doi:10.1016/j.chemosphere.2018.07.124 https://www.sciencedirect.com/science/article/pii/S0045653518313900?via%3Dihub
- (2019). Ema.europa.eu. Retrieved 30 July 2019, from https://www.ema.europa.eu/en/documents/scientific-discussion/protelos-epar-scientific-discussion_en.pdf