Let me preface today's blog with a
head's up that I spent 5 hours researching this subject before writing the
blog. It's a little technical, but I thought the detail was important.
Although I may have a pretty good handle on the subject, I
may also have missed something that wasn't available on the internet. Please feel free to comment if you feel I missed something.
Last Thursday, Dr. Oz told his audience about four supplements, extensively researched by his staff, which he highly touts as anti-aging supplements. The four were resveratrol, vitamin D, fish oil, and strontium. Please see my previous blogs about fish oil (Tuesday, April 10, 2012 titled ‘Et tu fish pills?’) and Vitamin D (Tuesday, March 20, 2012 titled ‘What's The Big Deal About Vitamin D? It turns out quite a bit.’
At a later date, I'll write about resveratrol. In the interim, please note that one of the leading, if not the number one in the world, resveratrol researcher, Depak Das at the University of Connecticut, was dismissed from his university post because he was found to have repeatedly falsified his resveratrol research data. This has thrown the entire field of resveratrol research into dispute and a major conference that was scheduled in India called Resveratrol 2012 was cancelled late last year as he was one of the top experts expected to present. Enough about resveratrol for now; today, let's have some fun with strontium.
Dr. Oz recommended that women take
680 mg of strontium each day separated from the calcium he also
recommends they take. Of course, he made no reference to recent studies
that suggest potential harm from taking calcium (see my blog from Friday, May 25, 2012, 'Calcium
Pills Raise Concerns -- Again!'). He mentioned on the show that
strontium has been studied in Europe and that the studied form is not available
in the U.S.
Here's what he didn’t share. The
form of strontium studied in Europe was strontium ranelate, a synthetic salt
that combines strontium with ranelic acid. The studies done in Europe
were good studies and one of the studies was published in the New England
Journal of Medicine, a peer reviewed prestigious journal published by the
Massachusetts Medical Society and associated with Massachusetts General
Hospital, the premiere Harvard affiliated public hospital. See reference below.
The study involved the
consumption of 2 grams of strontium ranelate each day for a period just short
of five years. The strontium clearly increased bone density on scans and
decreased fracture risks in post-menopausal women. It was generally well
tolerated except for increased nausea and diarrhea during the first three
months of administration. All study
participants also consumed calcium and Vitamin D at different dosages. As a result of the study, the drug was
approved and is only available by doctor prescription for dispensing by a pharmacist
to people at high risk of fractures in Europe, and requires strict medical
supervision.
Why strict medical
supervision? Strontium competes with calcium and magnesium and displaces them.
What that does to your bone health and overall health has not been studied and
is unknown. There are reports that it
can cause a condition called osteomalacia, which involves the softening of
the bones caused by defective bone mineralization secondary to inadequate
amounts of available phosphorus and calcium, or because of overactive resorption
of calcium from the bone, often as a result of hyperparathyroidism. In other words, taking strontium may interfere
with your normal function of calcium uptake by bones.
A review of comments
from users found on the internet included, a doctor “urged caution and told
me about the deaths due to 'hypersensitivity syndrome' and a second consultant
told me she was still not happy with calculation of DEXA scores.” The reference
to the DEXA scores is that when doing the diagnostic DEXA Scan tests for
osteoporosis, the test results are apparently skewed by the use of strontium. There were many comments that indicated no
problems.
So why isn’t it available
in the U.S.? The answer is because the French company that owns the patent has
not pursued FDA approval. The apparent reason for this and the one most often
cited is that the FDA would require some homegrown research before approving it
and the company doesn’t want to foot the bill. So you can’t get it here.
Of course, some
entrepreneurial folks decided that if you can get the synthetic strontium
ranelate here, they should cook up some strontium citrate because as it has no
synthetic compound involved (ranelic acid is synthetic and citrate is not) and
therefore can be sold as a supplement here in the U.S. How did they come up with the recommended 680
mg dose? Apparently, strontium ranelate contains 680 mg of strontium. How much strontium does strontium citrate
contain? I can’t tell you.
Also, what’s the
difference between the way citrate and ranelate act in your body? I don’t know
and nor does anyone else because it hasn’t been studied. Let’s look at an example
of two other different chemical molecules binding together. Sodium when
combined with chloride becomes sodium chloride, the salt we eat. When sodium is
combined with citrate, it becomes monosodium citrate, a salt used to prevent
anticoagulation of stored blood. Different chemicals when combined create
different compounds.
So what’s the biggest problem
with taking strontium citrate to prevent or treat osteoporosis? Beyond some of the
concerns cited above, it’s never been studied and reported on in humans.
There was a study begun
in the U.S. at University of California Davis Medical Center a few years ago
that was meant to be completed and results reported in 2010, but the study,
named the Scope Study, has mysteriously disappeared. I’m not kidding. There are conspiracy theories
all over the internet regarding what happened to this study. Some claim the bisphosphonate
companies got to them. Just theories with no evidence whatsoever to support them.
My experience is when a research institute goes mum on a study, it’s often due
to something going wrong with the study. Nonetheless, the results never came out. That
gives me pause to ever recommend such a drug under such circumstances.
Furthermore, while strontium
ranelate was studied with 680 mg of strontium, studies with far less amounts have
never been reported. If it is actually good for you, could less work just as
well?
Strontium is present in our food
supply. For example, it is available in vegetables such as spinach, lettuce,
carrots, peas, beans, potatoes and celery. Wheat, barley and other grains used
to make bread also have significant levels of strontium. According to one
source I found, flour, grains and breads average 2,150 mg per gram of stable
strontium.
So as always, before taking a pill
containing a super high dose of a mineral which has not been studied for a
prolonged period of time, you should increase your intake of foods containing that
mineral that have been used for millions of years.
It is important to remember that high-dose strontium is essentially a
bone drug, and, as with all bone drugs, it is only indicated when there is a
clear high risk of fracture defined
as a 20% likelihood of a major osteoporotic fracture over the next 10 years.
The bottom line is that
the long-term safety and efficacy of strontium citrate has not been evaluated
on humans in large-scale medical trials.
That’s why once again I
say shame on Dr. Oz for recommending it to the general population without good
science to support what is available in the U.S. It only serves to make people more anxious and confused that maybe they have misssed something. It is often dangerous to experiment on your own body.
By the way, here are the chemical structures for strontium ranelate and strontium citrate. Do they look similar? If no, it's because they are not. One, ranelate binds with two atoms of strontium, while the other, citrate, only binds with one atom.
By the way, here are the chemical structures for strontium ranelate and strontium citrate. Do they look similar? If no, it's because they are not. One, ranelate binds with two atoms of strontium, while the other, citrate, only binds with one atom.
Strontium Ranelate
Strontium
Citrate
References:
Meunier PJ, Roux C, Seeman E, et al.
The effects of Strontium Ranelate on the risk of vertebral fracture in women
with postmenopausal osteoporosis. NEJM 2004 350;459 -68
Reginster JY, Seeman E, DE Vernejoul
MC, et al . Tropos Study. J Clin Endocrinol Metab 2004–1774. Strontium ranelate
reduces the risk of nonvertebral fractures in post-menopausal women with
osteoporosis.
