Strontium Citrate And Osteoporosis: What Ingredient Works?

THE LATEST NEWS ABOUT STRONTIUM CITRATE

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Strontium is an essential trace element that plays a key role in bone formation and maintenance. For example, strontium has the dual effects of promoting bone formation and inhibiting bone resorption, affecting various signaling pathways’ biochemical and molecular mechanisms, etc.

The problem of osteoporosis is that as we age, the amount of bone reabsorbed into the blood exceeds the number of macrophages that can differentiate into osteoblasts to form bones, leading to deformation of the bone structure, reduction in bone density and hardness, and prone to fractures. Phenomenon. As the population ages, the number of osteoporosis and resulting fractures is increasing.

Strontium And Bone Formation

The element strontium was discovered by Scottish scientist Davy in 1808 and named after his hometown town of Strontia. Strontium is a very abundant element on Earth, accounting for 0.04% of the total weight of the crust. But in living organisms, strontium is a trace element. The human body contains approximately 320 mg of strontium, mainly in bone and joint tissues. Strontium has very similar properties to calcium. Strontium ions have two positive charges and sometimes partially displace calcium ions into calcium hydroxyapatite in bones. The increased strontium in bones can improve bone strength, reduce calcium loss, and increase calcium deposition.

A U.S. Navy study of data from 10-year physical examinations of 270,000 recruits found that only 360 had no cavities. Thirty-six of them came from the same place, the town of Rossberg, Ohio. The town’s water contains higher levels of strontium than water elsewhere. The strontium content in drinking water reaches 6 mg/L ~ 10 mg/L. It can significantly reduce the incidence of dental caries. It also shows that strontium is very important for the growth of bones and teeth.

How Does Strontium Work?

In 1952, strontium (strontium lactate) was first reported to be used together with calcium to treat osteoporosis and remineralize bones [1].

In 1959, the Mayo Clinic in the United States studied strontium acetate to treat osteoporosis. The effect is good [2]. However, the detection methods at that time were backward, and there was no CT scan to measure bone density and other technologies. Therefore, the judgment of efficacy mainly relies on the patient’s self-perception description.

Later, intensive nuclear testing in the 1860s led to reports about the radioactive isotope 90Sr, and people began to fear strontium. Therefore, healthcare research on strontium has been suspended for 20 years. It was not until after 1980 that research on preventing and treating osteoporosis with strontium gradually increased. In order to differentiate, non-radioactive strontium is called stable strontium.

Strontium is present in the hydrated layer of bones. Due to its hydration effect, it promotes the repair of micro-damages in bones and prevents small cracks from merging into larger cracks [3]. Strontium has the dual effects of promoting bone formation and inhibiting bone resorption. Its mechanism of action includes the following aspects. [4]

1. It promotes osteoblast proliferation.
2. It improves multiple indicators of osteoblasts and promotes the mineralization of bone matrix.
3. It inhibits osteoblast apoptosis.
4. It inhibits osteoclast differentiation by increasing osteoprotegerin (OPG) levels and reducing receptor activators for nuclear factor-κβ ligand (RANKL) levels.
5. It reduces osteoclast activity.
6. It promotes osteoclast apoptosis.

According to research by Bayhan et al. [5], taking strontium ranelate for 3 months can significantly reduce serum homocysteine levels. It is one reason why strontium can prevent and treat osteoporosis. Homocysteine is an intermediate in the metabolism of methionine and cysteine. Under normal circumstances, it can be quickly converted into glutathione and S-adenosyl methionine, SAMe. Its concentration remains at a low level. However, if the body’s metabolism is abnormal, its concentration will accumulate, causing various diseases, including cardiovascular disease and osteoporosis. It is a clinically sensitive and broad disease marker. Therefore, treatment of osteoporosis can start by reducing homocysteine, that is, supplementing vitamin B6, vitamin B12, folic acid, and strontium compounds.

Strontium ranelate contains one ranelate radical and two strontium ions. Ranelic acid is a synthetic organic acid using citric acid as the starting material and does not participate in human metabolism. As the clinical application of strontium ranelate increases, some reports also show that strontium ranelate is ineffective or has an insignificant effect [6-7]. There are increasing reports of side effects, including nausea, diarrhea, headaches, and eczema. More serious side effects may lead to venous thromboembolism, pulmonary embolism, and severe cardiovascular disease [8-9]. EMA has issued two announcements restricting the use of strontium ranelate in May 2013 and March 2014. The French Pharmaceutical Economic Commission also determined that strontium ranelate was insufficiently effective in 2014. In the United States, strontium ranelate has not been approved by the FDA.

Judging from the results of relatively few studies on strontium non-ranelate salts, their efficacy and mechanism of action are consistent with those of strontium ranelate, both of which are strontium ions. That is to say, there is no essential difference from other strontium salts, such as strontium chloride, strontium citrate, strontium acetate, strontium gluconate, etc.

Strontium Dosage and Safety

Studies have shown that the effects of strontium are dose-related, with low doses increasing calcium absorption as the dosage increases. Exceeding a certain amount is not conducive to calcium absorption. For rats, the optimal dose is 7.65 mg/d, while the high dose of 76.56 mg/d affects calcium absorption and causes hypocalcemia [10]. Strontium salts are nontoxic, but their safety depends on calcium intake. With a low calcium diet and insufficient vitamin D, higher strontium content in food may lead to a high incidence of rickets in children [11]. Since calcium absorption is superior to that of strontium, under normal calcium intake, even a daily intake of strontium up to 1000 mg/d will not cause abnormal symptoms [12].

At present, there are no regulations on the daily intake of strontium in various countries.

Conclusion: Strontium Citrate And Osteoporosis Works

Currently, basic and clinical research on Strontium Citrate And Osteoporosis is limited. However, it is undeniable that natural strontium salts like Strontium Citrate have effective strontium components. In addition to its effects on bone metabolism, other biological functions of strontium and dietary nutrition also require further study.

References

1. SHORR E,CARTER A C.The usefulness of strontium as an adjuvant to calcium in the remineralization of the skeleton in man[J].Bulletin of the Hospital for Joint diseases,1952,13(1):59-66.
2. GABY A R.Preventing and reversing osteoporosis[M].New York:Three Rivers Press,1994.
3. ]BONNELYE E,CHABADEL A,SALTEL F,et al.Dual effect of strontium ranelate:stimulation of osteoblast differentiation and inhibition of osteoclast formation and resorption in vitro[J].Bone,2008,42:129-38.
4. [19]MARIE P J,FELSENBERG D,BRANDI M L.How strontium ranelate,via opposite effects on bone resorption and formation,prevents osteoporosis[J].Osteoporosis International,2011,22(6):1659-1667.
5. BAYHAN I,UYGUR D,UGURLU N,et al.Strontium ranelate decreases plasma homocysteine levels in postmenopausal osteoporotic women[J].Rheumatology International,2009,29(3):263-266.
6. BLAKE G M,FOGELMAN I.Bone:Strontium ranelate does not have an anabolic effect on bone[J].Nature Reviews Endocrinology,2013,9(12):696-697.
7. [35]CHAVASSIEUX P,MEUNIER P J,ROUX J P,et al.Bone histomorphometry of transiliac paired bone biopsies after 6 or 12 months of treatment with oral strontium ranelate in 387 osteoporotic women:randomized comparison to alendronate[J].Journal of Bone and Mineral Research,2014,29:618-628.
8. KAUFMAN J M,AUDRAN M,BIANCHI G,et al.Efficacy and safety of strontium ranelate in the treatment of osteoporosis in men[J].The Journal of Clinical Endocrinology&Metabolism,2013,98(2):592-601.
9. [37]DONNEAU A F,REGINSTER J Y.Cardiovascular safety of strontium ranelate:real-life assessment in clinical practice[J].Osteoporosis International,2014,25(2):397-398.
10. [42]NIELSEN S P.Review-the biological role of strontium[J].Bone,2004,35(3):583-588.
11. [43]OZGÜR S,SÜMER H,KOÇO LU G.Rickets and soil strontium[J].Archives of Disease in Childhood,1996,75(6):524-526.
12. [44]MELNYK L J,DONOHUE M J,PHAM M,et al.Absorption of strontium by foods prepared in drinking water[J].Journal of Trace Elements in Medicine and Biology,2019,53:22-26.