Strontium is a calcium-like mineral that concentrates in bone, sold as a supplement and, in some countries, a restricted prescription. Its strongest benefit is fewer spine fractures in women with bone loss, though part of the bone-density rise is a measurement effect. Blood clots are the main serious risk; a heart-attack signal stays disputed. (Full Review)

Protocol

Prescription Dose

2 g daily

Strontium ranelate, on a background of calcium and vitamin D

Supplement Dose

680 mg daily

Elemental strontium as citrate, closest to the studied dose

Timing

Single bedtime dose

At least 2 hours after the evening meal, away from calcium

Time to effect

Fracture Risk Reduction

1–3 years

Meaningful reduction is a multi-year outcome

Bone-Density Readings

Within 1 year

Readings rise on scans in the first year

Skeletal Retention

Months to years

Benefit and density artefact persist after stopping

Benefits

High: Reduction of spinal fractures; increased bone-density readings

Medium: Reduction of non-vertebral fractures

Low: Hip fracture reduction in the highest-risk elderly; symptom relief in knee osteoarthritis

Speculative: Dental remineralization and tooth sensitivity

Contraindications

Current or prior venous thromboembolism

Established ischemic heart disease or prior myocardial infarction (recent, within 90 days)

Peripheral or cerebrovascular disease

Uncontrolled hypertension

Severe kidney impairment (creatinine clearance below 30 mL/min)

Pregnancy and breastfeeding

History of severe drug hypersensitivity (e.g., DRESS)

Key Interactions

Calcium (supplements, dairy, fortified foods)

Quinolone and tetracycline antibiotics (ciprofloxacin, levofloxacin, doxycycline, tetracycline)

Oral bisphosphonates and other bone drugs (alendronate, risedronate)

Antacids and mineral supplements (magnesium, aluminum, zinc, iron)

Additive clot-risk agents (estrogen-containing hormone therapy, thalidomide-class drugs)

Risk & Side Effects

High: Venous thromboembolism; gastrointestinal effects

Medium: Cardiovascular events; severe hypersensitivity reactions

Low: Misleading bone-density readings; nervous-system symptoms

Speculative: Unknown long-term safety of supplement-dose citrate

Monitoring

Marker	Target	Why
Bone mineral density (DXA T-score)	Trend upward; T-score above -2.5	Tracks the core bone target
eGFR	> 60 mL/min/1.73m²	Strontium is kidney-cleared; guards against accumulation
Serum calcium	8.6–10.0 mg/dL	Ensures calcium sufficiency and detects imbalance
25-hydroxyvitamin D	40–60 ng/mL	Vitamin D repletion is needed for bone benefit
C-terminal telopeptide (CTX)	Lower half of reference range	Gauges bone-resorption activity and response
hs-CRP	< 1.0 mg/L	Contextual cardiovascular-risk marker given heart-safety concerns

Cadence: Kidney function and clot/cardiovascular status at 3–6 months, then every 6–12 months; repeat DXA at 12–24 months interpreted with the strontium artefact in mind; review continued need at least yearly.

Qualitative Assessment

Absence of new fractures or height loss over time
No leg swelling, calf pain, chest pain, or breathlessness (possible clot warning signs)
No widespread rash or unexplained fever, especially early in treatment
Stable digestion without persistent diarrhea or nausea
General mobility, strength, and energy maintained or improved

Strontium for Health & Longevity

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment