Strontium is a calcium-like mineral built into bone, sold as a now-withdrawn prescription drug and as a supplement. It appears to build bone while slowing its breakdown, and the prescription form cut broken bones, mainly in the spine. But bone scans overstate real gains, and concerns about heart attacks and clots cloud its safety. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Bone mineral density (DXA T-score) | T-score above −1.0; trend stable or improving | Tracks the primary target outcome |
| 25-hydroxyvitamin D | 40–60 ng/mL | Supports bone response; deficiency limits benefit |
| Serum calcium | 9.4–9.9 mg/dL | Confirms calcium status; strontium handling tracks calcium |
| Estimated glomerular filtration rate (eGFR) | >90 mL/min/1.73m² | Strontium is renally cleared; impairment raises exposure |
| Blood pressure | <120/80 mmHg | Cardiovascular safety screening and monitoring |
| Bone turnover markers (e.g., P1NP, CTX) | Within premenopausal reference range | Gauges remodeling response |
Cadence: DXA every 1–2 years; blood pressure and cardiovascular review every 6–12 months; renal function and calcium/vitamin D annually; prompt evaluation for any rash with systemic symptoms or new cardiovascular event.