May 2007
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May 10, 2007
Ortho-Bone: "I thought you couldn't mix Calcium and Strontium?"
Q: What do you think about all these new supplements which contain a full day's dose of Strontium along with calcium, magnesium, and other key nutrients all in one convenient bottle?
A: They're a disaster.
In his review, Dr. Reginster specifically notes (pg. 1914) that "The simultaneous intake of [Strontium] and calcium remarkably reduces the bioavailability of [Strontium]. This is probably due to competition at the sites of active absorption. Simultaneous food intake also has a negative influence on the bioavailability of [Strontium]". Based on this critical factor, Dr. Reginster recommends that high-dose Strontium should not be taken "concomitantly with a meal or a calcium intake."
The competition between Strontium and calcium for absorption has long been known, and is the basis for the fact that all of the trials using strontium with major bone-health outcomes have carefully ensured that the supplement is taken on an empty stomach, away from calcium in food or in supplements. In the largest and best-designed trials women have taken their Strontium first thing in the morning, half an hour to an hour before breakfast, and/or three hours after dinner in the evening; they took their calcium supplements separately, with a meal.
This is the protocol supported by pharmacology and by clinical trials, and it is the one that we recommend unless your doctor specifies otherwise. It is obviously impossible to follow this protocol if you're taking a supplement that combines calcium and Strontium in the same pill or powder! Such formulations are, therefore, not the "convenient," "inexpensive" deals they initially seem, but are ill-designed and likely ineffective "kitchen sink" hodgepodges. Persons taking these supplements will not reap the full benefits of Strontium documented in the clinical trials. This is a major health issue, especially for people with advanced osteoporosis. If they and their physicians are taking these combination supplements instead of a reliable, separate supplement, or instead of an established drug therapy, the results could be ruinous.
Note that these problems do not hold if there is only a small, nutritional amount of Strontium in a core bone health supplement - doses in the range of 500 micrograms to 5 milligrams, which are typical of human dietary intakes. Such doses are appropriate, as they preserve the ratio of calcium and Strontium present naturally in whole-food diets. In fact, all natural calcium sources also have a small amount of Strontium in them, because of the similar metabolism of the two nutrients in living beings. The presence of calcium with no Strontium in calcium supplements might be expected to upset this natural balance, leading to suppression of whatever Strontium is in your diet, ultimately perturbing the natural balance of minerals in your bone.
Indeed, some evidence already exists that, over a lifetime, these low, nutritional doses of Strontium do have a role to play in your health. For example, it was discovered in the 1960s that areas with more Strontium in the water have a lower incidence of dental caries14,15 - a finding which was to be reinforced by the findings of at least eight more studies over the course of the next few decades.
Some of these Strontium-calcium combination products further shoot their users in the foot by using poor forms of key ingredients. Some, for instance, use poor forms of calcium, such as cheap calcium carbonate (which has low gastric tolerance and which reduces your absorption of other nutrients by neutralizing stomach acid) and synthetic calcium hydroxyapatite (an extremely poorly-absorbed synthetic calcium phosphate salt, not to be confused with ossein microcrystalline hydroxyapatite complex (MCHC), an extract of bone-health nutrients contained in an intact calcium crystalline matrix). Others use magnesium carbonate as a magnesium source; this is another antacid, and like calcium carbonate is poorly absorbed. Likewise, one of these products is even trading off of the research on Menatetrenone (MK-4) - the mammalian form of vitamin K2 and the one used in all of the "vitamin K2 menatetrenone" clinical trials - to sell another "vitamin K2:" the unproven, bacterial menaquinones.
Everyone concerned about their bone health needs a core calcium supplement such as Ortho-Bone Supplement, along with other key nutrients such as magnesium, vitamin D3, and Menatetrenone. In such a supplement, a small, nutritional dose of Strontium is a good balancing act, reflecting the trace levels of Strontium naturally present in food. But if you need the potent support of a megadose" "Strontium supplement, it should absolutely not come in a combination with calcium. You need a separate Strontium supplement, taken at a separate time.
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