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Question
As a kidney transplant patient, I
take lot of drugs, which can result in bone density
loss. My doctor prescribed Fosamax, but I stopped
taking it because of the side effects. Recently, I
read about strontium, which appears to be as effective
as Fosamax in promoting bone density, but without the
side effects. What do you think about strontium as an
alternative to Fosamax?
-- Gary
Answer
Since you’re a kidney transplant
patient, I would advise against taking anything
without the supervision and approval of your
physician. Here’s the story about strontium:
The drug you no doubt read about is
strontium ranelate, a combination of the mineral
strontium with ranelic acid. It has been licensed for
sale in the UK and elsewhere in Europe for treatment
of osteoporosis in postmenopausal women. A number of
studies have shown that it can strengthen bone and
reduce the risk of fractures, even among women 74
years of age or older when risks are highest. Use of
strontium ranelate to strengthen bone and prevent
fractures has been escalating since the positive
results of a three-year clinical trial were published
in the January 29, 2004 issue of the New England
Journal of Medicine. In that study, researchers in
Europe and Australia randomly assigned 1,649 women age
50 and older who had at least one vertebral fracture
due to osteoporosis to take calcium plus vitamin
D and two grams of strontium ranelate or just calcium
and vitamin D without the drug. The women who took the
supplements and the drug had fewer new vertebral
fractures and increased bone mineral density of the
spine and hip to a greater degree than the women who
took only the supplements. In fact, the supplement
group actually showed a loss of bone mineral density.
Since then at least one other study has shown that
strontium ranelate reduces the risk of non-vertebral
fractures, including hip fractures.
In Britain, the recommended dose is
two grams daily taken at bedtime, at least two hours
after eating (any type of food) or drinking (any
liquid other than water), both of which can affect
absorption.
Strontium ranelate is not yet
approved by the FDA for treatment or prevention of
osteoporosis in the United States. It remains under
study.
By
Andrew Weil, M.D.
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