What this test measures
Stable (non-radioactive) strontium follows calcium metabolism — incorporates into bone, modestly affects BMD measurements (DEXA artefact). Radioactive strontium-90 is a fission product — measured as part of radiation-incident monitoring (Bhopal, nuclear accidents) but not in routine practice. Most clinical strontium tests measure stable strontium in patients on strontium ranelate.
Why it matters
Strontium ranelate (Protelos) was used for severe osteoporosis but was largely withdrawn in Europe (2017) due to cardiovascular risk; rarely prescribed in India now. The drug raises serum strontium ~10-fold and is incorporated into bone — overestimating DEXA T-scores by 0.5–1.0. Environmental stable strontium has no significant toxicity at common exposures; radioactive Sr-90 is a long-lived bone seeker associated with leukaemia and bone sarcoma.
How to prepare
Fasting morning trace-metal-free serum sample for therapeutic monitoring. Note timing of last dose if on strontium ranelate (3 hours post-dose for trough). Random or 24-h urine for environmental assessment.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Serum Strontium (µg/L)[1][2] | 20 – 60 (no supplementation) | Below background — not clinically meaningful in isolation. | > 200 — likely on strontium ranelate or supplements; correct DEXA T-score down by 0.5–1.0; review CV risk on ranelate. > 5,000 — therapeutic strontium ranelate steady state. |
Strontium clinical bands
| Sr (µg/L) | Context | Action |
|---|---|---|
| < 60 | No supplementation | Normal |
| 60 – 200 | Possible dietary strontium / OTC supplement | Review supplement intake |
| 200 – 5000 | Strontium ranelate use (steady state) | Continue if treatment indicated; review CV risk |
| > 5000 | Recent dosing / accumulation | Check timing of dose; review need for therapy |
Frequently asked questions
Does strontium really build bone?
Strontium ranelate increases BMD measurements partly by direct stimulation of osteoblasts and partly by physical incorporation (strontium is heavier than calcium and artificially raises DEXA scores). Fracture-reduction evidence is real but modest; cardiovascular safety concerns limit current use.
Is over-the-counter strontium citrate effective?
Evidence for OTC strontium citrate is much weaker than for strontium ranelate. Many guidelines do not recommend it.
Will it affect my DEXA scan?
Yes. Strontium's higher atomic number falsely raises BMD T-scores by 0.5–1.0. Disclose use so the result is interpreted correctly.
Is radioactive strontium something to worry about?
Sr-90 from nuclear fallout and weapons testing is a long-lived bone seeker associated with leukaemia and bone cancer. Environmental levels in India are low; no routine clinical monitoring is needed.
Related Toxicology / Trace Elements tests
Tests commonly ordered alongside STRONTIUM, or that help interpret an unexpected result.
Sources & references
- Mayo Clinic Labs — Strontium, Serum · accessed 2026-05-30T00:00:00.000Z
- ATSDR — Toxicological Profile for Strontium · accessed 2026-05-30T00:00:00.000Z
- EMA — Strontium Ranelate Safety Review · accessed 2026-05-30T00:00:00.000Z
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