NutriStack
Prednisone and Strontium, a caution.
Prednisone can cause clinically important bone loss when used chronically. Strontium supplements may make DXA bone density results look higher because strontium in bone attenuates X-rays more than calcium, which can obscure whether steroid-induced bone loss is actually controlled.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Prednisone and Strontium
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Prednisone can cause clinically important bone loss when used chronically. Strontium supplements may make DXA bone density results look higher because strontium in bone attenuates X-rays more than calcium, which can obscure whether steroid-induced bone loss is actually controlled.
Mechanism. Strontium can partially substitute for calcium in bone mineral and artifactually increase DXA-measured bone mineral density. Prednisone independently increases fracture risk by suppressing bone formation and increasing bone resorption.
Recommendation. Do not use strontium as a substitute for guideline-based prednisone bone protection. Tell your clinician and imaging center if you use strontium, especially before DXA testing, so bone density trends are interpreted cautiously.
Sources (3)
- Humphrey MB, Russell L, Danila MI, et al. 2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Care Res (Hoboken). 2023;75(12):2405-2419. PMID 37884467
- Nielsen SP, Slosman D, Sorensen OH, Basse-Cathalinat B, De Cassin P, Roux CR, Meunier PJ. Influence of strontium on bone mineral density and bone mineral content measurements by dual X-ray absorptiometry. J Clin Densitom. 1999;2(4):371-379. PMID 10677790
- Blake GM, Fogelman I. Effect of bone strontium on BMD measurements. J Clin Densitom. 2007;10(1):34-38. PMID 17289524
Stack Score
How this pair moves the number.
Effect on the composite score
If both Prednisone and Strontium are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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