Condition
    Moderate Evidence
    Effectiveness 1/5

    Strontium for Osteoporosis

    Prescription strontium ranelate did reduce fractures in large trials, but it was withdrawn in Europe for raising heart attack risk — and over-the-counter strontium citrate has never been tested for fracture prevention. Much of the apparent bone-density benefit is a DEXA measurement artifact.

    Overview

    Prescription strontium ranelate did reduce fractures in large trials, but it was withdrawn in Europe for raising heart attack risk — and over-the-counter strontium citrate has never been tested for fracture prevention. Much of the apparent bone-density benefit is a DEXA measurement artifact.

    Verdict

    Not supported

    The drug form worked but had cardiovascular harm; the supplement form is untested. DEXA improvements are largely an artifact.

    How It Works

    Strontium replaces calcium in hydroxyapatite and activates the calcium-sensing receptor to stimulate osteoblasts. Because strontium atoms attenuate X-rays more than calcium, DEXA scans overstate true density gains substantially.

    Dosing & Protocol

    Typical dose

    Recommended dose
    Not recommended
    Expected timeframe
    Not applicable

    Protocol

    form
    Not applicable
    duration
    Not applicable
    co factor
    The verdict is no, and this one is about harm rather than absence of benefit. Prescription strontium ranelate at 2 g/day did reduce vertebral and hip fracture in trials, but it was restricted and then withdrawn across Europe because of myocardial infarction, venous thromboembolism and severe hypersensitivity (DRESS) risk. Over-the-counter strontium citrate is a different, unstudied salt with no fracture data, and strontium falsely inflates bone density scan readings because it is denser than calcium, giving an illusion of improvement.
    titration
    Not applicable
    starting dose
    Not recommended

    Evidence

    What the studies say

    SOTI and TROPOS (n>6,000 combined) showed strontium ranelate reduced vertebral fractures by ~40% and hip fractures in high-risk subgroups — but post-marketing surveillance revealed increased myocardial infarction and thromboembolism, leading to EMA withdrawal. No fracture-outcome trial exists for supplement strontium citrate. With proven, safer alternatives (calcium/vitamin D where deficient, resistance training, and medications when indicated), strontium supplements are not recommended.

    Strontium ranelate for preventing and treating postmenopausal osteoporosis

    Score: 9/10
    2006
    systematic_review

    O'Donnell S, Cranney A, Wells GA +2 more

    Strontium ranelate reduces fractures but carries thromboembolic and gastrointestinal risks.

    View source

    Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study

    Score: 8/10
    2005
    rct
    n=5091

    Reginster JY, Seeman E, De Vernejoul MC +10 more

    Strontium ranelate reduces nonvertebral fracture risk in postmenopausal osteoporosis.

    View source

    Nationwide registry-based analysis of cardiovascular risk factors and adverse outcomes in patients treated with strontium ranelate

    Score: 6/10
    2014
    cohort

    Abrahamsen B, Grove EL, Vestergaard P

    Cardiovascular safety concerns contributed to regulatory restriction of strontium ranelate.

    View source

    The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis

    Score: 9/10
    2004
    rct
    n=1649

    Meunier PJ, Roux C, Seeman E +10 more

    Strontium ranelate reduces vertebral fracture risk in postmenopausal osteoporosis.

    View source

    Safety

    Caveats

    Do not use strontium supplements for osteoporosis. The prescription form was withdrawn for cardiovascular harm, and the supplement form has no fracture-prevention evidence while still distorting DXA scans, which undermines monitoring of real treatment. Osteoporosis has effective, well-evidenced options: bisphosphonates, denosumab, and anabolic agents, alongside adequate calcium, vitamin D and resistance exercise. Strontium is contraindicated with a history of venous thromboembolism, ischaemic heart disease, stroke or uncontrolled hypertension, and it interferes with calcium absorption and binds tetracycline and quinolone antibiotics. Contraindicated in pregnancy and breastfeeding. Get a fracture risk assessment and a DXA scan instead.

    Less likely to help if

    Everyone: the supplement form has no fracture evidence and the prescription form was withdrawn for harm.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.