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Strontium (ranelate / citrate)
A bone-seeking mineral. The prescription salt strontium RANELATE cut fracture risk in large osteoporosis trials — but was restricted over cardiovascular (heart-attack) and clot risk, and the OTC strontium CITRATE sold as a supplement is a different, far less studied salt. Also falsely inflates bone-density scans.
What the evidence says
Strontium doesn't have enough studies with structured effect-size data yet to pool a verdict. Browse the studies below for individual findings.
Most evidence is from high-quality meta-analyses and randomised trials published 2002–2025 with a typical study size of 4,995 participants.
Based on 9 studies · 3 meta-analyses · 2 RCTs · 7,368 total participants
Confidence
High confidenceBy outcome
Strong fracture-reduction evidence exists only for prescription strontium ranelate, not the OTC citrate sold as a supplement, and ranelate was restricted over cardiovascular and clot risks.
5 trials ongoing or recruiting · 32 completed on ClinicalTrials.gov
5 of the completed trials have posted results
Registered trials show research momentum for Strontium, not proof of effect — a registration is a plan, and posted results are sponsor-reported, not peer-reviewed. They are never counted toward the evidence rating above.
Browse these trials on ClinicalTrials.govClinicalTrials.gov · as of Oct 2026
Strontium is a mineral chemically similar to calcium that incorporates into bone. Its strong fracture evidence comes specifically from strontium RANELATE, a prescription drug that reduced vertebral fractures by 31% to 47% versus placebo in a pooled analysis of two large RCTs.
However, ranelate was restricted by European regulators after trials showed increased cardiovascular events (heart attack) and venous clots, plus rare severe drug reactions (DRESS).
The strontium CITRATE sold over-the-counter as a supplement is a DIFFERENT salt with far less direct fracture evidence — the citrate-vs-ranelate efficacy gap is often glossed over by marketers.
Strontium is denser than calcium, so it also artifactually inflates DXA bone-density scans, making readings look better than the real bone change. Treat with caution.
Strontium ranelate both stimulates osteoblast bone formation and inhibits osteoclast resorption.
Strontium substitutes for calcium in bone mineral (and inflates DXA readings).
How Strontium works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
Avoid — ranelate increased heart-attack risk.
Tell your clinician — strontium inflates the reading.
Compete for absorption — separate dosing by 2+ hours.
Strontium reduces their absorption — separate dosing.
Tip: Avoid with cardiovascular history; the basis for regulatory restriction
Tip: Avoid with clot history. The ranelate product information lists VTE as common: about 0.7% a year over 5 years in phase III trials, relative risk 1.4 versus placebo (Protelos SmPC, section 4.8). A ranelate finding, not established for citrate.
Tip: Stop at once and seek care if a rash with fever appears, and never restart. The ranelate product information lists DRESS as rare, usually starting 3 to 6 weeks into treatment, and fatal cases were reported (EMA, Protelos SmPC and 2007 review)
Tip: Take at bedtime
Strontium has an evidence score of 4.2/10 — emerging evidence based on 9 indexed studies, including 2 meta-analyses. A bone-seeking mineral. The prescription salt strontium RANELATE cut fracture risk in large osteoporosis trials — but was restricted over cardiovascular (heart-attack) and clot risk, and the OTC strontium CITRATE sold as a supplement is a different, far less studied salt. Also falsely inflates bone-density scans. Representative study: PMID 19436941.
Dosing for Strontium: Prescription ranelate was 2g/day. OTC strontium citrate products typically supply 340-680mg elemental strontium daily, as the label states it (not calculated from the salt weight). The citrate range is a typical label dose, no cited study tested strontium citrate. Individual needs vary — start at the lower end of the range and adjust based on how you respond.
The best time to take Strontium is before bed. It can be taken on an empty stomach. Take away from food and calcium (which compete for absorption) — e.g.
Strontium should be used with caution — talk to a healthcare provider before taking it. Reported side effects include venous thromboembolism (ranelate trials), cardiovascular events (ranelate), DRESS / severe skin reaction (ranelate). How often they occur is not established for all of them. Use caution if any of these apply to you: History of cardiovascular disease, ischemic heart disease, or stroke (a restriction on prescription ranelate, with no equivalent data for citrate); History of venous thromboembolism (clots) (a restriction on prescription ranelate, with no equivalent data for citrate); Uncontrolled hypertension.
Magnesium
Mixed evidenceSupports 300+ enzymatic reactions — critical for sleep, stress response, muscle function, and cognitive health.
Zinc
Likely helpsInvolved in 300+ enzymatic reactions — supports immune defense, testosterone production, wound healing, and sleep quality.
Boron
Mostly mechanism / observationalTrace mineral. In small human studies, low boron intake gave poorer attention and memory, and one week of boron raised free testosterone in 8 men. Benefits from supplements are not established.
Calcium
Too few graded studiesBuilds and maintains bone density while supporting muscle contraction, nerve signaling, and cardiovascular function.
Explore: Best supplements for Body Health
Reviewed by Dr. Baher Al Hakim · Last reviewed June 2026 · evidence from 9 studies · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.
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