NutriDex

The Supplement Research Compendium
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Strontium

Bone-seeking mineral with real fracture data — but cardiac safety flags.

Moderate evidence 🧂Mineral

✚ Updated · How we grade evidence

Evidence tier
Moderate
Research weight
Citations
8 verified / 8
Classification
Mineral
❝
What the evidence says. Graded moderate: large multi-year RCTs (SOTI, TROPOS) prove strontium ranelate cuts vertebral and hip fractures, but a myocardial-infarction and clotting signal forced EMA restriction in 2014, and the over-the-counter citrate form has almost no fracture-outcome data of its own. (Moderate evidence: Several controlled trials; effects real but modest or context-dependent.)

What is Strontium?

Strontium is a mineral used for reduce vertebral fracture risk. NutriDex grades the human evidence as Moderate. Strontium is a calcium-like mineral that deposits in bone and slows resorption. The prescription salt strontium ranelate is the best-studied form: in the 3-year SOTI trial (n=1,649) it reduced new vertebral fractures by 41%, and in TROPOS it cut non-vertebral fractures by 16% and hip fractures by 36% in high-risk women. Network meta-analysis ranks it first for total-hip bone density. However, DEXA overstates real gains because strontium's heavy atom inflates the reading. Crucially, trials showed more heart attacks (about 1.7% vs 1.1%) plus a venous-clotting and severe-skin-reaction (DRESS) signal, so European regulators restricted it to severe osteoporosis and it has since been largely withdrawn. Over-the-counter strontium citrate, marketed as a 'natural' alternative, has minimal direct fracture evidence and likely carries the same risks.

Purported Benefits

✓Reduce vertebral fracture risk
✓Reduce non-vertebral & hip fracture risk
✓Raise bone mineral density
✓Slow postmenopausal bone loss

Evidence by outcome

The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.

OutcomeEvidenceEffectStudies
Reduce vertebral fracture riskSOTI RCT cut new vertebral fractures 41% over 3y; sustained at 5y. Applies to prescription ranelate, not OTC citrate. Strong ↑ benefit · large 3
Reduce non-vertebral & hip fracture riskTROPOS RCT cut non-vertebral fractures 16% and hip 36%, but only in high-risk women aged >=74. Moderate ↑ benefit · moderate 1
Raise bone mineral densityNetwork meta-analysis ranked it first for total-hip BMD, but DEXA overstates real gains via the heavy strontium atom. Moderate ↑ benefit 1
Cardiovascular harm (myocardial infarction)Pooled RCT data showed more MI (1.7% vs 1.1%); prompted EMA restriction and near-withdrawal. Moderate ⚠ risk · small 1
Venous thromboembolism riskPrescription-event monitoring of 10,782 users found VTE 6.24/1,000 patient-years, matching the trial clotting signal. Moderate ⚠ risk · small 1

Dosing & Compounds

Typical Dose
Prescription strontium ranelate was 2 g/day; supplement strontium citrate is sold at ~340–680 mg/day elemental strontium, taken away from food and calcium.
Active Compounds
Strontium ranelate (prescription)Strontium citrate (supplement)Strontium chloride

Safety & Cautions

Strontium ranelate raised heart-attack risk in trials (about 1.7% vs 1.1%) and is contraindicated in ischemic heart disease, peripheral arterial or cerebrovascular disease, uncontrolled hypertension, and any history of venous thromboembolism or immobilisation; it was largely withdrawn after 2014. It can trigger life-threatening skin reactions (DRESS, Stevens-Johnson, TEN) — stop immediately for rash with fever. Strontium binds the same sites as calcium and reduces absorption of tetracycline and quinolone antibiotics, so separate doses by 2+ hours; it also artificially inflates DEXA bone-density readings. Over-the-counter strontium citrate is not a proven-safe substitute and should be avoided in anyone with cardiovascular or clotting risk. Educational only — always check with your doctor or pharmacist before combining Strontium with any medicine.

Key Studies

Meta-analysis Lin 2021 ✓ PubMed
Network meta-analysis ranked strontium ranelate first for total-hip BMD, but flagged EMA's 2014 CVD restriction as limiting use.
RCT Meunier 2004 (SOTI) ✓ PubMed
Strontium ranelate 2 g/day cut new vertebral fractures 41% over 3 years in 1,649 postmenopausal women (49% in year 1).
RCT Reginster 2005 (TROPOS) ✓ PubMed
16% relative reduction in all non-vertebral fractures and 36% reduction in hip fracture in high-risk women (age >=74, low BMD).
RCT Roux 2008 ✓ PubMed
Cut vertebral fracture risk 35% over 4 years even in younger women (50–65) with severe osteoporosis (RR 0.65).
RCT Reginster 2009 (long-term) ✓ Full text
Antifracture efficacy was sustained over 5 years of strontium ranelate treatment in postmenopausal osteoporosis.
Safety Cooper 2014 ✓ Full text
Safety review: RCT MI signal prompted EMA to restrict strontium ranelate to severe osteoporosis without cardiovascular disease.
Review Reginster 2012 ✓ PubMed
Pooled SOTI/TROPOS RCT data showed higher myocardial infarction with strontium ranelate (1.7% vs 1.1%; OR ~1.6).
Cohort Osborne 2010 ✓ PubMed
Prescription-event monitoring of 10,782 users found VTE rate 6.24/1,000 patient-years, consistent with the trial clotting signal.
8 sources cited · 8 verified Search all studies on PubMed ↗

Common questions about Strontium

What is Strontium used for?

Strontium is most often taken for Reduce vertebral fracture risk, Reduce non-vertebral & hip fracture risk, Raise bone mineral density, Slow postmenopausal bone loss. Bone-seeking mineral with real fracture data — but cardiac safety flags.

Does Strontium work — what does the evidence say?

Moderate evidence. Several controlled trials; effects real but modest or context-dependent. Strontium is a calcium-like mineral that deposits in bone and slows resorption. The prescription salt strontium ranelate is the best-studied form: in the 3-year SOTI trial (n=1,649) it reduced new vertebral fractures by 41%, and in TROPOS it cut non-vertebral fractures by 16% and hip fractures by 36% in high-risk women. Network meta-analysis ranks it first for total-hip bone density. However, DEXA overstates real gains because strontium's heavy atom inflates the reading. Crucially, trials showed more heart attacks (about 1.7% vs 1.1%) plus a venous-clotting and severe-skin-reaction (DRESS) signal, so European regulators restricted it to severe osteoporosis and it has since been largely withdrawn. Over-the-counter strontium citrate, marketed as a 'natural' alternative, has minimal direct fracture evidence and likely carries the same risks.

What is the typical dose of Strontium?

Prescription strontium ranelate was 2 g/day; supplement strontium citrate is sold at ~340–680 mg/day elemental strontium, taken away from food and calcium.

Is Strontium safe? Any cautions or side effects?

Strontium ranelate raised heart-attack risk in trials (about 1.7% vs 1.1%) and is contraindicated in ischemic heart disease, peripheral arterial or cerebrovascular disease, uncontrolled hypertension, and any history of venous thromboembolism or immobilisation; it was largely withdrawn after 2014. It can trigger life-threatening skin reactions (DRESS, Stevens-Johnson, TEN) — stop immediately for rash with fever. Strontium binds the same sites as calcium and reduces absorption of tetracycline and quinolone antibiotics, so separate doses by 2+ hours; it also artificially inflates DEXA bone-density readings. Over-the-counter strontium citrate is not a proven-safe substitute and should be avoided in anyone with cardiovascular or clotting risk.

How many studies support Strontium?

NutriDex cites 8 sources for Strontium, graded "Moderate".

Cite this page
APA

Peh, D. (2026). Strontium: Benefits, Dosage, Side Effects & Evidence. NutriDex — The Supplement Research Compendium. Retrieved 26 Jun 2026, from https://nutridex.info/s/strontium

BibTeX
@misc{nutridex_strontium,
  author       = {Peh, Daryl},
  title        = {Strontium: Benefits, Dosage, Side Effects \& Evidence},
  year         = {2026},
  howpublished = {NutriDex --- The Supplement Research Compendium},
  url          = {https://nutridex.info/s/strontium},
  note         = {Reviewed by Dr Daryl Peh, MBBS Singapore, MMed FM. Accessed 2026-06-26}
}

For medical claims, citing the underlying primary studies linked above is preferred. NutriDex is an educational reference, not medical advice.

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