Evidence Level
Strontium has the strongest evidence of any trace mineral for bone health, but primarily for the prescription ranelate form. The SOTI trial (Meunier et al., 2004, n=1,649) and TROPOS trial (Reginster et al., 2005, n=5,091) demonstrated significant vertebral and non-vertebral fracture reduction with strontium ranelate in postmenopausal osteoporosis. However, post-marketing surveillance revealed increased cardiovascular events, leading the EMA to restrict its use to severe osteoporosis in patients without cardiovascular risk factors. OTC strontium citrate has not been studied in large RCTs, but shares the same active element. An important caveat: strontium artificially inflates DEXA scan readings by approximately 10% due to its higher atomic number, meaning some of the apparent BMD increase is measurement artifact.