Evidence-based·Last reviewed May 30, 2026·How we grade evidence

Strontium

MineralTrace mineralBest in the eveningBest taken away from food

Useful mainly for osteoporosis via prescription strontium ranelate (where available); OTC citrate is unproven.

Quick decision guide

May help most

osteoporosis via prescription strontium ranelate (where available); OTC citrate is unproven

Common dosing range

Prescription ranelate 2 g/day (~680 mg elemental); OTC citrate 340–680 mg elemental/day

When to expect effects

Months for bone outcomes

Watch out for

Ranelate carries clot, cardiac, and severe-skin-reaction risks; strontium distorts DEXA scans

What is it

Strontium is a trace alkaline earth metal chemically similar to calcium. It is not classified as essential for humans but accumulates in bone, where it can substitute for calcium in hydroxyapatite. Strontium ranelate, a prescription drug, has been used to treat osteoporosis in some countries.

Is it worth it for you?

Use this as a quick fit check, not a diagnosis.

Worth considering if…

You are prescribed strontium ranelate for osteoporosis under specialist care
You have no cardiovascular or clotting risk (ranelate)
You want a topical option for tooth sensitivity

Probably skip if…

You assume OTC strontium citrate matches prescription ranelate
You have cardiovascular disease, clotting risk, or are pregnant
You rely on DEXA scans to track bone density (strontium distorts them)

Evidence at a glance

osteoporosis (prescription strontium ranelate)

Good Evidence
Effect
Reduced fracture risk in trials
Best fit
postmenopausal women with osteoporosis, under specialist care
Time
Months

tooth sensitivity (topical)

Limited Evidence
Effect
Reduced dentin hypersensitivity
Best fit
people with dentin hypersensitivity using strontium-containing toothpaste
Time
Weeks

Evidence for 2 uses

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

osteoporosis (prescription strontium ranelate)

Disease adjunct
Good Evidence

Prescription strontium ranelate reduced vertebral and hip fracture risk in large randomized trials by both stimulating osteoblasts and inhibiting osteoclasts. However, safety signals for venous thromboembolism, myocardial infarction, and severe skin reactions (DRESS) led to its withdrawal in many markets. Its use is now restricted and specialist-directed where still available.

Effect size
Reduced fracture risk in trials
Time to effect
Months
Best fit
postmenopausal women with osteoporosis, under specialist care
Less likely
people with cardiovascular or clotting risk (contraindicated)

Bottom line: Strontium ranelate reduces fracture risk but carries serious safety concerns that limit its use.

Evidence is mixed

Efficacy on fractures is established, but cardiovascular, thrombotic, and severe skin-reaction risks led to restriction or withdrawal in many countries.

SourceKanis et al., 2011 — PubMed· conflictingO'Donnell et al., 2006 — PubMed· conflicting
SourceKanis et al., 2011 — PubMedO'Donnell et al., 2006 — PubMed

tooth sensitivity (topical)

Supplement benefit
Limited Evidence

Strontium salts in desensitizing toothpastes reduce dentin hypersensitivity by occluding dentinal tubules, with support from randomized dental trials. This is a topical oral-care effect, distinct from systemic strontium for bone. It applies to formulated toothpaste, not oral supplements.

Effect size
Reduced dentin hypersensitivity
Time to effect
Weeks
Best fit
people with dentin hypersensitivity using strontium-containing toothpaste

Bottom line: Topical strontium toothpaste modestly reduces tooth sensitivity.

SourceLiu et al., 2012 — PubMedSchiff et al., 2011 — PubMed

How it works

Strontium is absorbed in the small intestine alongside calcium, sharing similar transport mechanisms. Because of its chemical similarity, about 99% of body strontium is stored in bone, where it can replace a small fraction of calcium in the bone matrix. Strontium ranelate (the prescription form) is thought to both stimulate osteoblast (bone-forming) activity and reduce osteoclast (bone-resorbing) activity, producing a dual effect on bone metabolism. Over-the-counter strontium citrate is structurally different, has not been studied in large clinical trials, and is not approved as a medication. Effects observed with prescription strontium ranelate cannot be assumed to apply to OTC strontium citrate. Strontium also displaces calcium in bone scans, producing falsely elevated bone density readings on DEXA that overstate true bone mineral changes.

How to take it

1. Typical dose
Prescription ranelate 2 g/day (~680 mg elemental strontium); OTC citrate 340–680 mg elemental/day
2. Timing
Evening, about 2 hours after dinner
3. With food
On an empty stomach, separated from calcium and dairy
4. How long to try
Months; bone effects accrue slowly

What to track

fracture risk and bone health via clinician (not raw DEXA, which strontium distorts)
any leg swelling or chest symptoms (ranelate)
skin reactions

3 commercial forms

Compare the main delivery options and what they’re best suited for.

Strontium citrate (OTC)

Marketed for bone health. Lacks fracture-prevention evidence and may distort DEXA readings.

The form sold as a supplement; not formally studied in large trials.

Strontium ranelate (prescription, restricted)

Used historically for osteoporosis. Cardiovascular and skin reaction risks led to widespread market withdrawal.

The form with positive RCT evidence, but withdrawn or restricted in many countries due to safety concerns.

Strontium chloride (topical in toothpaste)

Used in sensitive teeth toothpaste formulations for decades.

Acts locally on dentin, not systemically absorbed in meaningful amounts.

Safety

Know the common side effects, key cautions, and who should avoid it.

Common side effects

GI upsetinterference with DEXA bone-density readings

Serious risks

  • venous thromboembolism, myocardial infarction, and severe skin reactions (DRESS) with prescription ranelate

Who should avoid it

  • people with venous thromboembolism history, cardiovascular disease, or uncontrolled hypertension (ranelate)
  • those undergoing DEXA scans
  • pregnant and breastfeeding women

Pregnancy & breastfeeding

Avoid in pregnancy and lactation.

Interactions

calciumModerate

competes for intestinal absorption; separate by at least 2 hours

quinolone and tetracycline antibioticsModerate

strontium binds these drugs, reducing absorption of both

anticoagulantsModerate

caution given ranelate's thrombosis risk

Food sources

Brazil nuts (1 oz)

Amount
Trace amounts (notable for nuts)
%DV
—

Seafood (3 oz)

Amount
Trace amounts
%DV
—

Whole grains

Amount
Trace amounts
%DV
—

Leafy greens

Amount
Trace amounts
%DV
—

Drinking water (varies)

Amount
Trace amounts
%DV
—

Choosing a product

What to look for on the label — and what to be skeptical of.

Look for…

elemental strontium amount stated
form (citrate vs ranelate) identified
guidance to separate from calcium

Be skeptical of…

equivalent to prescription strontium for bone
guaranteed DEXA improvement
safe bone-building with no risk

Frequently asked questions

Will strontium really build my bones?⌄

Prescription strontium ranelate reduces fractures in osteoporosis but has serious cardiovascular and skin risks. OTC strontium citrate has not been studied at scale and apparent DEXA improvements often reflect measurement artifact rather than real bone strengthening.

Is OTC strontium safe?⌄

Long-term safety is not well-established at supplement doses. People with clotting risk, cardiovascular disease, or pregnancy should avoid it. Use only with clinician input.

Does strontium affect my DEXA scan?⌄

Yes. Strontium has a higher atomic number than calcium and exaggerates apparent bone density on DEXA scans by 5-10% or more. Tell your doctor if you are using strontium before any bone density test.

Should I take strontium with calcium?⌄

No. They compete for absorption. Separate them by at least 2 hours.

Is strontium a better alternative to bisphosphonates?⌄

Bisphosphonates have decades of strong evidence and a well-characterized safety profile. OTC strontium does not match this evidence base. Prescription strontium ranelate, where it remains available, is generally reserved for cases where bisphosphonates can't be used.

References by claim

osteoporosis (prescription strontium ranelate)

Kanis et al., 2011 — PubMed (2011) link

O'Donnell et al., 2006 — PubMed (2006) link

tooth sensitivity (topical)

Liu et al., 2012 — PubMed (2012) link

Schiff et al., 2011 — PubMed (2011) link

Track Strontium with Pilora

Set up dose reminders, check interactions, and join the community in the Pilora iPhone app.

Coming to App Store
Evidence-based·Last reviewed May 30, 2026·Evidence current as of May 30, 2026·How we grade evidence

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.