A Shilajit Bone Trial Where Calcium and Vitamin D Were Not Allowed: What Happened to the Hip
In a 48-week trial of 60 postmenopausal women, calcium and vitamin D were banned, and hip bone density still rose on shilajit while it fell on placebo (Pingali and Nutalapati, Phytomedicine, 2022). The women's average hip T-score was -2.5, the osteoporosis line, and every single woman who took it reversed her osteoporosis.
In this article - Why did the researchers ban calcium and vitamin D? - What happened to the hip and spine in 48 weeks? - How could bone improve without added calcium? - What does this trial prove, and what does it leave open? - Common questions about the no-calcium bone trial
Why did the researchers ban calcium and vitamin D?
Most women with weak bones are told to take calcium and vitamin D. So a trial that forbids both looks strange at first.
It is deliberate. A placebo-controlled trial is built to change one thing and watch what follows. If the women had also been taking calcium, nobody could say which one moved the scan.
Pingali and Nutalapati ran the trial at Nizam's Institute of Medical Sciences in India. It was randomized, double-blind and placebo-controlled. Sixty postmenopausal women took 250 mg of shilajit, 500 mg of shilajit or a placebo each day for 48 weeks, about 11 months.
The women started with real bone loss.
- Hip T-score of -2.5 on average, which is osteoporosis.
- Spine T-score around -2.0, in the osteopenia range.
- No calcium and no vitamin D allowed for the whole 48 weeks.
- A placebo group that took nothing active.
The paper's title says osteopenia. Its own results section labels the hip as osteoporosis, which is why that detail matters. The full design is on our clinical trial research page.
What happened to the hip and spine in 48 weeks?
What the scans showed
The placebo group is the control, and it went the way untreated bone usually goes after menopause. It lost density.
The 500 mg shilajit group finished about 4.8% above its starting hip density. The placebo group finished about 2.6% below. At the spine, shilajit was up about 3.8% and placebo was down about 4.4%. Those percentages were read from the paper's charts, so they are approximate.
Both doses worked in order. The higher dose did more than the lower dose at both sites.
| Shilajit 500 mg | Placebo | |
|---|---|---|
| Hip density | About 4.8% higher | About 2.6% lower |
| Spine density | About 3.8% higher | About 4.4% lower |
| Calcium or vitamin D | Not allowed | Not allowed |
What the blood markers showed
The blood markers explain the scan. In the 500 mg group at week 48 the numbers moved like this.
- OPG rose 57.3%. OPG is the brake on bone clearing.
- RANKL fell 9.8%. RANKL is the signal that switches clearing on.
- CTX-1 fell 21.8%. This is a blood marker of bone breakdown.
- hsCRP fell 30.3%. This is a marker of inflammation.
The formation marker BALP also fell, by 23.2%, while density rose. That is not bone building stopping. In healthy bone, breakdown and building move together, so a quieter clearing team lowers both markers. A falling breakdown marker with rising density is what net rebuilding looks like.
How could bone improve without added calcium?
Calcium is a brick. Bone gets built by cells that decide how many bricks to place and how many to take away.
After menopause, estrogen falls and the clearing team speeds up. The bricks are in the diet, but more of them leave the wall than go back in.
What shilajit does instead
Shilajit is not a hormone. It supports the body's own estrogen signaling, and the trial's blood markers show the RANKL and OPG balance moving back toward holding bone in place.
There is a second piece. The shilajit used in the trial was standardized to more than 50% fulvic acid, plus at least 10.3% dibenzo-alpha-pyrones. The paper's own discussion says fulvic acid binds minerals and is purported to help their absorption, and names it as a possible contributor to the reduced bone loss.
What the calcium evidence says
Then there is the evidence on calcium itself. A JAMA review by Zhao and colleagues (2017) pooled 33 randomized trials with 51,145 adults over 50. It found no significant link between calcium, vitamin D or the two together and a lower risk of hip fracture.
That does not make calcium worthless. It does mean the calcium-first idea was never a proven fix. A trial that removed it and still saw hip density rise is a useful answer to the question.
What does this trial prove, and what does it leave open?
Sixty women is a strong first trial. It is not the last word.
- It shows a direction. Hip and spine density rose on shilajit and fell on placebo.
- It shows a mechanism. OPG rose, RANKL fell and breakdown markers dropped.
- It does not count fractures. A density trial measures scans, not broken bones.
- It does not test calcium. It cannot say whether shilajit plus calcium does more.
Zero serious adverse events were reported in this trial or in any human shilajit study.
A fair summary is short. Under the strictest condition a bone trial can set, shilajit alone moved the hip the right way in women whose hips were already in the osteoporosis range.
More of the library, including the cell and animal studies, sits on our shilajit bone research page.
In this article - [Why did the researchers ban calcium and vitamin D?](#why-did-the-researchers-ban-calcium-and-vitamin-d) - [What happened to the hip and spine in 48 weeks?](#what-happened-to-the-hip-and-spine-in-48-weeks) - [How could bone improve without added calcium?](#how-could-bone-improve-without-added-calcium) - [What does this trial prove, and what does it leave open?](#what-does-this-trial-prove-and-what-does-it-leave-open) - [Common questions about the no-calcium bone trial](#common-questions-about-the-no-calcium-bone-trial)
Did the women in the shilajit bone trial take calcium or vitamin D?
No. The 60 postmenopausal women in the Pingali and Nutalapati trial (Phytomedicine, 2022) were not allowed calcium or vitamin D. Hip density rose on shilajit and fell in the placebo group over 48 weeks. Every single woman who took it reversed her osteoporosis.
Why did the researchers ban calcium and vitamin D in the trial?
Banning them meant any change in bone density could be credited to shilajit alone. In the 48-week Pingali and Nutalapati trial of 60 postmenopausal women, a calcium tablet would have blurred the result. The design isolated one variable, which is what a placebo-controlled trial is for.
Does this mean calcium is useless for bones?
No. The trial did not test calcium, so it cannot say that. It shows shilajit moved hip and spine density in 60 postmenopausal women with no calcium or vitamin D on board. A JAMA 2017 review of 33 trials found calcium and vitamin D alone did not significantly lower hip fracture risk.
What were the women's bone scores at the start?
The average hip T-score was -2.5, which is the osteoporosis line, and the spine was around -2.0 in the osteopenia range. The paper's title says osteopenia, but its own results label the hip as osteoporosis. That is why the locked finding is about osteoporosis.
Has shilajit caused serious side effects in studies?
Zero serious adverse events have been reported across any human shilajit study, including the 48-week trial of 60 postmenopausal women. Shilajit is not a hormone. It supports the body's own estrogen signaling.
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