Potassium citrate and bone turnover in postmenopausal women
What it found
In 401 postmenopausal women across five trials, potassium citrate lowered one urine marker of bone breakdown at 1 month but made no clear difference to other bone markers or calcium levels.
The authors say the evidence is still inconclusive.
What they found
Studies in people
Urine NTX at 1 month
Potassium citrate significantly reduced urinary N-terminal telopeptide (NTX) at 1 month compared with placebo.
Other bone markers
No significant effects were seen on serum C-terminal telopeptide (CTX) at 3 or 6 months, or on procollagen type 1 N-terminal propeptide (P1NP) at 3, 6, or 12 months.
Urinary potassium
Potassium citrate significantly increased urinary potassium excretion at both 3 months and 6 months.
Calcium and related measures
Urinary calcium, serum calcium, parathyroid hormone, and urinary pH showed no statistically significant differences between groups.
Other findings
Evidence sufficiency
Trial sequential analysis indicated that the available evidence for P1NP at 3 and 6 months remains inconclusive, with the accrued sample size below the required information size.
What the authors conclude
“Potassium citrate supplementation showed a selective reduction in urinary NTX, suggesting a potential effect on bone resorption.”
Also in their conclusions
- They say potassium citrate supplementation showed a selective reduction in urinary NTX, suggesting a potential effect on bone resorption.
- They note that no consistent significant effects were observed on other bone turnover markers, including CTX and P1NP, or on calcium-related biochemical outcomes.
- They advise that further large, well-designed trials with longer follow-up are needed to clarify the role of potassium citrate in preventing postmenopausal bone loss.
How it was done
Osteoporosis and osteopenia are major health burdens among postmenopausal women. Potassium citrate, an alkaline salt that neutralizes the acid load in the diet, is a preventive measure for bone loss.
They searched four databases for randomized controlled trials of potassium citrate supplementation in postmenopausal women. Five trials involving 401 women were included, and the authors assessed how sufficient the evidence was.
What it can’t tell you
- We summarised it from the abstract only.
- The clinical relevance of the reduction in urinary NTX remains uncertain.
- The evidence for P1NP at 3 and 6 months is inconclusive because the sample size was below the required information size.
- The review cannot show whether potassium citrate prevents bone loss or fractures over the long term.
Who paid
- Conflicts
- Declarations. Conflict of interest: The authors declare no conflict of interest. Ethics Approval and Consent to Participate: Not applicable. Consent for Publication: Not applicable.
- Authors work at
- Kuwait Institute for Medical Specializations, Kuwait; Arabian Gulf University, Kingdom of Bahrain
The paper
- Title
- Effects of Potassium Citrate Supplementation on Bone Turnover Markers in Postmenopausal Women: A GRADE-Assessed Systematic Review, Meta-analysis and Trial Sequential Analysis
- Type
- Systematic review and meta-analysisThe authors follow a set, published method to find every relevant study, then combine the numbers from them into one result.
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- AlSejari N, Alkhulaifi NS, Alenezi RS, Alharran AM, Alsubaiei AA (2026). Effects of Potassium Citrate Supplementation on Bone Turnover Markers in Postmenopausal Women: A GRADE-Assessed Systematic Review, Meta-analysis and Trial Sequential Analysis. Calcified tissue international. doi:10.1007/s00223-026-01569-9PubMed 42423994DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error