Pingali 2022: shilajit and bone density trial

This is the longest shilajit trial so far, and one of only two that focused on women. Researchers at the Nizam’s Institute of Medical Sciences in Telangana, India, followed postmenopausal women with osteopenia, bone density lower than normal but not yet low enough to count as osteoporosis, for almost a year.

On placebo, the women’s bone density kept falling, as expected after the menopause. On shilajit, it fell more slowly, and the higher dose did better. Markers of bone breakdown, oxidative stress and inflammation moved in the same direction.

What did the Pingali 2022 study do?

Sixty women aged 45 to 65 were randomised to one of three daily treatments for 48 weeks: placebo, 250 mg of shilajit extract, or 500 mg. Bone mineral density (BMD) at the lumbar spine and the femoral neck (the top of the thigh bone, at the hip) was measured at the start, at 24 weeks and at 48 weeks. Blood markers were taken at 0, 12, 24 and 48 weeks (Pingali and Nutalapati, 2022).

What did it find?

Women on placebo lost bone density at both the spine and the hip over the 48 weeks. In both shilajit groups the loss was smaller, and more so at 500 mg than 250 mg. The percentage change from baseline was significantly better than placebo at 24 and 48 weeks in both shilajit groups (p < 0.001). The abstract does not give the actual percentages.

Blood markers backed this up. CTX-1, a marker of bone being broken down, fell in both shilajit groups, as did BALP and RANKL, while OPG, which protects bone, rose. None of these changed on placebo. MDA, a marker of oxidative damage, fell and the antioxidant glutathione (GSH) rose from week 12 onward. hsCRP, a marker of inflammation, fell progressively.

What does this mean?

It is the strongest single piece of evidence for a benefit of shilajit in women. The design is good: randomised, double-blind, placebo-controlled, with two doses and nearly a year of follow-up. The dose-response pattern, with more effect at the higher dose, and the agreement between bone scans and blood markers make a chance finding less likely.

It also fits with other evidence on bone. A trial in Iran found that shilajit, there called momiai, shortened healing time after a broken shin bone (see Sadeghi 2020), and a trial in young men found it raised a marker of collagen production, collagen being a major part of bone (see Neltner 2024).

That is why we grade shilajit for bone health as moderate.

What doesn’t it show?

• Fewer fractures. Bone density is a surrogate measure. Preventing broken bones is what matters, and the trial was far too small and short to test that.
• That it works as well as standard treatment. Shilajit was compared with a placebo, not with bisphosphonates, HRT, or calcium and vitamin D.
• That it reverses bone loss. The abstract describes the loss as attenuated (slowed), not reversed.
• That any shilajit product would work. The extract was described as standardised and aqueous, but not named in the abstract, so you can’t match it to a product on the shelf.
• That it is safe for everyone. The abstract does not report side effects.

How much should we trust it?

Moderately. The design is the best kind for this question, but it is one trial from one institution with two authors and about 20 women per group, and it has not been repeated. The abstract also leaves out the size of the bone density changes, dropout numbers, side effects and funding, all of which a reader would want to judge it fully.

If you have osteopenia or osteoporosis, keep to the treatment and advice from your GP or specialist. Shilajit has not been tested alongside those treatments, so tell your doctor before adding it. See is shilajit safe? for more.

Where does this study fit?

This trial is the main evidence on our shilajit and bone health page, and its 500 mg dose is one of the figures on our dosage page. For the other human trials, see the research library.