Probiotic and synbiotic supplements for osteoporosis: a meta-analysis of randomized trials.

BACKGROUND

Probiotic/synbiotic, have been proposed as a supplement to improve bone health markers. However, findings evidence remains inconsistent. This meta-analysis aimed to assess the effects of Probiotic/synbiotic supplementation on osteoporosis.

METHODS

A systematic search was carried out in PubMed, Embase, Web of Science, and the Cochrane Library up to June 2025 to evaluate the efficacy of probiotic or synbiotic supplementation for osteoporosis. Data were pooled using a random-effects model to calculate standardized mean differences (SMD) and 95% Confidence intervals (CIs).

RESULTS

Ten studies were included in this meta-analysis. Probiotic/synbiotic supplementation significantly decreased PTH levels (SMD = -1.19; 95% CI: -2.13, -0.26; P = 0.012), and increased lumbar spine BMD (SMD = 0.86; 95% CI: 0.01, 1.71; P = 0.047). However, probiotic/synbiotic supplementation did not significantly affect BMD of the total hip (SMD = 0.64; 95% CI: -0.56, 1.83; P = 0.296), C-terminal telopeptide (CTX) (SMD = -0.37; 95% CI: -0.75, 0.02; P = 0.063), osteocalcin (SMD = 0.24; 95% CI: -0.34, 0.82; P = 0.415), alkaline phosphatase (ALP) (SMD = 0.60; 95% CI: -0.61, 1.81; P = 0.334), and osteoprotegerin (SMD = -1.04; 95% CI: -3.19, 1.10; P = 0.340). Begg's test revealed no significant publication bias.

CONCLUSIONS

The current meta-analysis revealed that probiotic/synbiotic supplementation beneficial effect on PTH, and lumbar spine BMD. No favorable effect of probiotic/synbiotic supplementation on BMD of the total hip, CTX, osteocalcin, ALP, and osteoprotegerin was observed.