Astragaloside IV is a major active component of Astragalus membranaceus, a traditional Chinese medicinal herb. While Astragalus has a long history of use in traditional medicine, its application specifically for osteoporosis is more recent and primarily supported by preclinical scientific research rather than tradition. Several in vitro and animal studies have investigated the effects of Astragaloside IV on bone metabolism. These studies suggest that Astragaloside IV may exert protective effects against osteoporosis by promoting osteoblast (bone-forming cell) differentiation and activity, inhibiting osteoclast (bone-resorbing cell) formation, reducing oxidative stress, and modulating inflammatory pathways involved in bone loss. For example, research in ovariectomized (OVX) rat models of osteoporosis has shown that administration of Astragaloside IV can improve bone mineral density and bone microarchitecture, possibly by activating the PI3K/Akt and Wnt/β-catenin signaling pathways.

However, it is important to note that these findings are mainly derived from laboratory and animal studies; there is currently a lack of robust clinical trial data evaluating the efficacy and safety of Astragaloside IV in human osteoporosis patients. Therefore, while the scientific rationale for its use exists, the evidence is preliminary and insufficient to recommend its clinical use for osteoporosis at this time.