Epimedium extract, commonly known as "Horny Goat Weed," has a long history of use in traditional Chinese medicine (TCM) for supporting bone health and treating conditions such as osteoporosis. In TCM, Epimedium is believed to tonify the kidney and liver, which are considered crucial for maintaining strong bones according to traditional theory. Ancient texts and modern herbal formularies frequently recommend Epimedium for the elderly or those with weakened skeletal systems.

Some modern scientific studies have investigated the effects of Epimedium, particularly its active compound icariin, on bone metabolism in animal models. These studies suggest that icariin may stimulate osteoblast activity (cells responsible for bone formation), inhibit osteoclasts (cells involved in bone resorption), and potentially help prevent bone loss. However, robust clinical evidence in humans is lacking, and most positive results are preclinical or from small-scale trials. Therefore, while traditional use is strong and some scientific rationale exists, the evidence base is not yet sufficient for a high scientific rating.

In summary, Epimedium extract’s use for skeletal support is primarily justified by traditional use, with limited but promising preclinical scientific support. More high-quality human studies are necessary to confirm effectiveness and safety for bone health.