Osteomalacia is a weakening of the bones. Problems with bone
formation or with the bone building process cause osteomalacia.
Osteomalacia isn’t the same as osteoporosis. Osteoporosis is a
weakening of living bone that has already been formed and is being remodeled.
Are the Causes of Osteomalacia?
Osteomalacia is most commonly caused by a lack of vitamin D.
Vitamin D is an important nutrient that helps you absorb calcium in your stomach.
Vitamin D also helps maintain calcium and phosphate levels for
proper bone formation. It’s made within the skin from exposure to ultraviolet
(UV) rays in sunlight. It can also be absorbed from foods like dairy products
Low levels of vitamin D mean that your body cannot process the calcium
your bones need for structural strength. This can result from a problem with
diet, lack of sun exposure, or a problem with your intestines.
If you’ve had surgery to remove parts of your stomach or small
intestine, you may also have a problem absorbing vitamin D or breaking down
food to release it.
Certain conditions can interfere with the absorption of vitamin
- Celiac disease can damage the lining of your
intestines and prevent the absorption of key nutrients like vitamin D.
- Certain types of cancer can interfere with
vitamin D processing.
- Kidney and liver disorders can affect the
metabolism of vitamin D.
- A diet that doesn’t include phosphates can cause
phosphate depletion, which can also lead to osteomalacia.
- Phenytoin and phenobarbital are drugs used to treat
seizures. They can also cause osteomalacia.
Are the Symptoms of Osteomalacia?
The symptoms of osteomalacia include the following.
- Bones that fracture very easily are the most
- Another symptom is muscle weakness. This happens
because of problems at the location where the muscle attaches to bone. You may
have a hard time walking and may develop a waddling gait.
- Bone pain, especially in your hips, is also a
very common symptom. This dull, aching pain can spread from your hips to your lower
back, pelvis, legs, and even your ribs.
If you also have very low levels of calcium in your blood, you
- irregular heart rhythms
- numbness around your mouth
- numbness in your arms and legs
- spasms in your hands and feet
Is Osteomalacia Diagnosed?
Blood tests that show the following can suggest you may have
osteomalacia or another bone disorder:
- low levels of vitamin D
- low levels of calcium
- low levels of phosphorus
You may also be tested for alkaline phosphatase isoenzymes. High
levels of these indicate osteomalacia.
Another blood test can check your levels of parathyroid hormone. High
levels of this hormone suggest insufficient vitamin D and other related
X-rays and other imaging tests can show small cracks in the bones
throughout your body. These cracks are called Looser’s transformation zones. Fractures
can begin there with even small injuries.
A bone biopsy may be required to definitively diagnose
osteomalacia. A needle is inserted through your skin and muscle and into your
bone to obtain a small sample. That sample is put on a slide and examined under
Usually, an X-ray and blood tests are enough to make a diagnosis and
a bone biopsy isn’t necessary.
Are the Available Treatments for Osteomalacia?
If osteomalacia is detected early, treatment can be as simple as
taking oral supplements of vitamin D, calcium, or phosphate.
If you have absorption problems due to intestinal injury or
surgery, or if you have a diet low in key nutrients, this may be the first line
of treatment. In rare cases, you can take vitamin D as an injection through
your skin or intravenously through a vein in your arm.
You may also be asked to spend some time outdoors in sunlight for
your body to make sufficient vitamin D within your skin.
If you have other underlying conditions that affect vitamin D
metabolism, they need to be treated. Liver cirrhosis and kidney failure must be
treated to reduce osteomalacia.
In severe cases of osteomalacia or rickets, children may have to
wear braces or have surgery to correct bone deformation
Can I Expect in the Long Term?
If it’s left untreated, osteomalacia will lead to many broken
bones and severe deformity.
With an increase in vitamin D, calcium, and phosphorus,
improvements can be seen in a few weeks. Complete healing of the bones takes
about six months.
Are Potential Complications of Osteomalacia?
Symptoms can return if sufficient vitamin D isn’t available.
They’ll also return if you stop taking supplements or if you have underlying
health conditions like kidney failure that aren’t addressed. Talk to your
doctor to create a treatment plan.