Osteomalacia

Overview

Definition

Osteomalacia is a bone disease. It causes bones to soften and weaken. Treatment can improve outcomes.

Causes

Vitamin D helps the body use calcium to build bone. The most common cause of osteomalacia is a low level of vitamin D. This may happen due to:

  • Not getting enough vitamin D
  • The body does not use or absorb vitamin D due to:
    • Certain diseases
    • Medicines
    • Toxins
    • Inherited conditions

Risk Factors

The risk of osteomalacia is higher in older adults and those with darker skin. Other things that raise the risk are:

  • Living in a nursing or assisted living home
  • Not getting enough sunlight
  • A diet low in vitamin D
  • Obesity
  • Conditions that can limit absorption of vitamin D, such as:
    • Gastrectomy
    • Certain small intestine diseases or surgery
    • Celiac disease
    • Cystic fibrosis
  • Seizure medicines
  • Paget disease of the bone
  • Primary hyperparathyroidism

SymptomsandDiagnosis

Symptoms

Osteomalacia often does not cause symptoms. In those that have them, symptoms may be:

  • Bone pain
  • Muscle pain or weakness
  • Problems moving around

The condition can also cause deformed and broken bones.

Curvature of the Spine
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Diagnosis

The doctor will ask about symptoms and past health. A physical exam may be done.

Tests may include:

  • Blood and urine tests
  • X-rays
  • Bone mineral density test
  • Bone scan
  • Bone biopsy—when other test results are not clear

This may be enough to make the diagnosis. The doctor may want to do more tests to find the cause.

Treatments

Treatment

The goal of care is to treat the cause. Problems from osteomalacia also need to be treated.

Options to treat the cause may be:

  • A diet rich in vitamin D
  • Vitamin D supplements
  • Calcium or phosphorus supplements
  • Regular sun exposure—in moderate amounts

If medicines caused the condition, they may need to be stopped or changed. Other medicines may be given to treat underlying causes.

Problems due to osteomalacia may also need to be treated. Options may be:

  • Braces to reduce or prevent bone deformities
  • Surgery to fix bone deformities—in serious cases

Prevention

To risk of osteomalacia may be lowered by:

  • A diet rich in vitamin D
  • Vitamin D, calcium, and other mineral supplements.
  • Regular but moderate sunlight exposure

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

Eat Right—Academy of Nutrition and Dietetics https://www.eatright.org 

National Institute of Arthritis and Musculoskeletal and Skin Diseases https://www.niams.nih.gov 

CANADIAN RESOURCES

Dietitians of Canada https://www.dietitians.ca 

Health Canada https://www.canada.ca 

References

Chang SW, Lee HC. Vitamin D and health - The missing vitamin in humans. Pediatr Neonatol. 2019;60(3):237-244.

Hypophosphatemia—approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypophosphatemia-approach-to-the-patient. Accessed August 8, 2021.

Osteomalacia. Cedars-Sinai website. Available at: https://www.cedars-sinai.edu/Patients/Health-Conditions/Osteomalacia.aspx. Accessed August 8, 2021.

Osteomalacia. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/13017-osteomalacia . . Accessed August 8, 2021.

Osteomalacia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteomalacia-om. Accessed August 8, 2021.

Vitamin D deficiency in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/vitamin-d-deficiency-in-adults. Accessed August 8, 2021.