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Osteomalacia

Vitamin D deficiency - osteomalacia; Calcium - osteomalacia

Osteomalacia is softening of the bones. It most often occurs because of a problem with vitamin D, which helps your body absorb calcium. Your body needs calcium to maintain the strength and hardness of your bones.

In children, the condition is called rickets.

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Vitamin D deficit
Calcium benefit

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Causes

A lack of the proper amount of calcium in the blood can lead to weak and soft bones. Low blood calcium can be caused by low vitamin D level in the blood.

Vitamin D is absorbed from food or produced by the skin when exposed to sunlight. Lack of vitamin D produced by the skin may occur in people who:

You may not get enough vitamin D from your diet if you:

Other conditions that may cause osteomalacia include:

Symptoms

Symptoms include:

Symptoms may also occur due to low calcium level. These include:

Exams and Tests

Blood tests will be done to check vitamin D, creatinine, calcium, phosphate, electrolytes, alkaline phosphatase, and parathyroid hormone levels.

Bone x-rays and a bone density test can help detect pseudofractures, bone loss, and bone softening. More importantly, osteomalacia can look like weakening of the bones from osteoporosis on bone density testing.

In some cases, a bone biopsy will be done to see if bone softening is present.

Treatment

Treatment may involve vitamin D, calcium, and phosphorus supplements taken by mouth. People who cannot absorb nutrients well through the intestines may need larger doses of vitamin D and calcium. This includes people who have some types of weight loss surgery.

People with certain conditions may need regular blood tests to monitor blood levels of phosphorus and calcium.

Outlook (Prognosis)

Some people with vitamin deficiency disorders will get better within a few weeks. With treatment, healing should happen within 6 months.

Possible Complications

Symptoms can return.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of osteomalacia, or if you think that you may be at risk for this disorder.

Prevention

Eating a diet rich in vitamin D and calcium and getting sufficient exposure to sunlight can help prevent osteomalacia due to vitamin D deficiency.

Related Information

Rickets
Vitamin D
Malabsorption
Acute kidney failure
Acidosis
Seizures
Lactose intolerance

References

Bhan A, Rao AD, Bhadada SK, Rao SD. Rickets and osteomalacia. In Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 31.

Chonchol M, Smogorzewski MJ, Stubbs JR, Yu ASL. Disorders of calcium homeostasis. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 18.

Demay MB, Krane SM. Disorders of mineralization. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71.

Weinstein RS. Osteomalacia and rickets. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 231.

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Review Date: 5/13/2020  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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