A Disease Often triggered by Vitamin D Deficiency
Osteomalacialeads to softened bones.
It may causebone pain, muscle weakness, difficulty walking, and an increased risk of bone fracture.
It can lead to heart problems.
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This article explains osteomalacia symptoms, as well as osteomalacia diagnosis and treatment.
In people who have very severe osteomalacia, there might be certain deformities of the skeleton.
For example, they might have a very hunched back (calledkyphosis).
Often the pain is worse when you first put weight on your bones.
Osteomalacia Causes
Osteomalacia reflects a disruption in how bone is produced in the body through mineralization.
This allows proteins, and minerals like calcium and phosphate, to harden into strong bones.
The process continues throughout your life as bone breaks down and is reformed with new bone tissue.
In osteomalacia, minerals don’t properly form in the bone.
New bone doesnt harden.
There is a decrease in the amount of calcium and other minerals available for making bone.
Vitamin D is important for proper mineralization of new bone matrix.
So deficiencies of phosphate can lead to osteomalacia.
Osteomalacia vs. Osteoporosis
Osteomalacia is different from osteoporosis.
Osteomalacia leads to softened bones while osteoporosis leads to bones that are too fragile and brittle.
It is possible to have features of both, but osteoporosis is the more common condition.
Your clinician must consider your symptoms and your total medical picture.
This is important to help rule out other potential causes and eventually get the correct diagnosis.
But healthcare providers often miss a diagnosis of osteomalacia, especially in the diseases early stages.
Laboratory tests can provide some helpful clues.
These key tests may be enough to help diagnose osteomalacia, but sometimes further tests are needed.
This is an invasive procedure that requires going under anesthesia.
But it isnt usually needed for a diagnosis.
It is especially important to distinguish osteomalacia from osteoporosis.
It is also complicated, because a person can have both osteomalacia and osteoporosis.
Often, such people are told they have osteoporosis, but the osteomalacia component is not diagnosed.
As part of your process of diagnosis, you might be told that you havehyperparathyroidismor secondary hyperparathyroidism.
Osteomalacia Treatment
Treatment for osteomalacia will depend on the underlying cause.
For someone with osteomalacia due to vitamin D deficiency, vitamin D therapy provides an effective treatment.
This works well for the majority of people with osteomalacia.
You might also need to take calcium supplements.
If you are responding well, you will probably be able to lower your dose.
Depending on the situation, you may need to keep taking vitamin D over the long-term.
However, not all types of osteomalacia respond to vitamin D therapy.
It can have other causes, such as kidney disease or thyroid changes.
It also can have serious consequences, especially with cardiomyopathy (a heart muscle problem) in babies.
Treatment usually relies on improved nutrition, with adequate vitamin D and calcium intake relieving the symptoms.
In some cases, it may resolve with a medication changes.
Talk to your healthcare provider if you have concerns or questions about osteomalacia.
Uday S, Hogler W.Nutritional rickets & osteomalacia: A practical approach to management.Indian J Med Res.
2020 Oct;152(4):356-367. doi:10.4103/ijmr.IJMR_1961_19.
2023 Nov 16;11(32):7785-7794. doi:10.12998/wjcc.v11.i32.7785.
Bhan A, Qiu S, Rao SD.Bone histomorphometry in the evaluation of osteomalacia.Bone Rep. 2018;8:125134. doi:10.1016/j.bonr.2018.03.005
