What is osteomalacia?

Osteomalacia refers to a marked softening of your bones, most often caused by severe vitamin D deficiency. The softened bones of children and young adults with osteomalacia can lead to bowing during growth, especially in weight-bearing bones of the legs. Osteomalacia in older adults can lead to fractures.

Osteomalacia differs from the more-common condition of having a low vitamin D level. Osteomalacia also differs from osteoporosis, which causes bone thinning.

How common is osteomalacia?

Only adults have osteomalacia. When the same thing happens in children, it’s called rickets. Osteomalacia is more common in women and often happens during pregnancy. Please discuss with your doctor for further information.


What are the symptoms of osteomalacia?

The common symptoms of osteomalacia are:

  • Bones that fracture very easily are the most common symptom.
  • 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 may have:

  • Irregular heart rhythms
  • Numbness around your mouth
  • Numbness in your arms and legs
  • Spasms in your hands and feet

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes 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 and fish.

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 D:

  • 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.

Risk factors

What increases my risk for osteomalacia?

The risk of developing osteomalacia is highest in people who have both inadequate dietary intake of vitamin D and little exposure to sunlight, such as older adults and those who are housebound or hospitalized.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How 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 problems.

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 a microscope.

Usually, an X-ray and blood tests are enough to make a diagnosis and a bone biopsy isn’t necessary.

How is osteomalacia treated?

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.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage osteomalacia?

The following lifestyles and home remedies might help you cope with osteomalacia:

  • Eat foods high in vitamin D. Foods naturally rich in vitamin D include oily fish (salmon, mackerel, sardines) and egg yolks. Also look for foods fortified with vitamin D, such as cereal, bread, milk and yogurt.
  • Take supplements, if needed. If you don’t get enough vitamins and minerals in your diet or if you have a medical condition affecting the ability of your digestive system to absorb nutrients properly, ask your doctor about taking vitamin D and calcium supplements.

Unprotected sun exposure can increase your risk of skin cancer. There’s no consensus among experts about what amount of sun exposure is safe and enough to prevent or treat osteomalacia.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: November 27, 2017 | Last Modified: November 28, 2017