Osteomalacia is a bone disease that occurs in a generalized way, that is, in the whole body at the same time, and that is caused by a deficit in the mineralization of the bone matrix.
Bone is made up of, among other elements, bone matrix and bone mineral. In osteomalacia , mineralization is decreased , but the bone matrix is proportionally increased. This distinguishes it from osteoporosis , in which both the bone matrix and mineral are decreased.
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What causes does it have?
For proper bone mineralization, calcium and phosphorus (which form hydroxyapatite crystals) and vitamin D are necessary. A sufficient supply of the three elements is necessary for it to occur properly. Therefore, osteomalacia can have different causes:
- Deficiency or altered function of vitamin D : it is the most frequent cause. It can occur due to an insufficient supply in the diet, due to little exposure to the sun, due to alterations in the absorption of vitamin D due to some digestive diseases, kidney diseases (such as nephrotic syndrome) or due to tissue resistance to the action of vitamin D .
- Decrease in phosphorus , which can occur due to idiopathic or familial causes, kidney diseases such as renal tubular acidosis, due to some types of cancer that cause oncogenic osteomalacia and other more infrequent diseases such as phosphaturic diabetes.
- Decreased calcium , due to insufficient supply or due to increased elimination in the urine (hypercalciuria).
- Drugs: some antiepileptic drugs, bisphosphonates, some antibiotics (such as rifampin and isoniazid), and cholestyramine.
What symptoms do you have?
The symptoms of osteomalacia are subtle, the most frequent form of osteomalacia being the so-called subclinical, that is, the one that does not produce symptoms . When symptoms do appear, they can include generalized bone pain , more common in long bones, such as those in the extremities, and pain in the ribs and pelvis, which worsens with exertion and – at night. Muscle pain and weakness may also occur in the context of vitamin D deficiency. In addition, the risk of bone fractures is higher when osteomalacia is present.
How is it treated?
The treatment of osteomalacia consists of treating the cause that produces it . As we have mentioned, the most frequent cause is vitamin D deficiency , which must be confirmed by blood tests , and supplemented when indicated.
Prevention measures
Regarding the prevention of osteomalacia, we must ensure sufficient intake of vitamin D:
- Calcium and phosphorus through diet, which occurs whenever we have a balanced diet that includes fruits, vegetables, legumes, oily fish, whole or semi-skimmed dairy products, eggs and nuts, among others.
- Controlled exposure to the sun will also help correct bone metabolism , avoiding the central hours of the day when the sun can cause sunburn and prolonged exposure.
- Physical exercise has a positive effect on metabolism and bone maintenance, so exercising outdoors first thing in the morning or late in the afternoon can be very beneficial.
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