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Causes
By Mayo Clinic staffYour body uses calcium and phosphate to build strong bones. Osteomalacia may occur if you don't get enough of these minerals in your diet or if your body doesn't absorb them properly. These problems may be caused by:
- Insufficient exposure to sunlight. Sunlight produces vitamin D in your skin. Your body needs vitamin D to process calcium. Osteomalacia can develop in people who spend little time in sunlight, wear very strong sunscreen, remain covered while outside, or live in areas where sunlight hours are short or the air is smoggy.
- Insufficient vitamin D intake. A diet low in vitamin D is the most common cause of osteomalacia worldwide. However, it's a less common cause in the United States because many foods, such as milk and cereals, are fortified with vitamin D.
- Certain surgeries. Removing part or all of your stomach (gastrectomy) can cause osteomalacia because your stomach breaks down foods to release vitamin D and other minerals, which are absorbed in your intestines. Surgery to remove or bypass your small intestine also can lead to osteomalacia.
- Celiac disease. In this autoimmune disorder, the lining of your small intestine is damaged by consuming foods containing gluten, a protein found in wheat, barley and rye. A damaged intestinal lining doesn't absorb nutrients, such as vitamin D, as well as a healthy one does.
- Kidney or liver disorders. Problems with your kidneys or liver can interfere with your ability to process vitamin D.
- Drugs. Some drugs used to treat seizures, including phenytoin (Dilantin, Phenytek) and phenobarbital, can cause osteomalacia.
References
- Osteomalacia. In: Firestein S, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: W.B. Saunders; 2008. http://www.mdconsult.com/das/book/body/121322005-3/806510556/1807/697.html#4-u1.0-B978-1-4160-3285-4..10092-0--s0200_3401. Accessed Feb. 19, 2009.
- Osteoporosis overview. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/default.asp. Accessed Feb. 19, 2009.
- Menkes CJ. Clinical manifestations and etiology of osteomalacia. http://www.uptodate.com/home/index.html. Accessed Feb. 19, 2009.
- Metabolic and endocrinologic problems: Osteomalacia. In: Barker LR, et al. Principles of ambulatory medicine. 7th ed. Philadelphia, Pa.: Lippincott, Williams & Wilkins; 2007:1444.
- Drezner MK. Osteomalacia and rickets. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/121322005-5/806576325/1492/956.html#4-u1.0-B978-1-4160-2805-5..50270-6_12054. Accessed Feb. 19, 2009.
- Menkes CJ. Diagnosis and treatment of osteomalacia. http://www.uptodate.com/home/index.html. Accessed Feb. 20, 2009.
- Calcium and vitamin D: Important at every age. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Nutrition/default.asp. Accessed Feb. 20, 2009.
