Osteomalacia Patient friendly summary

  • UVB light may reduce osteomalacia risk by producing vitamin D.
  • Vitamin D may reduce osteomalacia risk by strengthening bones and muscles through improving calcium absorption and metabolism.

Osteomalacia refers to a softening of the bones. This is usually caused by a vitamin D deficiency.

In children, this condition is called rickets.

With osteomalacia, there is a defect in the bone-building process. Soft bones are more likely to bow and fracture than harder, healthy bones. Achy bone pain and muscle weakness are the major signs and symptoms of osteomalacia.

Osteomalacia is not the same as osteoporosis. This is another bone disorder that can also lead to bone fractures. Osteoporosis is caused by a weakening of previously constructed bone.

Risk factors

Risk factors for osteomalacia include:

  • Low ultraviolet-B (UVB) light exposure
  • Low vitamin D blood levels
  • Vegetarian diets

Low vitamin D blood levels are caused by little exposure to solar ultraviolet-B (UVB) light. This may occur by staying indoors, having dark skin, covering too much of the body while in the sun, and wearing sunscreen.

Low vitamin D levels may also be caused by poor gastrointestinal (GI) absorption or the use of some drugs.

Vegetarian diets are generally high in grains. Phytates are antioxidant compounds in grains. They bind to calcium and prevent its absorption in the GI tract. However, calcium is needed for bone strength, and supplements might be considered.

However, meat diets may reduce the risk of osteomalacia.

Sunlight exposure and osteomalacia risk

Those who have limited exposure to mid-day sun have increased risk of osteomalacia.

Solar UVB light is the primary source of vitamin D for most people. Thus, those who have limited exposure to mid-day sun have increased risk of osteomalacia. During mid-day, the sun is high enough in the sky to allow sufficient UVB light to reach the earth’s surface. People who are dark skinned or wear clothing that covers much of the body are at risk. This particularly includes people from the Middle East, India, and Pakistan. Two studies are of interest:

  • A study in India found osteomalacia in adolescent girls. They had restricted outdoor activities, wore traditional dress code, and had low calcium intake.
  • A study in Glasgow, Scotland, found that daylight outdoor exposure reduced the risk of osteomalacia.

Vitamin D and osteomalacia

Vitamin D levels

Severe vitamin D deficiency (below 8 ng/mL [20 nmol/L]) may cause osteomalacia.

In Minneapolis, researchers studied 150 people with persistent, nonspecific musculoskeletal pain who did not respond to treatment. In this group, 100% of the African Americans, East Africans, Hispanics, and American Indians had deficient levels of vitamin D. The authors concluded that those with nonspecific musculoskeletal pain should be screened for vitamin D deficiency.

How vitamin D works

Vitamin D benefits people with osteomalacia because it:

  • Increases absorption of dietary calcium
  • Improves calcium metabolism and bone strength
  • Increases muscle strength and neuromuscular control


According to studies, vitamin D may reduce the risk of osteomalacia.

Vitamin D and calcium

Calcium may also play a role in reducing the risk of osteomalacia.


Those with osteomalacia may benefit from vitamin D and calcium supplementation.

A study in Saudi Arabia reported: “Remarkable recovery was documented in all patients following oral cholecalciferol (vitamin D3) and calcium supplementation.”

People diagnosed with osteomalacia could take large doses of vitamin D3. For the first week or two, 50,000 international units (IU) (1250 mcg) vitamin D3 might be taken several times a week. This will raise vitamin D blood levels rapidly. Afterwards, lower doses might be taken. Raising vitamin D blood levels of 30–40 ng/mL (75–100 nmol/L) would be the goal.

Find out more...

We will be adding a detailed evidence summary on this topic in the near future.  Please check back soon to find out more.

Page last edited: 04 June 2011