Osteomalacia is softening of the bones. It is a defect in the bone-building process, i.e. the body is not able to break down and use vitamin D to absorb calcium, necessary for building the bones and maintain their strength. Primarily, osteomalacia develops due to a lack of vitamin D. Soft bones means they are prone to easy fracture.

Osteomalacia was common in the past. As one of the causes is lack of vitamin D, nowadays more attention is paid as to the foods that contain this vitamin, exposure to sun or appropriate supplementation.

Although any child whose diet does not contain enough vitamin D or calcium can develop osteomalacia, it is more common in children with dark skin, children born prematurely, and children taking medication that interferes with vitamin D. Older adults can also develop osteomalacia due to inadequate intake of vitamin D or those who are hospitalized or housebound.

Osteomalacia differs from osteoporosis as the former is a defect in the bone-building process, while the latter is weakening of already constructed bone.


Symptoms of Osteomalacia

The symptoms of osteomalacia are:

  • pain in the bones
  • muscle weakness
  • back pain or pain in the hips, legs or ribs
  • partial fractures, called Looser’s zones, that can further lead to complete fractures


These symptoms are associated with lack of vitamin D.

Symptoms of osteomalacia due to low calcium levels are:


These symptoms make it difficult to move, stand, walk, run or climb the stairs. The symptoms may ease while resting.



The cause of osteomalacia is mainly the lack of vitamin D, which further processes calcium and phosphorous to build strong bones.

The body needs approximately 10 micrograms (µg) of vitamin D per day to protect itself from osteomalacia. The skin can produce up to 100 µg a day in the summer, so the body stores vitamin D for the winter months.


Other causes of osteomalacia are:

  • insufficient intake of vitamin D in the diet
  • insufficient exposure to the sun
  • chronic liver disease
  • celiac disease
  • epilepsy tablets
  • chronic kidney failure
  • stomach surgery
  • cancer


Risk factors of Osteomalacia

The risk factors of osteomalacia are:

  • age – either children or people over 65
  • dark skin
  • insufficient exposure to sunlight
  • pregnancy
  • obesity
  • vegetarianism
  • alcoholism
  • family history
  • living at high latitude



The complications from osteomalacia are broken bones, which most often happen in the ribs, spine, and legs.



Osteomalacia can be prevented by a regular intake of 10–20 µg vitamin D a day. Vitamin D is found in oily fish (salmon, mackerel, sardines), egg yolks, mushrooms. If vitamin D is still insufficient, then supplements will do. Sun exposure is also important; however, not for too long because long exposure to the sun may cause skin cancer.