Osteomalacia as a result of vitamin D deficiency

Endocrinol Metab Clin North Am. 2010 Jun;39(2):321-31, table of contents. doi: 10.1016/j.ecl.2010.02.001.


Osteomalacia is an end-stage bone disease of chronic and severe vitamin D or phosphate depletion of any cause. Its importance has increased because of the rising incidence of vitamin D deficiency. Yet, not all cases of osteomalacia are cured by vitamin D replacement, and furthermore, not all individuals with vitamin D deficiency develop osteomalacia. Although in the past osteomalacia was commonly caused by malabsorption, nutritional deficiency now is more common. In addition, recent literature suggests that nutritional vitamin D deficiency osteomalacia follows various bariatric surgeries for morbid obesity. Bone pain, tenderness, muscle weakness, and difficulty walking are all common clinical manifestations of osteomalacia. Diagnostic work-up involves biochemical assessment of vitamin D status and may also include a transiliac bone biopsy. Treatment is based on aggressive vitamin D repletion in most cases with follow-up biopsies if patients are started on antiresorptive or anabolic agents.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Bariatric Surgery / adverse effects
  • Child
  • Female
  • Fractures, Bone / drug therapy
  • Humans
  • Incidence
  • Mobility Limitation
  • Muscle Weakness / diet therapy
  • Muscle Weakness / metabolism
  • Muscle Weakness / pathology
  • Obesity, Morbid / surgery
  • Osteomalacia / diagnosis
  • Osteomalacia / drug therapy*
  • Osteomalacia / etiology*
  • Vitamin D / analysis
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / complications*
  • Young Adult


  • Vitamin D