Preventing and Treating Osteomalacia-Rickets

Since we've been covering vitamin D lately, I thought we'd discuss some of the metabolic bone diseases caused by D deficiency in children and adults, like osteomalacia, aka rickets in children.

According to the Mayo Clinic, Osteomalacia refers to a softening of your bones, usually caused by a vitamin D deficiency. In children, this condition is called rickets. Soft bones are more likely to bow and fracture than are harder, healthy bones.

Osteomalacia is not the same as osteoporosis, another bone disorder that can also lead to bone fractures. Osteomalacia results from a defect in the bone-building process, while osteoporosis develops due to a weakening of previously constructed bone [1].

Some theorize that a low level of vitamin D causes calcium-depletion in bones which in turn can increase the risk of fractures and bone loss (osteopenia and osteoporosis) in individuals with these deficiencies.

Since 20 to 25 million individuals in the U.S. have osteomalacia, let's look at the things we can do to prevent and treat this disorder.

Symptoms of osteomalacia and rickets:

  • Bone pain
  • Muscle weakness
  • Fragility fractures (fractures that occur with little injury, like a fall from a standing height that results in a fracture).

Bone pain can present in the spine, pelvis and legs.  Muscle weakness will be noted,  in a patients limbs, reduced mobility and an unstable gait [1].


  • Osteomalacia can develop from a lack of exposure to sunlight
  • Vitamin D deficiency
  • Stomach surgeries that can cause malabsorption problems
  • Celiac disorder
  • Liver or kidney disorders
  • Certain medications, used for seizure disorders like phenytoin and phenobarbital [1].

Treatments for osteomalacia/rickets:

  • Calcium
  • Phosphorus
  • Vitamin D [2]

Testing for osteomalacia/rickets:

  • Blood tests that measure calcium, vitamin D, phosphate and creatinine.
  • Other tests used for osteomalacia are:

o   X-rays

o   Bone biopsies

o   Bone density tests (DXA) [2]

Vitamin D, calcium and phosphates are important to good bone health.   Since we have a large number of individuals with this disorder (osteomalacia) in the U.S. and also in other countries, it's important that children/babies and adults get the required amounts of these nutrients to help to prevent some of these disorders.

In the U.S. the Institute of Medicine (IOM) recently reported the Recommended Daily Allowances (RDA) for children, adults and the elderly.   Check the list below to see if you are giving your children enough and also yourself.   These recommendations are for those who have a calcium and D score in the normal range, so if you or your child fall into the deficient state, speak with your doctor to see if you should be supplementing with more, since these recommendations can't be advised across a large range of differing nutrient needs.   Some of us require much more than what was advised, since this is not a one-size-fits-all recommendation due to many differing health histories for each individual.

Institute of Medicines RDA on Calcium and Vitamin D

Ages 1-3 daily calcium intake

700 milligrams (mgs) calcium (** Ca**) per day

Ages 4-8

1,000 mgs of Ca a day


1.500 mgs of Ca a day

Women 19-50

1,000 mgs of Ca a day

Men up to the age of 70

1,000 mgs of Ca a day

Women 51 and older

1,200 mgs of Ca a day

Men over 71

1,200 mgs of Ca a day

Ages 1-71 daily D intake

600 IU's of D a day

Adults over 71

800 IU's of D a day

I hope this information helps to educate the reader on this medical disorder of osteomalacia and you're able to prevent or treat this nutrient deficiency.  Keep in mind, that if you do have this disorder, you may need to supplement with more than what the IOM recommends depending on your vitamin D and calcium testing scores, which will determine your personal needs.


1. Mayo Clinic, By Mayo Clinic Staff on Osteomalacia and Rickets

2. PubMed Health: Osteomalacia August 31, 2010