Causes and risk factors
Vitamin D helps in absorption of calcium in the stomach. It is also needed for proper balance of calcium and phosphate levels during bone formation. It is manufactured in the skin with help of UV rays from sunlight. It is also absorbed from diet such as dairy products and fish. Causes of Osteomalacia include deficiency due to lack of vitamin D in diet, certain drugs and its side effects, certain gastric surgeries where the breakdown of vitamin D from food is affected. Intestinal problems due to which the absorption of calcium is difficult e.g. Diseases like celiac disease, certain type of cancers, kidney and liver derangements that affect the metabolism of vitamin D also lead to the disease. Lack of exposure to sunlight due to smog, or use of very strong sunscreen causes Osteomalacia.
Clinical presentation
Bone fractures without any major injury is common symptom. Dull and aching pain in bones especially in hips is commonly seen. It can spread to lower back, ribs, pelvis and legs. Muscle weakness, weakness of arms and legs, muscular spasms is experienced. There is inability to move or perform regular activities. Low calcium levels in blood lead to arrhythmia and irregular heartbeats. It can also cause numbness in muscles and in hands and feet.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Blood tests should be conducted to determine the levels of vitamin D, calcium and phosphorus, creatinine, parathyroid hormones, electrolyte levels. Imaging studies such as X-ray will show weakness, low density and cracks in the bones. Bone density is recommended. Bone biopsy is the most accurate measure to diagnose Osteomalacia.
Treatment
Treatment involves Oral supplements of vitamin D, calcium and phosphates. Vitamin D can also be taken as an injectable or intravenously. Treating underlying disease that is hampering the vitamin D metabolism. Correction of bone deformity by supportive care such as braces or surgery is done. Exposure to early sunlight will also help in managing the condition.
Other Modes of treatment
The other modes of treatment can also be effective in treating Osteomalacia. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Osteomalacia .
