Are your bones weak and easily broken? (Osteomalacia) Let's talk about it today!

Do you sometimes feel pain in your bones? Or do you feel like your bones are going to break even with the slightest movement? The reason for this may be something you don't expect. Today we are going to talk about Osteomalacia, a common but not very common disease among adults. What happens in this is that our bones gradually become soft and weak.

So what is osteomalacia?

Simply put, osteomalacia is a condition in which your bones become soft, lose their strength, and become more susceptible to breaking. Think of bones that used to be like dried clay becoming soft like a lump of clay that has been soaked in water.

The main reason for this is vitamin D deficiency . Vitamin D is essential for our body to absorb minerals called calcium and phosphorus. This calcium and phosphorus are what give our bones strength and hardness. So, when there is not enough vitamin D, the bones do not receive these minerals properly. Then they do not become thick enough and become weak. This is a bit similar to the disease called rickets that occurs in young children when there is not enough vitamin D. At first, you may not realize that you have osteomalacia. But over time, you start to feel pain in your bones. Especially in the lower part of the body, that is, in the hip area and thighs. Gradually, this pain can spread throughout the body. Sometimes, even a small movement can cause pain. But remember, you don't have to live with this pain . You can see a doctor to find out the cause and get treatment.

What are the symptoms of osteomalacia?

The main symptom of this condition is bone pain . This pain is most often felt in your hips, buttocks, and legs. In addition, other symptoms may include:

• Bones break very easily . Sometimes, even a slight fall or a bump can break a bone.
• Muscle pain, stiffness, and weakness. This may be more noticeable after you've finished working out or exercising.
• Difficulty walking, or a change in the way you walk (gait) . Sometimes you may feel as if you are losing your balance when walking.
• Muscle spasms or cramps . These can occur especially in the hands and feet.
• A tingling or prickling sensation in the limbs. This is called paresthesia in medical terms.
• Falling more often than before.

What is the main reason for this?

The main factor that affects the development of osteomalacia is vitamin D deficiency . This is often caused by not getting enough sunlight . Also, not getting enough vitamin D from the foods we eat is a reason for this. Remember, vitamin D is essential for the absorption of calcium and the maintenance of healthy bones. There are other factors that affect this:

• Some digestive system conditions can cause food to not be absorbed properly (malabsorption) . For example, if you have a disease that reduces absorption in the intestine.
• Kidney failure .
• Liver disease.
• Long-term use of certain antiseizure medications .
• Some very rare genetic conditions .

Who is at higher risk of developing osteomalacia?

When exposed to sunlight, our skin naturally produces vitamin D. However, in cases like these, your skin may not be able to make enough vitamin D:

• If you live in an area with a cold, sunny climate .
• If you work indoors all day.
• If you wear clothes that cover most of your body.
• If you have darker skin pigmentation (darker skin needs more sun exposure to produce vitamin D).

Also, you may not be getting enough vitamin D from the foods you eat for reasons like:

• If you don't eat any milk or milk products .
• If you follow a completely vegetarian or vegan diet (but this is not a problem if you plan it properly).
• If you have a condition that prevents your body from absorbing food properly (malabsorption), such as Crohn's disease or Celiac disease.
• If you have recently had bariatric surgery , for example, gastric bypass surgery.

Apart from these people, other groups are at increased risk of developing osteomalacia:

• For people with obesity .
• AgeFor those over 65.
• For pregnant or breastfeeding mothers .

How do you accurately diagnose osteomalacia?

When you see a doctor, he or she will first do a physical examination . Then, he or she will ask about your family medical history and your own health. He or she will also ask about your diet and exercise habits. Next, they will order a blood test to check your blood levels of vitamin D, calcium, and phosphorus . If you have osteomalacia, low vitamin D levels are the main sign . However, low calcium or phosphorus levels can also be a sign of the condition. To confirm the diagnosis, your doctor may also check the levels of:

• Creatinine
• Electrolytes
• Alkaline phosphatase
• Parathyroid hormone `(Parathyroid hormone)`

Other tests you can do include:

• A 24-hour urine test to check the amount of calcium in your urine.
• X-rays to check for weakened bones or fractures.
• A bone mineral density scan to measure the density of your bones and monitor for bone loss.
• A bone biopsy is a procedure in which a small piece of bone is taken and examined to see if the bone has actually softened.

What are the treatments for osteomalacia?

Osteomalacia is usually treated with vitamin D, calcium, and/or phosphorus supplements . Your doctor will decide how much of these you need. If you have malabsorption issues or have recently had bariatric surgery, you may need to take higher doses of vitamin D and calcium. Although these supplements may help with your osteomalacia, it may take several months for your symptoms to improve.. Depending on the severity of your condition, you may need to take vitamin D for a long time. If you stop, osteomalacia may come back. People with conditions like liver disease or kidney failure may need additional treatment and support. Your doctor will check your blood levels regularly. You may also be given a special type of vitamin D. In addition to these, you can also do the following to reduce or correct the symptoms of osteomalacia:

• Sufficient sun exposure .
• Consume more foods containing vitamin D and calcium.
• Wearing braces to reduce or prevent bone deformities.
• In very severe cases, surgery may be required to correct bone deformities.

Can we prevent the development of osteomalacia?

Yes, we can largely prevent this. There are two main things we need to do:

• Getting enough sunlight for the body .
• Getting enough vitamin D and calcium from the foods we eat.

Depending on where you live and the time of year, you may be able to get enough vitamin D from sunlight alone. Generally, someone with fair skin should be in the sun for 10 to 15 minutes two to three days a week. People with darker skin may need to stay in the sun a little longer. But this should be direct sunlight . Neither sunlight coming through windows nor sunlight falling on clothing can produce enough vitamin D. However, it is not good to stay in the sun for too long without sunscreen . Because too much sun exposure increases the risk of skin cancer . Therefore, it is best to ask your doctor how long you should stay in the sun. You will not get all the vitamin D you need from food alone. But it can help. There are some foods that naturally contain vitamin D. For example:

• Oily fish: like tuna, salmon, sardines, mackerel.
• Rainbow trout fish.
• Red meat.
• Beef liver.
• Mushrooms.
• Egg yolks.
• Cod liver oil.

Some other foods have vitamin D added artificially (fortified foods). Talk to your doctor about which sources are best for you. However, different foods have their pros and cons, so you need to consider that. If you still don't think you're getting enough vitamin D from sunlight and food, your doctor may recommend that you take a supplement.

What is the outlook for recovery for someone with osteomalacia?

If this disease is caught early and treated properly (such as with supplements) , most people will start to recover within a few weeks. However, it can take up to six months for your bones to heal and become strong again .

How do I take care of my bones?

As we age, it becomes even more important to take care of our bones. Here are some things you can do to help keep your bones healthy:

• Eat enough foods containing vitamin D and calcium.
• Get enough sunlight .
• Maintain a healthy body weight that suits you.
• Engage in regular physical activity .
• Don't smoke .
• If you drink alcohol , limit it to a certain amount .

When should I see a doctor?

If you have bone pain, or any of the symptoms of osteomalacia we discussed earlier, see a doctor immediately . He or she can check your blood levels to determine if this condition has affected you.

What questions should I ask the doctor?

It may be helpful to ask these questions when you visit your doctor:

• Are dietary supplements alone enough to cure osteomalacia?
• What other treatments do you recommend?
• What activities should I avoid until I recover?
• What types of exercises can help treat or prevent this condition?
• What else can I do to prevent this condition from affecting me in the future?

The most important things to keep in mind (Take-Home Message)

If you are also experiencing pain in your lower body, especially in your bones, it could be osteomalacia. The main cause of this is a lack of vitamin D. Therefore, it is very important to get enough sun exposure and eat foods containing vitamin D. If the symptoms persist, be sure to see a doctor. He or she can determine if your bone pain is due to a vitamin D deficiency and help you become a person with healthy bones.