What is Osteomalacia?
Osteomalacia (and Rickets) This bony disorder is produced when body has an inadequate supply of vitamin D. It may be due to insufficient amounts of this vitamin being present in diet. But the body is also able to manufacture (synthesise) its own supply with adequate exposure to sunlight. Too little sunshine may also predispose persons to Osteomalacia, especially if aggravated poor supply in the food. It is far more prominent in places such as Great Britain, where summers are short. It is relatively uncommon in countries such as Australia, where there is a superabundance of natural sunshine, and exposure is a national pastime.
The body requires 400 international units a day for growing children, and substantially less in the adult state. The foods rich in vitamin D are few in number and are often not popular. They include the oily fishes such as salmon and herring, and margarine (that is fortified with vitamin D). There is a small, variable amount in eggs. Therefore, without sunlight exposure on a regular basis, it is easy for many people to be deficient. It also seems more probable in certain migrants (such as Pakistanis) who eat foods notoriously low in vitamin U, and come from an area where there is ample sunlight, to a country where there is a sudden deprivation.
In children this disease is referred to as rickets; in adults, as osteomalacia. Bony deformity and muscles that lack tone are characteristic features. There is a marked reduction of calcium in the blood. In growing children, due to an interference with normal bone growth, bowing and knock-knees can occur, and the skull may show softening. Softened bones may cause pain. Commonly this starts in the spine and may spread to the thighs, arms and ribs, and perhaps other bones. Usually the bones themselves arc painful, rather than the joints.
Muscle weakness is often a prominent feature, especially the upper muscles of the lower limbs. This can make many movements difficult, such as walking up stairs. A typical waddling gait may be in evidence.
This disease is easily treated by making certain the diet is adequate in vitamin D, that supplements are given in cases where a deficiency is Possible (such as with babies), or making certain that there is adequate exposure to sunlight. Vitamin capsules of vitamin D (often in the form of calciferol) 1,000 mg per day are given.
However, in the event of a deficiency being in evidence, this dose may be increased to 10,000 mg daily. Often this is best given in capsule form. However, as there is sometimes “patient resistance” to this treatment, a tailor-made method may be necessary.