Causes

Osteomalacia results from a defect in the bone-maturing process. Your body uses the minerals calcium and phosphate to help build strong bones. You might develop osteomalacia if you don't get enough of these minerals in your diet or if your body doesn't absorb them properly. These problems can be caused by:

• Vitamin D deficiency. Sunlight produces vitamin D in your skin. Dietary vitamin D is usually from foods to which the vitamin has been added, such as cow's milk.

  People who live in areas where sunlight is limited, get little exposure to sunlight or eat a diet low in vitamin D can develop osteomalacia. Vitamin D deficiency is the most common cause of osteomalacia worldwide.

• Certain surgeries. Normally, the stomach breaks down food to release calcium and other minerals that are absorbed in the intestine. This process is disrupted if you have surgery to remove part or all of your stomach or to bypass your small intestine and can result in vitamin D and calcium deficiency.
• Celiac disease. In this autoimmune disorder, foods containing gluten, a protein found in wheat, barley and rye, can damage the lining of your small intestine. A damaged intestinal lining doesn't absorb nutrients well, and can lead to vitamin D and calcium deficiency.
• Kidney or liver disorders. These organs are involved in activating vitamin D in your body. Problems with your kidneys or liver can affect your body's ability to make active vitamin D.
• Drugs. Some drugs used to treat seizures, including phenytoin (Dilantin, Phenytek) and phenobarbital, can cause severe vitamin D deficiency and osteomalacia.