Osteomalacia, Fibromyalgia, or Vitamin D Deficiency?
Osteomalacia is not a disease I’ve come across in pediatrics, but it’s one I’m starting to wonder about as we are seeing more and more severe Vitamin D deficiency. Rickets, a disease in children where the bones are soft and legs become bowed, is basically the equivalent of Osteomalacia in older individuals.
Osteomalacia is typically thought of as a bone disease from severe and chronic low vitamin D levels, or low phosphate levels, or both. Not all stricken are cured by Vitamin D replacement, and not all individuals with Vitamin D deficiency get Osteomalacia.
Symptoms of Osteomalacia are classically bone pain that can be throbbing or achy. Pain can be in the arms or legs, chest or back, and the hips or pelvis. There can also be weakness, and in the elderly, difficulty walking. The symptoms are like those of fibromyalgia, which was almost an unknown condition 20-30 years ago. Classic signs of fibromyalgia are muscle pain, bone aches, weakness, and fatigue. These symptoms are not very different from those symptoms known to be caused by Vitamin D deficiency. It’s possible that these symptoms may be creeping into the pediatric age group also.
The key is to get your Vitamin D level checked. If it’s low or less than optimal, then it can take months of supplementation with adequate doses to build back the Vitamin D stores and the calcium depletion that may have occurred. Remember to take enough (but not too much) calcium along with the Vitamin D. A modest dose of real sunlight may be a good addition. Could it be that our fear of the sun for the past 20 years has resulted in this new disorder rarely seen in the past?