What is population group at highest risk for Osteomalacia?

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A old man with a couple of milk in his hand who is at risk group of Osteomalacia

Overview

The bones are important in the body because they provide a framework to the body, protect vital organs and aid in the production of blood cells, that carry oxygen and nutrient to the different parts of the body.

Many diseases can negatively impact the bones. One of the most common disorders is osteomalacia, a condition that is characterized by the softening of the bones, caused by severe deficiency of vitamin D. Commonly, young adults are affected by the condition, leading to bowing during growth.

The condition keeps the bones from mineralizing or hardening, which they normally do.
As a result, people with this condition are prone to bone bending and breaking. Only adults have osteomalacia because when kids have it, it’s called rickets. During pregnancy, women are at a higher risk of having osteomalacia. Hence, getting the needed vitamin D and calcium is important.

Osteomalacia Causes

Osteomalacia happens when there is a defect in the bone maturing process the bones usually go through. The body uses the minerals calcium and phosphate to build and strengthen the bones. If you do not get adequate amounts of these minerals, you may develop osteomalacia.

The most common causes include:

Celiac disease – Celiac disease is an autoimmune disorder, wherein the consumption of food containing gluten can damage the lining of the small intestine. As a result, there is an impaired ability to absorb important nutrients and minerals, including vitamin D and calcium.

Vitamin D deficiency – Vitamin D is produced when the skin gets enough sunlight. People who live in areas where the sunlight hours are short or those who do not eat enough vitamin D food sources are at a higher risk of developing osteomalacia. Vitamin D deficiency is the number one cause of osteomalacia across the globe.

Some surgeries – Usually, the stomach breaks down food to release vitamin D and other minerals absorbed in the intestines. If surgery is conducted in the area and the process is disrupted, it can result in the deficiency of vitamin D, and eventually, osteomalacia.

Some drugs – Some drugs used to treat and manage seizure disorders can cause vitamin D deficiency and eventually, osteomalacia. Phenytoin like Dilantin and Phenytek, are some of the drugs that can cause this vitamin deficiency.

Liver and kidney disorders – The kidneys and liver are important in the activation of vitamin D in the body. If there are kidney or liver problems, these could interfere with the body’s ability to activate vitamin D.

What is population group at highest risk for Osteomalacia?

Adults are most commonly affected by osteomalacia. Children may suffer from the effects of vitamin D deficiency in the form of rickets, but older adults are at the highest risk of getting osteomalacia, here’s why:

Adequate vitamin D status is important for musculoskeletal health throughout life. Vitamin D promotes calcium absorption in the intestines, plays a pivotal role in muscle function and bone turnover, and allows that mineralization of osteoid tissue in the bones.

The importance of vitamin D was first recognized in children, who can develop a condition called rickets. Vitamin D deficiency in adults may lead to osteomalacia, which is characterized by bone pain, proximal myopathy, skeletal deformity and propensity to low trauma fractures.

The elderly are at particularly high risk of developing osteomalacia, which is frequently misdiagnosed. The major cause of osteomalacia in the elderly is still, vitamin D deficiency.

Vitamin D plays a vital role in the mineralization of bones and calcium circulation. When there is a deficiency of this vitamin, it leads to an increased parathyroid hormone (PTH) production. When this happens, it can lead to secondary hyperparathyroidism, which increases bone turnover and the risk of fracture.

Vitamin D is provided to the body through skin synthesis by the ultraviolet B radiation from the sun. Vitamin D can also be absorbed by the food we eat. These processes become less efficient with age. Usually, vitamin D deficiency is common in the elderly, particularly those staying in care homes, where there are less movement and mobility, and the restriction of sun exposure. In some cases, the lack of appetite to eat or the lack of money to buy food can contribute to the problem.

Hence, the elderly and their families should be aware that vitamin D deficiency can cause osteomalacia, which should be included in the medical history taking when older people seek medical attention for a fracture. Vitamin D should always be included in the routine examinations in older adults. Also, vitamin D supplements should be given to older people, even in tropical areas.

The government should also see to it that even the poor older adults get the nutrients they need from food and supplements. Health programs should include the importance of vitamin D in the body, the bones, and overall health.