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Osteoporosis

Are Osteomalacia and Vitamin D Deficiency Related?

04/24/2007

Question:

I was diagnosed several years ago with fibromyalagia, although the rheumatologist I saw said I did not have all the clinical symptoms. Recently, I had a Dexascan and blood tests done because of some bone loss I had in my jaw. My dexascan was normal, but my vitamin D levels were very low, 18.5ng/ml referance range (32-100). Calcium and PTH were in the normal range. My vitamin D levels may have been even lower since I was actually taking a supplement two months prior to this test. Can you have a negative dexascan and still have osteomalacia? Can osteomalacia affect just one bone? I suspect I never had fibromyalgia, but was just vitamin D deficient.

I am also undergoing orthodontic treatment, because several dentists thought that my bone loss may be due to my bad bite. I`m at a loss if I should continue if I do have osteomalacia. My orthodontist has not seen any literature regarding osteomalacia/hypovitamintosis and orthodontia. I have also posed these questions to my doctor, but she has not responded. She did say that she was not sure what the implications were for vitamin D deficiency and orthodontia.

Answer:

I presume you are replenishing your vitamin D with large doses for a while (e.g. 50,000 IU per week for 8 weeks, followed by 600-800 IU of vitamin D3 per day).  If someone thinks you may have osteomalacia, you should see a bone specialist for further evaluation. 

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Response by:

Margery Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati