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What Is the Difference between Osteoporosis and Osteomalacia?

By Debra Barnhart
Updated Mar 03, 2024
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Osteoporosis and osteomalacia are diseases that affect bone strength and vitality; however, their causes and symptoms are fundamentally different. A degeneration of existing bones that sometimes occurs among older people, osteoporosis is not limited to the older population. On the other hand, osteomalacia causes the bones to soften and is the result of a breakdown in the body’s ability to build healthy bones, either due to a dietary deficiency or an underlying disease.

Resulting in brittle, porous bones, osteoporosis is a condition in which bone density is compromised. The development of bone mass peaks in the early 30s and then declines as people age. People with good bone mass in their early 30s are less likely to develop osteoporosis in later years.

A number of factors may increase the chances of getting osteoporosis, including a reduction in the hormone estrogen, a deficient diet, over-consumption of alcohol, and smoking. Post-menopausal women have an increased risk of osteoporosis, because estrogen protects bone density. A diet deficient in calcium, vitamin D and phosphorous can also contribute to bone loss.

The causal connections between smoking or excessive consumption of alcohol and osteoporosis are difficult to assess. Some experts claim that moderate consumption of alcohol, even up to two drinks per day, may help to prevent bone loss. Others claim that research indicates a negative correlation, with bone density decreasing from excessive alcohol consumption. Osteoporosis is more common among smokers, but again the causal connection is hard to establish. It may well be that people who smoke and drink excessively have poor health habits in general, thus leading to an increased risk of osteoporosis.

While both osteoporosis and osteomalacia are conditions that cause bone degeneration, osteomalacia produces soft bones instead of brittle bones. In younger people, this disorder is known as rickets. Osteomalacia results from dietary deficiencies in vitamin D and calcium. The cause for these deficiencies may go beyond dietary intake though, and be the result of an underlying condition that prevents absorption of these nutrients. Certain kidney and liver disorders as well as celiac disease — the inability to process foods containing gluten — can prevent the body from properly absorbing the necessary nutrients to build bones.

Broken bones can result from either osteoporosis and osteomalacia; however, osteoporosis seldom has any overt symptoms until bone fractures occur. Osteomalacia, on the other hand, might produce pain in the lower spine, hips and legs, and can cause muscle weakness. Treatment for both osteoporosis and osteomalacia can include calcium and vitamin D supplements, although physicians often prescribe medications for osteoporosis that may reverse and correct bone loss.

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