Hypomagnesemia causes - Low magnesium levels

Oct 1, 2014 Home › Magnesium deficiency › What is hypomagnesemia › Hypomagnesemia causes - Low magnesium levels causes

What are the causes of hypomagnesemia?

Low magnesium levels in the blood serum is the cause of hypomagnesemia. Hypomagnesemia is caused when the blood serum magnesium falls below 0.7 mmol/L (1.4 mEq/L).

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Hypomagnesemia is an underrecognized and underdiagnosed condition as rarely serum magnesium levels are tested. Serum magnesium (Mg²⁺) deficiency is not uncommon in alcoholics, hospitalized patients and in those taking diuretics or proton pump inhibitor drugs (PPIs).

Asymptomatic hypomagnesemia is found to occur in patients with type 2 diabetes. Magnesium is essential for the life processes as it is involved in hundreds of biosynthetic and enzymatic reactions in the human body. Causes of hypomagnesemia include inadequate magnesium intake, malnutrition, poor absorption, gastrointestinal loss, excessive renal loss, rare disorders, extensive injuries or burns and the use of diuretics and certain medications.

Common causes of hypomagnesemia

The most common causes of low levels of magnesium in the blood include malnutrition, inadequacy in diet, malabsorption, gastrointestinal losses, renal losses and alcoholism.

Hypomagnesemia due to malnutrition and malabsorption

Elderly persons are very vulnerable to develop hypomagnesemia due to inadequate nutrition, poor absorption and excessive excretion. In severely malnourished or starving patients refeeding syndrome occurs when they are fed with high carbohydrate food. With the expanding extracellular fluid volume, there is sharp fall in mineral serum levels and a marked low in serum magnesium.

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Patients dependent on total parenteral nutrition also do not receive sufficient balanced nutrition and may have low serum Mg²⁺ levels and hypomagnesemia. Preterm babies may have some degree of renal insufficiency and develop hypomagnesemia. Pregnancy and lactation may also cause low magnesium levels and hypomagnesemia when there is inadequate intake.

Gastrointestinal (GI) magnesium losses and hypomagnesemia

Gastrointestinal losses is the major cause of hypomagnesemia. These losses may occur due to prolonged vomiting, nasogastric suction, diarrhea or chronic dysentery. Vomiting and nasogastric suction, apart from emptying the upper GI tract, remove the secretions as well as some of the body fluids. Hence repeated nasogastric suction or vomiting can cause low magnesium levels and hypomagnesemia.

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The distal GI tract fluids are richer in Mg²⁺ when compared to upper GI tract fluids. When diarrhea or dysentery occurs, body fluids rich in minerals are lost, leading to low serum magnesium levels and hypomagnesemia. The distal GI tract is the major site of magnesium absorption. Any infection or damage to this region of the bowel can lead to low magnesium uptake. Any surgical removal of part of the small intestine or bypass surgery may reduce the mineral absorption and cause hypomagnesemia.

Renal magnesium losses and hypomagnesemia

Renal Mg²⁺ losses primarily occur due to renal disorders, kidney malfunction or dysfunction. Basically there is decreased tubular reabsorption of Mg²⁺ ions in renal ailments. The medical conditions such as renal tubular acidosis, acute tubular necrosis, glomerulonephritis, pyelonephritis or massive diuresis after relief of urinary tract obstruction, cause low magnesium levels due to its reduced reabsorption and active excretion from the body.

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Diuretics interfere with magnesium reabsorption and cause low levels of the mineral in the serum. Antibiotics like gentamicin and anti-cancer drugs like cisplatin are noted to cause low serum levels of the mineral and symptomatic hypomagnesemia. It is also to be noted that excessive supplementation of vitamin D or calcium results in low magnesium levels due its excessive excretion.

Alcoholism and hypomagnesemia

Hypomagnesemia is caused in most of alcoholics and patients affected by withdrawal symptoms or delirium tremens. Alcohol has diuretic action and stimulates renal excretion leading to low serum levels of the essential minerals. Alcoholics in general suffer from malnutrition and malabsorption.

Disturbed magnesium homeostasis and hypomagnesemia

The redistribution of magnesium from extracellular space to intracellular space or bone can cause low serum Mg²⁺ levels. Massive mineralization of the bones occurs in the case of the surgical removal of one or more of the parathyroid glands (parathyroidectomy) or surgical removal of entire thyroid gland (total thyroidectomy). In such cases there is disturbed homeostasis of magnesium with drastic transfer from extracellular fluid space to bones leading to its low levels in the serum and hypomagnesemia. Mg²⁺ homeostasis is disturbed when insulin therapy is carried out for diabetic ketoacidosis. Insulin increases the movement of potassium, magnesium and phosphorus into the cells leading to low serum mineral levels.

Prescription proton pump inhibitors (PPIs) and hypomagnesemia

Prescription proton pump inhibitor drugs are widely used to treat conditions such as high gastric acid secretion, gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. FDA drug safety communication of March 3, 2011 informed public that taking prescription PPI drugs could cause low serum magnesium levels leading to hypomagnesaemia if taken for prolonged periods. Low strength OTC PPIs may not pose the risk of hypomagnesaemia. FDA advises periodic analysis of serum magnesium levels in the event of prolonged prescription PPI use.

Hypomagnesaemia caused by inherited disorders

Gitelman syndrome, Bartter syndrome, autosomal-dominant hypocalcemia with hypercalciuria (ADHH), isolated recessive hypomagnesemia (IRH), isolated dominant hypomagnesemia (IDH) with hypocalciuria and hypomagnesemia with secondary hypocalcemia (HSH) are some of the low serum magnesium levels caused by inherited genetic mutations.

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References:
1.Kevin J. Martin, Esther A. González, Eduardo Slatopolsky. Clinical Consequences and Management of Hypomagnesemia. JASN November 1, 2009 vol. 20 no. 11 2291-2295
2.David R. Mouw, Robyn A. Latessa. What are the causes of hypomagnesemia? J Fam Pract. 2005 February;54(02):156-178.
3.FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)(3-2-2011)
http://www.fda.gov/drugs/drugsafety/ucm245011.htm

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Hypermagnesemia symptoms - Hypermagnesemia treatment - causes

Aug 26, 2014 Home › Hypermagnesemia definition › Magnesium deficiency symptoms › Hypermagnesemia causes - Hypermagnesemia symptoms and treatment

Hypermagnesemia is a rare disorder of electrolyte balance caused by elevated levels of serum magnesium. Early symptoms of hypermagnesemia are general lethargy and hypotension.

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Treatment of the disorder is essentially by immediate discontinuation of magnesium intake and haemodialysis. Elevated serum magnesium level is of rare occurrence, as in healthy individuals excess amounts of the mineral is eliminated by the kidneys in the urine.

Hypermagnesemia symptoms

Depending upon the level of increase in serum magnesium, symptoms of hypermagnesemia progress in severity. Some of the symptoms are listed below:

• Lethargy,
• nausea,
• hypotension,
• hyporeflexia,
• hypoventilation,
• vasodilatation,
• arrhythmia,
• hypoxic encephalopathy,
• bradycardia,
• asystole and
• cardiac arrest.

Hypermagnesemia causes

Intake of very large doses of magnesium-containing supplements, laxatives or antacids by persons with renal insufficiency can cause hypermagnesemia.

Absence of hemodialysis in the event of acute renal failure, causes elevated magnesium levels in the blood serum.

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Intestinal hypomotility causes decreased elimination of the mineral as well as its increased absorption from the gastrointestinal tract.

Adrenal insufficiency is known to cause secondary hypermagnesemia.

Pregnant women under preeclampsia or eclampsia treatment, are given magnesium sulfate infusion to prevent eclamptic seizures and to control blood pressure. Close monitoring is necessary to prevent rise in serum levels of magnesium.

Neonates may receive excess magnesium from their eclamptic mother who has undergone magnesium sulfate infusion.

An episode of diabetic ketoacidosis and dehydration can cause hypermagnesemia.

Release of massive amounts of intracellular magnesium in conditions such as rhabdomyolysis, hemolysis or tumor lysis syndrome can contribute to elevated levels of the mineral in the blood serum.

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Endocrine system impairment as in hypothyroidism or hyperparathyroidism can cause this disorder.

Excessive consumption of magnesium compounds as supplements or laxatives can cause hypermagnesemia in constipated individuals.

Kutsal E et al reported a case of severe hypermagnesemia as a result of excessive purgative ingestion in a child without renal failure. She was given magnesium hydroxide cathartic tablets for seven days for relieving constipation. The serum magnesium levels reached 14.9 mg/dL and the child had symptoms of lethargy and hypotension when referred to hospital. Immediate hemodialysis improved her condition and the magnesium level was brought under control with the resolution of symptoms.

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In another case reported by Weng YM et al, a 70 years old women suffering from constipation, had the magnesium oxide tablets retained in the gastrointestinal tract without evacuation. It caused continuous absorption and rebound of hypermagnesemia leading to prolonged hypotension and hypoxic encephalopathy.

Hypermagnesemia treatment

The first step in treatment is withdrawing magnesium supplementation in all forms.

In patients suffering from persistent bowel hypomotility (constipation) even after the use magnesium based laxatives, gastrointestinal tract evacuation or decontamination must be carried out to stop continued absorption of the mineral.

Intravenous calcium gluconate is administered as treatment to negate the effect of hypermagnesemia on the neuromuscular and cardiac functions.

In case of renal sufficiency intravenous diuretics are administered to speedup the elimination of the excess mineral.

In case of hypermagnesemia induced by other diseases, simultaneous treatments must carried out.

In cases of renal insufficiency or failure, hemodialysis is the only treatment option available to remove excess magnesium.

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References: 1.Kutsal E, Aydemir C, Eldes N, Demirel F, Polat R, Taspnar O, Kulah E. Severe hypermagnesemia as a result of excessive cathartic ingestion in a child without renal failure. Pediatr Emerg Care. 2007 Aug;23(8):570-2.

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Causes of malnutrition - Poverty - Hunger

Home › Nutritional deficiency › Malnutrition - Causes - Poverty - Hunger

Poverty and hunger causes malnutrition

Proper balanced nutrition is required for the function of life process.

Poverty and the resultant hunger causes malnutrition in populations, as food become beyond their reach due to high prices. Even in United States, a Symbol of Affluence, after the economic meltdown there are many households with low-income who do not always have sufficient healthy food to eat and suffer poverty and hunger.
Most of the hunger and lack of food occurs not due to lack of availability of food, but due to poverty making people ill-afford it.
As protein rich food is usually priced high, it causes people in poverty, to knowingly opt for malnutrition by going in for cheaper calorie rich food to satisfy their hunger.
Poverty and hunger have devastating effect on children.

Worldwide, poverty, hunger and malnutrition are the causes for more than 50% of the childhood deaths.

Malnutrition for a prolonged period of time affects physical and mental development of poverty and hunger affected children for the rest of their lives.

This causes reduction in capabilities and starts a poverty and hunger cycle as they become less suitable in the competitive job market; their children again become victims of poverty and hunger.

Lack of balance in food habits causes malnutrition

Poverty or no poverty, malnutrition can also be due to unbalanced consumption of nutrients.

The deficiency of proteins and/or micro nutrients creeps into the health of many people due to malnutrition.

Initially this goes unnoticed and manifests and causes devastating effects after a long period of time.

Deficiency of vitamins and minerals due to their undernourishment or malnutrition causes people to get affected by deficiency diseases like anemia, loss of vision, rickets and osteomalacia, scurvy and beriberi without suffering either poverty or pangs of hunger.

This malnutrition arises due to their food habits and lack of knowledge about nutritional requirements.

Excess and over consumption of food causes malnutrition

Malnutrition arises not only due to poverty and hunger but also due to excess consumption of nutrients.

The excess consumption of calories is usually accompanied by protein and micro nutrient deficiency and causes malnutrition.

Occupying the upper and middle class of the society in many developing countries (which are afflicted by poverty), these segments of population following the human inclination for sweet and fatty food, load themselves with red meat products and nutritionally empty and calorie rich fast foods; Ironically they also suffer malnutrition of micro nutrients and are afflicted with obesity and related health problems though are free from poverty.

This coupled with reduced physical activity causes a large section of them to suffer from heart diseases.

Health disorder causes malnutrition

The risk of malnutrition increases in chronic illness. Especially diseases of gastrointestinal tract, liver and kidney have an immediate impact on the nutritional status of the affected person.

Diseases of chronic nature like, coeliac disease, cancer and AIDS interfere with the absorption and utilization of certain nutrients leading to a state of chronic deficiency and malnutrition.

Some of the predisposing factors which lead to of malnutrition are, lactose intolerance, burns, fractures, trauma, pancreatitis, chronic nausea and vomiting, impaired intake, dysphagia, anorexia, cystic fibrosis and malabsorption.

Addiction to drugs or alcohol causes malnutrition

People who have developed dependency to alcohol or drugs may neglect their diet requirements due to reduced sense of hunger.

These habits affect their work and financial status pushing them into poverty and hunger.

Further dependency for a long period can affect their body organs like liver leading to inefficient absorption and utilization of nutrients leading to malnutrition.

Wars and conflicts are causes of malnutrition

Wars, conflicts and civil-wars ruin nations of their productivity and drag the inhabitants into poverty and hunger.

Conflict causes the supply mechanism gets derailed and the surplus food production regions of the nation get stagnation of the produce and suffering its loss due to lack of storage facilities slip into financial problems and hunger.

The deficit regions suffer non-availability of food.

Another aspect of the war is that it makes people to flee from their homes in the war zone; as refugees they become totally helpless and fully dependent on doles from relief agencies to stave off hunger.

Natural disaster causes malnutrition

When natural disasters like, earthquakes, hurricanes, floods and tsunamis strike, many a breadwinner is lost in the calamity, pushing the survivors of his family into poverty and hunger.

The survivors lose their land, property and wherewithal of their livelihood and get thrown into a life of poverty and hunger.

Poor sanitation and unsafe water causes malnutrition

Poor sanitation and hygiene leads to communicable diseases like hepatitis and gastroenteritis to prevail in groups of population.

These affliction can affect the liver and gastrointestinal tract due to which absorption and utilization of nutrients is affected and leads to malnutrition.

Unsafe water carries  many waterborne diseases in the children in poverty ridden countries.

Gender bias and neglect of child nutrition causes malnutrition

In the third world countries, especially in South Asia, there is lack of care of women and children.

Pregnant women are not properly cared for their increased nutritional needs and causes malnutrition in them; this may happen both in poverty and hunger or in affluence. This in turn makes children born to them suffer malnutrition.

The newborn gets milk poor in quality from a week mother and the infant's growth is affected.

The switch towards formula feed and cow milk starves the infant of vital antibodies from the mother, making the infant susceptible to infections and diseases.

Old age related causes of malnutrition

Every fourth elderly American is affected by malnutrition.

Elderly people in all developed and underdeveloped countries suffer from protein and micronutrient malnutrition, for which the causes are many.

Energy needs of the elderly decreases without change in the requirements of other nutrients.

The food balance has to change with slight reduction in carbohydrates without change in the balance of other nutrients.

The shift from the traditional natural food sources of their younger days to modern processed food of present days decreases their nutritional balance and causes malnutrition.

The nutritional status of elderly people is negatively impacted by the mental and physiological changes due to aging and hunger.

With decreased sense of smell and taste, food appears bland to them and causes reduction in their appetite and hunger.

Problem of dental and oral health, difficulty in chewing food and difficulty in digestion leads to reduced intake of food and malnutrition.

The progressive loss of hearing and vision in elderly makes them less mobile and reduces their physical activity.

Their immunity decreases with malnutrition, causes them to suffer many old age diseases.

This depletes their finances and makes them to suffer from poverty and hunger.

Another aspect of malnutrition is food distribution.

It is estimated by FAO (food and agriculture Organization) that 80% of the children suffering lack of food and hunger are from developing countries which have food surplus. It is due to poverty or supplies not reaching them.

The shift towards primary and commodity market for safer investments causes the food prices to sky-rocket sinking vulnerable populations into poverty, hunger and malnutrition.

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Vitamin D deficiency causes rickets in children

Home > Vitamin D deficiency causes rickets

Deficiency of vitamin D or/and calcium and phosphorus are the causes of the nutritional disorders and rickets disease in children.

A number of factors including lack of sunlight exposure and nutritional vitamin D deficiency cause rickets. Certain metabolic disorders, digestive disorders and genetic factors can also lead to rickets.

Lack of sufficient exposure to sunlight (ultraviolet B light) causes rickets

Most of the vertebrate animals including man produce vitamin D in their skin photochemically, with the exception of cats, dogs and a few other animals.

The ultraviolet B light (UVB) from the sun reacts with 7-dehydrocholesterol in the stratum basale and stratum spinosum of the epidermis layer (upper layer of skin) and by a chemical process cholecalciferol is synthesized.

The melanin pigment deposits in the skin function as UVB filter and the dark-skinned people have to be exposed to, more sunlight than the light colored people to produce the same quantity of cholecalciferol.

Children and people who always live and work indoors and are rarely exposed to sunlight are high risk group for developing deficiency of vitamin D.

The intensity of sunlight decreases with higher latitudes and in children living there deficiency of cholecalciferol arises in winter especially if they are dark skinned.

Nutritional deficiency of calcium and phosphorus causes rickets

Calcium and phosphorus are very important for the formation and growth of bone tissue and bones. Any insufficiency of these minerals lead to bone deformities and rickets disease.

Maternal deficiency of cholecalciferol, calcium and phosphorus causes rickets in the newborns

The deficiency in pregnant women reduces the availability of these to the fetus.

Bone formation in the fetus may be affected and the density of the bones is reduced and results low birth weight.

Further if the shortfall is not cured by supplements, birth deformities occur in the newborn children.

Nursing mother's nutritional deficiency causes rickets disease in the infant.

The human milk has just sufficient quantities of cholecalciferol in a healthy woman.

If the lactating mother is not having sufficient reserves of it and is poorly nourished having little exposure to sunlight, the milk becomes poor in this nutrient.

Lactose intolerance and food habits causes rickets disease

Milk and milk products which are rich in calcium are not tolerated by some people and they have problem digesting them.

Unless they eat other sources of calcium they develop vitamin D deficiency.

Vegans who do not include milk and milk products are among the high risk groups to get vitamin D deficiency.

Malabsorption of fats from intestine causes rickets disease

Vitamin D is fat-soluble and requires dietary fat in the intestine for absorption.

In various conditions and ailments like Crohn's disease, cystic fibrosis and in certain liver disorders fat and vitamin D absorption from the intestine is affected and results in its deficiency.

Certain medication causes rickets disease

Phenobarbital and phenytoin are used for preventing and controlling epileptic seizures.

These drugs convert vitamin D into inactive compounds by increasing the hepatic metabolism. This leads to reduction in calcium absorption. Orlistat (weight-loss drug) and cholestyramine (cholesterol-lowering drug) reduces absorption of fat soluble vitamin D.

Corticosteroids like prednisone can affect cholecalciferol metabolism and decrease calcium absorption and result in rickets.

Hereditary predisposition for rickets disease

Vitamin D resistant rickets is hereditary. Here the rickets disease is inherited as a sex-linked genetic disorder. In this condition kidney is impaired from retaining phosphate.

Excessive use of sunscreen and spending more time in-doors causes this ailment.

Understanding the causes and proper preventive measures and treatment can resolve rickets disease.

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What's scurvy - Definition - Causes

Home > Scurvy definition and its causes

Scurvy disease is an adverse health condition due the deficiency of vitamin C (ascorbic acid) in diet.

What's scurvy and its definition

Definition: It is the fatal disease due to lack of/insufficient intake of ascorbic acid in diet leading to spongy gums, loosening of the teeth, livid spots formation on the skin , bleeding from most of the mucous membranes and bleeding into the skin.

Infantile scurvy definition: Infantile scurvy is an acute form (also called as Barlow's disease) affecting malnourished children and causes subperiosteal hemorrhages, paleness, bad breath, coated tongue and diarrhea.

Causes of scurvy disease

As described earlier the main reason for this condition is the diet deficient in vitamin C and its malabsorption.

• Dietary deficiency of ascorbic acid may be due taking diet poor in this vitamin. Diet lacking fresh fruits and vegetables leads to the ailment.
• The process of food preparation sometimes leads to loss of ascorbic acid and is one of the causes of this disease. Food preservation and storage method also leads to this condition.
• Infantile scurvy is sometimes found in babies, whose mothers had taken very high doses of ascorbic acid during pregnancy.
Scurvy disease pictures: Hemorrhage of gums caused by vitamin C deficiency (enlarge)
• Infants who are not breast-fed if not given vitamin C supplements can develop the condition.
• Persons with digestive insufficiency and elderly persons with impaired digestion develop deficiency of vitamin C.
• Alcoholics due to impaired absorption can develop the deficiency of ascorbic acid.
• Persons under high stress and bedridden persons have the possibility of developing this ailment.

Though there are many causes for acquiring the scurvy disease, the definition of what's it, gives us clue about the treatment and cure by supplementing the diet with vitamin C.

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Causes of seasonal affective disorder - SAD - winter depression

Home > Causes of SAD

The causes of SAD are not fully understood but factors like living in higher latitudes, reduced daylight, low temperatures, hormone regulation and short days seem to be causes the disorder.

Bright light induces certain chemical changes in brain and stimulates hypothalamus, a part of the brain responsible for controlling sleep, appetite and mood.

Lack of sufficient light reverses the chemical process in the brain affecting our mood, sleep and activeness. These changes lead to SAD depression.

Disturbed circadian rhythm and SAD disorder

Circadian rhythm or our biological clock regulates our sleep and wakefulness.

The reduction of daylight in fall and winter disrupts the sleep pattern causing depression.

Reduction in the levels of serotonin and SAD depression

Serotonin is a natural chemical found in the brain which being a neurotransmitter has the ability to affect our sleep, appetite and mood.

The levels of serotonin are affected by sunlight and reduced daylight means reduced production of serotonin.

This results in the ineffective transmission of signals from the nerves to brain and causes the disorder.

Affected persons produce less serotonin in fall and winter.

Increase in the secretion of melatonin

Melatonin, a hormone produced by the pineal gland in the brain controls our sleep pattern.

In darkness the gland produces melatonin, helping us to sleep.

In the daylight the production of the hormone is reduced and we wake up. Persons affected by winter blues have been found to produce more melatonin in the reduced sunlight period.

Genetic causes of SAD

Possibility of genetic transmission is suggested in the results of research work on this disorder.

Close relatives and siblings of the SAD patients have been found to develop this depression.

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Osteomalacia causes - soft bones - adults - vitamin D deficiency

Home › Osteomalacia › Nutritional deficiency › Rickets in children › Soft bones

Among many factors, severe vitamin D deficiency causes osteomalacia resulting in soft bones by their hypomineralisation in adults.

Adult skeletal structures after attaining growth, due to many factors connected with vitamin D deficiency, lose the calcium and phosphorus in them during bones turnover and become soft. The causes of osteomalacia are numerous.

Insufficient exposure to sunlight is one of the prime causes of osteomalacia (soft bones)

People living in higher latitudes face shorter days, especially in winter. They are also compelled to be home bound due to adverse weather conditions and soft bones result. In darker skinned people the soft bones problem is compounded due to their reduced vitamin D synthesis ability. This is due to high melanin pigment deposits in their skin which cut off UV-B rays from reaching the vitamin D producing region of the skin and causes vitamin D deficiency and osteomalacia (soft bones).

Deficiency of vitamin D in diet is one of the causes of osteomalacia

The plant sources of vitamin D are very limited. Animal fats especially fish oils and fats are rich in vitamin D. Eggs and animal liver also contains vitamin D. Fortified milk and fortified cereal flours also can be good sources. Vegans who do not even drink milk are in the risk of getting osteomalacia and soft bones. Economically weaker sections of the people are prone to get affected by both calcium and vitamin D deficiency. This causes osteomalacia and soft bones.

Living in places continuously affected by fog and smog causes osteomalacia

Residents of the cities continuously covered by fog and smog may be affected or get into presymptomatic stage of this ailment and soft bones.

Medicine used in the treatment of epilepsy and seizures causes osteomalacia

Epileptics may suffer from soft bones. Epileptic seizures are prevented and controlled by phenobarbital and phenytoin. These drugs increase the hepatic metabolism. By this reaction the vitamin D is converted into inactive forms and the calcium absorption is affected leading to soft bones.

Orlistat (weight-loss drug) and cholestyramine (cholesterol-lowering drug) reduce absorption of fat soluble vitamins like vitamin D. Corticosteroids like prednisone may decrease calcium absorption and causes osteomalacia (soft bones) by affecting cholecalciferol metabolism.

Malnutrition during pregnancy causes osteomalacia

Pregnant women transfer lots of vitamin D, calcium and phosphorus to the growing fetus. The vitamin D and calcium reserves in the pregnant woman's body are tapped to maintain uninterrupted supply to the growing fetus. If the supplies are not replenished by diet, supplements and sunlight exposure deficiency results and causes osteomalacia and soft bones.

Celiac disease causes osteomalacia

Celiac disease (coeliac disease) is a disorder of the small intestine which is autoimmune in nature with genetic predisposition. In this disease there is a reaction of the body to gluten protein present in wheat. There is inflammation of the small intestine and atrophy of the villi which are responsible for nutrient absorption.

Hence there no nutrient absorption and along with many deficiency induced ailments, severe deficiency of vitamin D also occurs and causes osteomalacia and soft bones. Certain types of cancers, hereditary disorders in the metabolism , renal diseases like renal tubular acidosis and disease of the liver can be the causes of osteomalacia and soft bones.