- Causes osteomalacia
- Aching pain in the lower limbs, hips, pelvis, lower spine and ribs
- May give weakness of limbs with waddling gate
- Calcium:
- Clinical hypocalcaemia is rare
- Secondary hyperparathyroidism increases bone resorption
- Bisphosphonates without correction of low vitamin D and without Calcium supplements may trigger symptomatic hypocalcaemia
- Monitor intact PTH twice a year