Phosphorus is the second most abundant mineral in the body and is an important component of bones and teeth. Your body also uses phosphorus to help maintain bone health, in energy systems and to help remove oxygen from red blood cells for use by your tissues. Low levels of phosphorus typically do not occur in healthy individuals, but they can develop in people with diabetes, celiac disease or alcoholism. Phosphorus deficiency can cause multiple problems, with the most significant changes occurring in the skeleton, energy systems and red blood cells.
Bone Damage: Osteoporosis
Your bones are made up of a mixture of calcium and phosphorus called hydroxylapatite. A normal balance of calcium and phosphorus is required for bone health -- if you have too much or too little of either mineral, your bones become less healthy. Having low levels of phosphorus can lead to a form of bone disease called osteoporosis. As the body's levels of phosphorus decrease, the bones lose mass and become very weak, brittle and much easier to break. Osteoporosis is a particularly dangerous complication of having low phosphorus because most people do not have symptoms until they actually break a bone.
Bone Damage: Osteomalacia
When combined with deficiencies in calcium and vitamin D, phosphorus deficiency can lead to a bone disease called osteomalacia. When phosphorus is low, your bones cannot mineralize properly and become soft, weak, and often crack and break easily. Osteomalacia is more easily recognized than osteoporosis and presents with general aches, pains and overall bone tenderness. Osteomalacia has the potential to cause permanent bone deformities, which can lead to joint damage, muscle pain and altered mobility.
Phosphorus Deficiency and Fatigue
All of the energy systems in your body use adenosine triphosphate, or ATP, as a type of energy currency. Phosphorus is a key component of ATP. Each individual ATP has three units of phosphate, which allows it to act as an energy source. When you have low levels of phosphorus, ATP is converted to adenosine diphosphate, or ADP, which has two phosphate units, or adenosine monophosphate, AMP, which only has one phosphate unit. Because of the lower amounts of phosphorus present, neither ADP nor AMP can produce as much energy as your body needs. This can lead to widespread muscle weakness, fatigue during day-to-day activities, low exercise tolerance and increased risk of injury.
Decreased Red Blood Cell Function
Phosphorus deficiency can also have a large impact on how well red blood cells work. One of the jobs of red blood cells is to carry oxygen through your bloodstream and to deliver it to tissues in your body. Red blood cells "hold onto" oxygen through a compound called hemoglobin; phosphorus is part of a metabolite called 2,3-DPG that helps red blood cells release oxygen to tissues at the appropriate time. When levels of phosphorus are low, 2,3-DPG does not work as well and less oxygen is released to tissues. This can cause widespread problems such as fatigue, weakness, general mental confusion and overall increased risk of injury.