We observed osteomalacia in patients who received certain iron formulations (FCM, SFO, IPM) that have previously been linked to hypophosphatemia in randomized controlled trials and observational studies.(1, 40) The mechanism seems to be an increase in FGF‐23.(3) FGF‐23 leads to renal phosphate loss and decreased activation of vitamin D. The clinical picture was bone pain, fractures, and pseudofractures.(2, 41) Most of the cases had an increase in ALP, and all isotope bone scans reported were abnormal. This evidence concerns the gene FGF23 and osteomalacia.