Metabolic Bone Disease in Leopard Geckos: Signs & Treatment

Reviewed by Dr. Jerry Ayaebi, DVM

Whether you are a first-time keeper or have been keeping Leopard Geckos for decades, chances are you have heard of Metabolic Bone Disease, or MBD.

MBD in Leopard Geckos is a serious and potentially fatal illness.

Luckily, metabolic bone disease is 100% preventable.

Leopard Geckos will never develop this illness if cared for correctly. However, some owners may be inadvertently putting their pet at risk. In this article we cover what MBD is, its signs, symptoms, treatments, and what you can do to prevent it.

Key Points

  • Metabolic bone disease in Leopard Geckos is a skeletal disease that causes their bones to become soft and weak. It is caused by a lack of calcium, vitamin D and UVB light.
  • Symptoms include a lack of appetite, weakness, broken bones, and soft, bendy legs.
  • In its early stages, most Leopard Geckos with metabolic bone disease lose their appetites and become lethargic. In more advanced cases, their legs, jaws, and spine may become bent or twisted. You might notice that they are unable to lift their bellies off of the ground in the usual healthy “dinosaur stance”.
  • Treatment includes dusting all feeder insects with a calcium/vitamin D3 supplement and installing a UVB light. More advanced cases may need calcium injections from a licensed veterinarian.

Leopard Gecko Metabolic Bone Disease

Metabolic Bone Disease in Leopard Geckos
(c) Instagram.

Metabolic bone disease in Leopard Geckos is a degenerative disease that targets their skeleton.

A lack of dietary calcium, vitamin D3 or UVB light, excess phosphorus, or a combination of these factors can cause metabolic bone disease. Without the ability to properly absorb and use calcium, your Leopard gecko’s normal calcium metabolism is interrupted.

This imbalance of calcium and phosphorus results in a loss of bone density and strength. This results in legs, jaws, and spines becoming bent or twisted.

In the veterinary world, MBD is also called secondary nutritional hyperparathyroidism.

This term means that their blood calcium levels are lowered because of a nutritional lack of calcium. This lack of calcium impacts the function of the parathyroid gland which regulates the amount of calcium and phosphorus in their blood.

Leopard Geckos need a 2:1 ratio of calcium to phosphorus in their diet.

This 2:1 ratio is very important to maintain healthy bone and muscle function. If phosphorus levels overtake calcium levels, bones lose their strength and density.

For this reason, varying your Leopard Gecko’s diet is essential! Feeding a mix of feeder insects (like crickets, mealworms, and dubias) dusted with a calcium supplement will help achieve this important 2:1 ratio.

When I first started learning about MBD, I was confused about the role that vitamin D3 played in this disease.

While vitamin D3 is not calcium, it helps them absorb calcium from their diet. Therefore, they will not be able to absorb enough calcium without vitamin D3, even if you are dusting insects with a calcium supplement.


Metabolic bone disease begins in Leopard Geckos when they have an imbalance of nutrients and vitamins, especially low calcium and vitamin D3. This imbalance makes it difficult for them to maintain strong, healthy bones and normal muscle function.

There are a few reasons why MBD can happen:

  • Not dusting feeder insects with a calcium supplement.
  • No UVB light.
  • Not enough vitamin D3, even if you have a UVB light.
  • Overfeeding insects high in phosphorus.

In short, these lizards need vitamin D3 to take the calcium they eat from their diet and use it in their bones. Pet geckos need UVB light to synthesize vitamin D3, though supplement powders are also helpful.

If Leopard Geckos don’t have enough calcium and/or vitamin D3, they are at risk for developing MBD.


Like with Crested Gecko metabolic bone disease, there are no official stages of MBD in Leopard Geckos. Instead, there is a more general description of three stages:

  1. Early
  2. Moderate
  3. Advanced

Early stages of metabolic bone disease in Leopard Geckos are characterized by weakness, lethargy, and a loss of appetite. You may notice their belly and tail becoming thinner too.

Geckos in the moderate stage show continuing weakness and weight loss, and they start to develop hard bumps along their lower jaw and spine. At this stage, most can make a full recovery with veterinary care.

In advanced cases, their legs and lower jaws are soft and flexible. Their legs and spine may look bent or crooked and they will be unable to lift themselves off of the ground or eat insects.

Severe metabolic bone disease where a gecko’s legs are so deformed it can no longer walk is usually not treatable. Untreated MBD is almost always fatal.


Signs of metabolic bone disease in Leopard Geckos can take several weeks or months (usually up to three) to fully progress. This delayed onset can make it tricky to recognize in its early stages.

The first signs of MBD are lethargy and loss of appetite, which are also symptoms of several other health problems. Limping and general weakness are also signs to watch for in the first few weeks.

As the disease progresses, more calcium is lost from a gecko’s bones. In contrast to early stages, advanced stages of MBD are very easy to recognize.

The following symptoms will become more obvious as metabolic bone disease worsens:

  • Bowed legs
  • Crooked or bent spine
  • Unusually flexible limbs and jaw
  • Inability to walk
  • Bumps on the spine, legs, and lower jaw
  • Weight loss

The symptoms of metabolic bone disease are the same for adult, juvenile, and baby geckos.

MDB progresses quicker in younger geckos and females because they have a higher metabolism than adult males. Proper lighting and vitamin supplementation at the hatchling and juvenile stages are crucial for preventing this disease.


Diagnosing MBD is a relatively straightforward process for a vet.

Your vet will start by asking you questions about your Leopard Gecko’s husbandry. They will want to know what the tank setup is like and what you feed / supplement.

They will then perform x-rays and a blood test for confirmation.

By looking at your gecko’s bone structure via x-ray, they will be able to see whether or not the bones look healthy and dense. They can also check blood calcium levels.

Author Tip: While metabolic bone disease is nearly always caused by husbandry mistakes, it is important for you to be honest with your veterinarian. This disease cannot be fixed unless you correct your husbandry.


MBD will start to reverse as soon as the underlying causes are resolved.

The initial treatment for mild cases of MBD is dietary calcium, vitamin D3 supplements and a new UVB light. Together, these husbandry changes immediately start reversing the disease’s progression and can cure mild cases in just a month or two.

Dusting insects with calcium and vitamin D3 powder helps get this essential vitamin into their bloodstream.

UVB light and vitamin D3 help a sick gecko metabolize the extra calcium and rebuild their bone strength.

To treat mild MBD cases at home, dust feeder insects with a calcium/vitamin D3 supplement at every meal.

In addition to dusting insects, leave out a small bottlecap of calcium powder in their tank 24/7 for them to lick.

Author Tip: After your gecko recovers, remove the bottlecap of calcium powder and reduce dusting to every two feedings. Though very rare, it is possible for these lizards to ingest too much calcium and vitamin D3. This is known as hypercalcemia.

If you suspect MBD, one of the best things you can do is buy a UVB light. I use Exo Terra’s ReptiSun 10.0 linear UVB bulb for all of my terrariums. Set this on a 12-hour on/off timer, and make sure the UV rays aren’t blocked by glass, foliage or a plastic top.

Leopard Geckos need UVB light to convert the calcium in their diet to a form that can be used by their bones. They use UVB radiation to synthesize vitamin D3 in their skin, which allows their bones to absorb calcium.

Advanced Treatment

If your Leopard Gecko has a more advanced case of metabolic bone disease your vet will start treatment by giving them injections of calcium under the skin, along with fluids to help with dehydration.

The most common forms of calcium prescribed by vets are calcium glubionate, calcium lactate and calcium gluconate.

Injections are usually the preferred treatment to reduce the chances of mineralization which can be harmful to the Leopard Gecko. Dr. Jerry Ayaebi (DVM) – More Reptiles

Your vet may also give your gecko a shot of a hormone called calcitonin. Normally, this hormone is produced in a gecko’s thyroid gland and works to regulate calcium levels in the blood. An extra boost of calcitonin can jumpstart a calcium-deficient gecko’s metabolism.

In extreme cases, with damaged or misshapen limbs, extra treatment will be needed.

Damaged limbs can be set with splints while they heal. A splint will help the bones heal in the right position.


Metabolic bone disease can be easily reversed if caught early enough.

Most Leopard Geckos in the early stages make a full recovery within a few weeks as soon as they are given vitamin supplements and UVB lighting.

Management of mild cases involves dusting prey with extra calcium and vitamin D3 powder and using a UVB light on a 12-hour schedule.

Unfortunately, advanced cases of metabolic bone disease can’t be cured.

Leopard Geckos severely affected by this disease may need to be euthanized, especially those unable to walk or eat. These geckos have poor quality of life.

For this reason, you should make sure you have the correct nutrition and lighting setup ready before bringing a Leopard Gecko home. If you notice your lizard not eating and acting lethargic or weak, don’t hesitate to take it to a vet for a checkup.

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