Rickets – The Preventable Deficiency Disease That Can Be Effectively Managed

From the very first moments of life, our body needs nutrients to develop properly. This is true even in utero, when the expectant mother must ensure the baby has everything it needs. Thus, it is advisable for women to carefully monitor their levels of important nutrients during pregnancy. Among these is vitamin D, which is closely linked to the appearance of a skeletal condition: rickets.

Rickets – what it is and how it manifests

Rickets is considered a childhood disease. In this case, young children may suffer from bone deformities, pain, or tenderness, especially in the arms, legs, pelvis, or spine. Children may also experience delayed growth.

Rickets is different from osteomalacia, which is a similar condition found in adults. Osteomalacia has similar characteristics to rickets, being caused by insufficient mineralization of mature bones. This is usually due to a deficiency in vitamin D or problems with calcium and phosphorus metabolism. The difference between the two is that rickets occurs only in children because their bones are still growing.

Optimal vitamin for healthy bones

In the case of osteomalacia in adults, supplements with Vitamin D3 Capsules could be of great help. These may be recommended if we have a vitamin D deficiency for various reasons, such as insufficient sun exposure or nutrient absorption disorders.

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Known for its bone-strengthening benefits, including in osteomalacia or even rheumatic disorders, this vitamin can work wonders. Vitamin D3 is responsible for fixing calcium and phosphorus in the body, thus ensuring strong and resilient bones. The product provides a 3-month supply, taking one gelatinous capsule every other day. The concentration of 5500 IU not only contributes to bone health but also provides the support the entire body needs.

Rickets in children and osteomalacia in adults – common symptoms

In most cases, rickets in children and osteomalacia in adults, respectively, are easily recognizable disorders. Among the most common symptoms of rickets are:

• Delayed or defective growth (the skeleton does not consolidate properly);
• Delayed motor skills (the child develops basic skills slowly);
• Pain in the spine, pelvis, and legs (which can be observed through reluctance to move or vocalization);
• Muscle weakness and fatigue upon exertion.

Because rickets softens the growing tissue at the ends of a child’s bones (growth plates), it can cause skeletal deformities such as:

• Bowed legs (knock-knees or bowlegs);
• Enlarged wrists and ankles (due to joints that cannot develop properly);
• Sternum involvement (which becomes prominent).

What can be observed in adults?

Among the most common signs of “rickets” in adults (osteomalacia) are:

• brittle bones, prone to fractures, sprains, and various injuries;
• fatigue, even a feeling of intense exhaustion;
• pain;
• stiffness;
• difficulty rising from a seated position or climbing stairs;
• muscle weakness and difficulty moving arms and legs.

Therefore, although the terminology differs (rickets in children and osteomalacia in adults), the pathological process is similar. Both involve a deficiency in bone mineralization due to nutritional or metabolic factors.

What are the causes that lead to the appearance of rickets symptoms?

A child’s body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if the child does not receive enough vitamin D or if they have problems properly assimilating it. In some situations, a lack of calcium or vitamin D can cause rickets.

How does vitamin D deficiency occur?

Causes that can lead to vitamin D deficiency include:

• Insufficient sun exposure. A child’s skin produces vitamin D when exposed to sunlight. Unfortunately, children tend to spend less time outdoors. They are also more likely to use sunscreen products, which block the sun’s action and, consequently, vitamin D production.
• Deficient diet. If a child’s diet does not include foods rich in vitamin D, rickets can easily occur. A proper diet should include fatty fish, eggs, or dairy products.

Can rickets be associated with other medical conditions?

Some children are born with or develop medical conditions that affect how their bodies absorb vitamin D. Some examples of such conditions include:

• Celiac disease;
• Inflammatory bowel disease;
• Cystic fibrosis;
• Kidney problems (especially chronic kidney disease, where vitamin D supplementation is recommended).

What are the risk factors associated with rickets?

Factors that can increase a child’s risk of developing rickets at some point include:

• Dark skin. Darker skin has more pigment, known as melanin. The cells at its base, melanocytes, reduce the skin’s ability to produce vitamin D from sunlight.
• Mother’s vitamin D deficiency during pregnancy. A child whose mother had a severe vitamin D deficiency may be born with signs of rickets. Another possibility is that they may develop them a few months after birth.
• Geographic location. Children living in geographical locations where there is less sun are at higher risk of rickets.
• Premature birth. Babies born prematurely tend to have lower vitamin D levels. This is explained by the fact that they had less time to receive vitamin from their mothers while in the womb.
• Medications. Certain anticonvulsant and antiretroviral medications used to treat HIV infections can affect the body’s ability to use vitamin D.
• Exclusive breastfeeding. Although breast milk is an extremely valuable and important product for infants, it does not contain sufficient vitamin D. Exclusively breastfed babies should receive vitamin D drops as supplements.

What are the complications of untreated rickets?

If a child shows signs of rickets, but no measures are taken to improve or treat it, it can lead to:

• Growth disorders (the child stops growing in height);
• Abnormally curved spine (scoliosis or other aggravated bone pathologies);
• Bone deformities;
• Dental defects;
• Seizures.

Does rickets heal? How can we manage and prevent this problem?

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Rickets is curable in most cases, especially if diagnosed and treated appropriately in the early stages of the disease. Treatment targets the underlying causes of rickets, such as vitamin D, calcium, or phosphorus deficiencies.

Here are the main therapeutic approaches:

• Vitamin D supplementation: This is the most common and effective treatment for rickets caused by vitamin D deficiency. Supplements help normalize vitamin D levels, facilitating calcium and phosphorus absorption into the bones.
• Calcium and phosphorus supplementation: In cases where rickets is caused by calcium or phosphorus deficiencies, supplementation with these minerals is necessary to help restore bone structure.
• Sun exposure: Vitamin D is known as the “sunshine vitamin” because our skin produces it when exposed to UV rays. The doctor may recommend increased controlled sun exposure as part of the treatment.
• Dietary correction: A balanced diet rich in vitamin D, calcium, and phosphorus is essential. This may involve consuming foods fortified with vitamin D, dairy products, fatty fish, and leafy green vegetables.
• Treatment of underlying conditions: If rickets is caused by a medical condition that affects the absorption of vitamin D or minerals, that condition must be treated to control rickets.

Preventing rickets in children

Sunlight remains the best source of vitamin D. In most seasons, 10 to 15 minutes of sun exposure is sufficient. If you have dark skin, if it’s winter, or if you live in a northern region, you need to be careful. In such situations, we may not be able to get enough vitamin D from sun exposure.

However, due to problems associated with skin neoplasms, sunscreen is recommended. Infants and young children, in particular, should avoid direct sun or wear appropriate clothing.

To prevent rickets, we must ensure that the child consumes foods that naturally contain vitamin D. This category includes fatty fish such as salmon and tuna, fish oil, and egg yolks. Other options include products fortified with vitamin D, such as:

• Infant formulas (commercially available);
• Cereals;
• Bread;
• Orange juice.

The dosage of vitamin D varies depending on age, health status, and other individual factors. In general, it is recommended that all infants receive 400 IU of vitamin D per day. This applies to both breastfed infants and those who consume formulas. For children over 1 year of age, 600 IU of vitamin D per day is sufficient for normal bone development.

For adults, the recommended daily dose is between 600 and 800 IU. Pregnant women, breastfeeding mothers, and individuals over 70 years of age may require a higher intake of vitamin D. Based on blood tests and serum vitamin D levels, each person’s daily required amount can be determined.

In conclusion, vitamin D is not just any vitamin, but a true connecting element necessary for the proper functioning of the body. In its absence, children can face rickets, an important deficiency disease that is difficult to control if it worsens. Moreover, adults must also be vigilant to prevent osteomalacia.

References:

1. https://www.nhs.uk/conditions/kidney-disease/treatment/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273061/
3. https://www.nice.org.uk/about/what-we-do/research-and-development/research-recommendations/ng203/21
4. https://www.davita.com/diet-nutrition/articles/basics/vitamin-d-and-chronic-kidney-disease
5. https://orthoinfo.aaos.org/en/diseases–conditions/rickets
6. https://www.ncbi.nlm.nih.gov/books/NBK562285/

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