What Is Rickets Causes Symptoms Diagnosis and Prevention
Deficiency of Which Vitamin Causes Rickets?
You may have heard about bone disorders while studying biology. You also know that Vitamin D is essential for bones. Rickets is a condition of bone disorder caused by a deficiency of Vitamin D, calcium, or phosphate. It leads to tenderness and weakness in the bones. It is seen commonly in children between 6-24 months of age. There are several types of rickets, such as hypophosphatemic rickets (vitamin-D-resistant rickets), renal or kidney rickets (renal osteodystrophy), and the common nutritional rickets (caused by a dietary deficiency of vitamin D, calcium, or phosphate). Here, we shall study about rickets symptoms, rickets causes, and about its treatment.
The condition of rickets is most common in children who are between 6 and 36 months old. Children are at highest risk of rickets because they are in the growing stages. Some children might not get enough vitamin D if they live in a region with little sunlight, follow a vegetarian diet, or don’t drink enough milk products. In some cases, rickets is hereditary. Rickets was more prevalent earlier, but it disappeared in developed countries during the 1940s. The reason was the introduction of fortified foods, such as cereals with added vitamin D.
Symptoms of Rickets
1 - Reduced growth and short height
2 - Fractures in bones
3 - Softening of bones
4 - Pain in the bones of arms, legs, pelvis, and spine
5 - Deformities in teeth
6 - Deformities in the skeleton-like bowlegs, and protruding breastbone. Fig.1
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Cause of Rickets
Regardless of the type of rickets, the cause is always a deficiency of vitamin D, calcium, or phosphate. Three characteristics of rickets include nutritional rickets, hypophosphatemic rickets, and renal rickets. The causes of rickets include:
1 - Premature birth (low levels of vitamin D, calcium, and phosphorus);
2 - Limited exposure to the sun (especially in high and low latitudes);
3 - Hereditary metabolic diseases (for example, hypophosphatemic rickets)
4 - Darkly pigmented individuals
5 - Babies born to vitamin D-deficient mothers;
6 – Renal or kidney diseases that affect calcium and phosphorus absorption
7 - Nutrition – Inappropriate calcium and phosphorus intake due to the avoidance of milk products.
Treatment for Rickets
Treatment focuses on replacing the missing vitamin in the body. This replacement will eliminate most of the symptoms associated with rickets. If a child has a vitamin D deficiency, then the doctor will advise the parents to increase their exposure to sunlight. They will also be encouraged to consume food products high in vitamin D, such as fish, liver, milk, and eggs.
Calcium and vitamin D supplements are also in use to treat rickets. The doctor can recommend the correct dosage, as it can vary based on the size of the child. Extra intake of vitamin D or calcium can be unsafe.
If skeletal deformities are present, a child may need braces to position their bones correctly as they grow. In severe cases, a child may need corrective surgery.
For hereditary rickets, a combination of phosphate supplements and high levels of a particular form of vitamin D is required to treat the disease.
Difference between Rickets and Osteomalacia
As mentioned earlier, rickets is of three types:
1 - Hypophosphatemic rickets (vitamin-D-resistant rickets),
2 - Renal or kidney rickets (renal osteodystrophy), and
3 - Common nutritional rickets (caused by a deficiency of vitamin D, calcium, or phosphate).
Common or classic nutritional rickets is medically termed osteomalacia. Nutritional rickets or osteomalacia is a condition caused by vitamin D deficiency. Note that Vitamin D is a fat-soluble vitamin that is essential for the healthy formation of bones and teeth and necessary for the proper absorption of calcium and phosphorus from the stomach. It occurs naturally in minimal quantities through some foods such as saltwater fish such as salmon, sardines, herring, and fish-liver oils. Vitamin D is also typically incorporated by skin cells in response to sunlight exposure. It is necessary for the proper absorption of calcium from the abdomen.
Most at risk for developing nutritional rickets are infants and children with dark-skin, exclusively breastfed infants, and babies who are born to mothers who are vitamin D deficient. Besides, older children who do not get enough exposure to direct sunlight or who have vegan diets may also be at risk.
FAQs on Rickets in Children and Adults Explained
1. What is rickets?
Rickets is a childhood bone disorder caused by a deficiency of vitamin D, leading to soft and weak bones. It occurs when there is impaired bone mineralization during growth due to low levels of vitamin D, calcium, or phosphate. As a result, growing bones cannot properly deposit minerals, causing skeletal deformities. It mainly affects infants and young children during periods of rapid growth.
2. What causes rickets in children?
Rickets is primarily caused by a deficiency of vitamin D, which disrupts normal calcium and phosphate metabolism. Common causes include:
- Insufficient sunlight exposure (reduced vitamin D synthesis in skin)
- Poor dietary intake of vitamin D or calcium
- Malabsorption disorders affecting the intestine
- Genetic conditions such as vitamin D–dependent rickets
Without adequate vitamin D, the body cannot absorb calcium efficiently, leading to weak bone formation.
3. How does vitamin D deficiency lead to rickets?
Vitamin D deficiency leads to rickets by reducing intestinal absorption of calcium and phosphate, which are essential for bone mineralization. The process occurs in steps:
- Low vitamin D decreases calcium absorption from the intestine.
- Blood calcium levels drop, triggering release of parathyroid hormone (PTH).
- PTH increases calcium resorption from bones.
- Bones become soft and poorly mineralized.
This results in skeletal deformities in growing children.
4. What are the common symptoms of rickets?
Common symptoms of rickets include bone pain, delayed growth, and skeletal deformities. Key signs are:
- Bowed legs or knock knees
- Soft skull bones (craniotabes)
- Delayed tooth eruption
- Muscle weakness
- Enlarged wrists and ankles
These symptoms occur because weakened bones cannot support normal body weight and growth.
5. What is the difference between rickets and osteomalacia?
Rickets affects growing children, whereas osteomalacia affects adults with fully developed bones. The key differences are:
- Rickets occurs before closure of epiphyseal growth plates.
- Osteomalacia occurs after growth plates have closed.
- Rickets causes bone deformities due to growth disturbance.
- Osteomalacia mainly causes bone pain and fractures without major deformities.
Both conditions are commonly linked to vitamin D deficiency.
6. How is rickets diagnosed?
Rickets is diagnosed through clinical examination, blood tests, and X-rays. Diagnosis typically includes:
- Low blood levels of vitamin D, calcium, or phosphate
- Elevated alkaline phosphatase
- X-ray findings showing widened growth plates and bone deformities
These findings confirm defective bone mineralization in children.
7. How can rickets be prevented?
Rickets can be prevented by ensuring adequate vitamin D, calcium intake, and safe sunlight exposure. Preventive measures include:
- Regular exposure to sunlight for natural vitamin D synthesis
- Consuming vitamin D–rich foods such as fortified milk and fish
- Vitamin D supplements for infants and high-risk children
- A balanced diet with sufficient calcium
Proper nutrition and sunlight are essential for healthy bone development.
8. What foods are rich in vitamin D for preventing rickets?
Foods rich in vitamin D help prevent rickets by supporting calcium absorption and bone health. Important sources include:
- Fatty fish such as salmon and mackerel
- Cod liver oil
- Egg yolks
- Fortified milk and cereals
Dietary intake combined with sunlight exposure maintains normal bone mineralization.
9. Can adults get rickets?
Adults do not get rickets but can develop osteomalacia, a similar condition caused by vitamin D deficiency. In adults:
- Growth plates are already closed.
- Bones become soft but usually do not deform.
- Symptoms include bone pain and increased fracture risk.
Thus, rickets specifically refers to defective bone mineralization in children.
10. Why are growing children more prone to rickets?
Growing children are more prone to rickets because their bones are rapidly lengthening and require high levels of calcium and phosphate for proper mineralization. During growth:
- Epiphyseal plates are actively forming new bone.
- Mineral demand is high.
- Vitamin D deficiency quickly affects bone structure.
If nutrients are insufficient, bones become soft and deformed during development.
