Rickets is a childhood skeletal disorder that’s caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the development of strong, healthy bones. People with rickets may have weak and soft bones, stunted growth, and in severe cases, skeletal deformities because of prolonged vitamin D deficiency. Sometimes people can inherit a certain type of rickets.
A vitamin D deficiency makes it difficult for your body to maintain sufficient levels of calcium and phosphate. When this occurs, your body produces hormones that cause calcium and phosphate to be released from your bones. When your bones lack these minerals, they become weak and soft.
Rickets is most common in children who are between 6 and 36 months old. Children are at the highest risk of rickets because they’re still growing. Children might not get enough vitamin D if they live in a region with little Sunlight, follow a vegetarian diet, or don’t drink milk products.
Signs and symptoms of rickets can include –
• Delayed growth
• Delayed motor skills
• Pain in the spine, pelvis, and legs
• Muscle weakness
• Bones that are soft can break easily
• A large forehead or abdomen
• Wide joints in the elbows and wrists
• Dental cavities and irregularities
Because rickets softens the areas of growing tissue at the ends of a child’s bones (growth plates), it can cause skeletal deformities such as –
• Bowed legs or knock knees
• Thickened wrists and ankles
• Breastbone projection
There are several causes of rickets, including –
Lack of vitamin D
The human body needs vitamin D to absorb calcium from the intestines. UV rays from sunlight help the skin cells convert a precursor of vitamin D from an inactive to an active state.
If a person does not make or consume enough vitamin D, their body may not absorbs sufficient calcium from the food they eat, causing low levels of calcium in the blood.
Low calcium levels result in irregularities of the bones and teeth, as well as nerve and muscle problems.
Children may lack vitamin D if they –
• Have dark skin
• Spend a lot of time indoors
• Always wear sunscreen when outside
• Follow a lactose-free or strict plant-based diet
• Have a health condition such as celiac disease, which prevents the body from making or using vitamin D
• Live in a place with high levels of air pollution.
Some types of rickets result from a genetic condition. These may be hereditary.
Hypophosphatemic rickets, for example, is a rare condition in which the kidneys are unable to process phosphate properly and ultimately leads to rickets.
Risk Factors –
Factors that can increase a child’s risk of rickets include –
• Dark skin has more pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight.
• Mother’s vitamin D deficiency during pregnancy increases the risk of developing rickets in the baby.
• Northern latitudes as at those geographical locations there is less sunshine.
• Premature birth also increases the risk of rickets because before due dates babies tend to have lower levels of vitamin D as they had less time to receive the vitamin from their mothers in the womb.
• Medications such as anti-seizure and antiretroviral medications appear to interfere with the body’s ability to use vitamin D.
• Exclusive breastfeeding increases the risk of developing rickets as breast milk doesn’t contain enough vitamin D to prevent rickets.
Left untreated, rickets can lead to –
• Failure to grow
• An abnormally curved spine
• Bone deformities
• Dental defects
• Heart problems
• Obstructed labor
• Life long disability
Your doctor may be able to diagnose rickets by performing a physical examination. They will check for tenderness or pain in the bones by lightly pressing on them. Your doctor may also order certain tests to help make a rickets diagnosis, including –
• Blood tests to measure the levels of calcium and phosphate in the blood
• Bone X-rays to check for bone deformities
In rare cases, a bone biopsy will be performed.
Treatment for rickets focuses on replacing the missing vitamin or mineral in the body. If your child has a vitamin D deficiency, your doctor child has a vitamin D deficiency, your doctor will likely want them to increase their exposure to sunlight, if possible. They will also encourage them to consume food products high in vitamin D, such as fish, liver, milk, and eggs. Calcium and vitamin D supplements can also be used to treat rickets.
If skeletal deformities are present, your child may need braces to position their bones correctly as they grow. In severe cases, your child may need corrective surgery.
For hereditary rickets, a combination of phosphate supplements and high levels of a special form of vitamin D is required to treat the disease.
In most cases, people can prevent rickets by consuming enough vitamin D and enough sun exposure.
The Office of Dietary Supplements (ODS) recommends a daily intake of –
• 400 IU for infants aged 0-12 months
• 600 IU for people aged 1-70 Years
• 800 IU for those above 70
However, it is difficult to say exactly how much vitamin D each need, as it depends on how much sun exposure they have and how much vitamin D their body can synthesize in the skin as a result of this.
To fulfill all the vitamin D requirements for the body following measures could be taken –
• Consuming fortified milk, orange juice, and other products rich in vitamin D.
• Taking a daily vitamin D supplement.
• Taking an occasional high dose of vitamin D when small daily doses are not possible.
Ayurvedic Perspective –
According to Ayurveda, rickets can be correlated with Phakka roga. The treatment is aimed at prakruata rasa nirmana with the improvement in agni by mridu shodhan followed by deepana, pachna, balya and brihana therapy.
Beneficial Herbs –
Effective Medications –
• Shukta Pisti
• Mukta Pisti
• Ashwagandha Churna
• Mahanarayan Tailam
• Ashwagandha Ghrita
• Amalaki Rasayan
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