Rickets Symptoms: Effects of Vitamin D Deficiency

Rickets Symptoms & Causes: Effects of Vitamin D Deficiency on Bone Health

Rickets is a childhood bone disease caused by a lack of vitamin D, calcium, or phosphate. It causes bones to soften and weaken, leading to skeletal deformities or developmental delays in children. Though more prevalent in infants and toddlers, adults can also be affected by a similar condition known as osteomalacia.

Rickets symptoms are crucial to understand to identify this condition early enough, treat it, and prevent complications. This article will cover the significant symptoms of rickets in different age groups, with special reference to baby rickets symptoms and rickets symptoms in adults. It also clarifies the biological effects of vitamin D deficiency on the skeletal system.

Keep reading for a detailed insight.

What is Rickets?

Rickets is an illness that targets bone growth in a developing child. It is primarily caused by a prolonged insufficient level of vitamin D, which plays an essential role in the absorption of calcium and phosphorus. When adequate vitamin D is not provided, calcium in the blood is reduced, resulting in weak or even soft bones.

It is more prevalent in developing nations with poor diets or little sun exposure. However, fortified foods and supplements have reduced their incidence in developed countries. In adults, the condition is called osteomalacia. It results in bone softening and pain. While it does not cause the same growth-related deformities as childhood rickets, it can lead to skeletal changes over time, such as a waddling gait due to pelvic bone softening.

What are the Causes of Rickets?

The primary cause of rickets is inadequate vitamin D due to insufficient dietary intake or lack of sunlight. Other causes may include:

• Inadequate exposure to the sun (e.g. at high latitudes, sedentary lifestyle)
• Dark skin pigmentation (which inhibits the synthesis of vitamin D)
• Exclusive breastfeeding without supplementation of vitamin D
• Malabsorption syndrome (e.g. celiac disease, Crohn's disease)
• Chronic kidney or liver diseases
• Hereditary diseases of phosphate metabolism

What are the General Rickets Symptoms?

Symptoms of rickets can vary based on the individual's age and the severity of the deficiency. However, the following signs are commonly observed across all ages:

1. Bone Pain and Tenderness

Children may refer to pain in their legs, pelvis, backbone, and lower back. They may also not be comfortable standing or walking for long durations.

2. Skeletal Deformities

One of the hallmark rickets symptoms is visible bone deformities, including:

• Bowed legs (genu varum)
• Knock-knees (genu valgum)
• Thickened wrists and ankles
• Pigeon chest (protruding breastbone)
• Skull abnormalities (soft skull or delayed closure of fontanelles)

3. Delayed Growth

Rickets is usually associated with poor growth in children, who experience a slow increase in height and weight relative to their peers. Growth retardation may be one of the earliest signs.

4. Muscle Weakness

Muscle tone is generally low, which results in weak posture and poor tone. Children can have problems standing up, stair climbing, or walking.

5. Dental Issues

The lack of vitamin D may also impact dent, leading to slow tooth eruption, enamel defects, and a high risk of cavities.

6. Increased Fracture Risk

Conditions of weakened bones give rise to susceptibility to fractures, particularly in the legs and arms.

Symptoms of Rickets in Babies

The rickets symptoms in babies might initially be relatively mild in infants and toddlers. Nevertheless, parents and caregivers must watch out for the following baby rickets symptoms:

• Delayed milestones, such as in sitting, crawling or walking
• Craniotabes, which is the softening of skull bones felt on touch
• Delayed Closure of Fontanelles (soft spots on the baby’s head)
• Hypotonia, which is poor muscular tone or “floppiness”
• Irritability and Restlessness
• Frequent infections, particularly respiratory infections, occur because of low immunity.
• Enlargement of the costochondral junctions of ribs (rachitic rosary)

A pediatric evaluation is critical if these symptoms are observed during the first few years of life.

Symptoms of Rickets in Adults

Adults do not develop rickets, but rickets symptoms in adults are similar to osteomalacia. This condition arises from prolonged vitamin D deficiency and includes:

1. Generalised Bone Pain

In adults, pain in the hip, lower back, rib, and leg is frequent.

2. Muscle Weakness

Weakness of proximal muscles (particularly in the thighs and shoulder region) results in the inability to climb stairs, get up after sitting, or lift items.

3. Fragile Bones

Fractures can develop even when there is a slight trauma, particularly in the spine, hips, or wrists.

4. Gait Abnormalities

People might walk with a limp or have a waddling gait due to muscular weakness and painful bones.

5. Fatigue

Low energy and fatigue are common among adults with osteomalacia.

These symptoms can be non-specific and mistaken for ageing or other chronic diseases, and understanding them can aid in early identification.

What is the Diagnosis of Rickets?

Doctors typically diagnose rickets through a combination of clinical examination and diagnostic tests:

• Blood tests: A decreased vitamin D, calcium, or phosphate, and raised alkaline phosphatase
• X-rays: To identify abnormalities in bones, e.g. bowing of legs, cupping of metaphysis and fraying of metaphysis
• Bone Mineral Density (BMD): To evaluate the extent of softening of the bone
• Genetic Testing: In suspected cases of hereditary rickets

What is the Treatment for Rickets?

Treatment depends on the underlying cause, but usually involves:

1. Vitamin D Supplementation

High-dose vitamin D is prescribed initially, followed by maintenance doses to prevent recurrence.

2. Calcium and Phosphate Supplements

Depending on the deficiency, oral calcium or phosphate may be added to the treatment.

3. Nutritional Guidance

Diet should include foods rich in vitamin D and calcium, such as:

• Fortified dairy products
• Egg yolks
• Fatty fish (like salmon and sardines)
• Fortified cereals

4. Sunlight Exposure

Encouraging moderate sun exposure, especially during early morning or late afternoon hours, helps improve natural vitamin D synthesis.

5. Treating Underlying Conditions

Those conditions must be managed concurrently if the rickets are due to malabsorption or kidney issues.

6. Surgery

In severe cases of skeletal deformities, surgical correction may be necessary.

What are the Preventive Strategies for Rickets?

Preventing rickets is largely achievable through simple lifestyle and dietary changes, such as:

• Daily sun exposure for at least 15 to 30 minutes, particularly on the arms and legs
• Vitamin D supplementation for breastfed infants, especially in the first year
• A balanced diet with adequate intake of calcium and vitamin D
• Regular pediatric check-ups for early detection in children
• Monitoring high-risk groups, such as those with chronic diseases or limited mobility

Rickets is a preventable and treatable condition. Early recognition of rickets symptoms, from bowed legs in children to rickets symptoms in adults, such as bone, significantly affects long-term bone health. With the right mix of medical treatment, dietary changes, and lifestyle modifications, most people fully recover.

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