Can rickets be treated with vitamin D3?

Written by Tong Peng
Pediatrics
Updated on November 22, 2024
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Rickets can be treated with Vitamin D3; first, we need to understand the pathology of the disease. It is a metabolic, obstructive disease caused by a deficiency of Vitamin D. Often, this deficiency leads to impaired calcium absorption in the body, causing osteoporosis and bone deformity. Infants typically exhibit symptoms like square skulls, pigeon chests, outward flaring ribs, bow legs, and knock knees. Additionally, it affects the baby's sleep quality. The lack of Vitamin D can increase the baby's neural excitability, leading to poor sleep and easy waking. Moreover, severe cases can affect growth and development. Presence of these symptoms should be confirmed by laboratory testing of 25-hydroxy Vitamin D3 to determine specific levels and choose the appropriate dose of Vitamin D3 supplementation. It is also encouraged to promote children's physical activity and exposure to sunlight to enhance the body's synthesis of Vitamin D, which is beneficial for bone development. (Medication should be administered under the guidance of a professional doctor.)

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Written by Mo Ming Hua
Pediatrics
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If rickets is not treated, what will be the impact?

Rickets, if untreated, mainly involves changes in skeletal deformities and motor function in children. Rickets is primarily caused by a deficiency in vitamin D, which is essential for promoting the absorption of calcium. A deficiency in vitamin D leads to reduced calcium absorption. Lower calcium absorption results in a calcium deficiency in the body, which in turn causes changes in the bones. In the early stages of vitamin D deficiency, the main symptoms are increased neural excitability, which may manifest as startle reactions, irritability, restlessness, and excessive sweating. During the active phase, symptoms of increased nervous system excitability become more pronounced, mainly presenting as skeletal deformities. What aspects do these skeletal deformities affect? One is the softening of the skull, pigeon chest, funnel chest, and changes resembling wristbands and anklets. If the condition worsens further, it can present as X-shaped legs, O-shaped legs, and spinal deformities. Thus, if rickets progresses, it can lead to skeletal deformities and impairments in motor functions, among other issues.

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Written by Li Jiao Yan
Neonatology
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Why does rickets cause sweating?

Rickets is a chronic, nutritional disease characterized by skeletal lesions due to a deficiency of vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism. It is primarily caused by a lack of vitamin D, which can increase neural excitability. Research shows that the vitamin D metabolite, 1,25-dihydroxyvitamin D3, is not only an essential nutrient but also a precursor to hormones. It is potentially related to various cells including those in the thyroid, pancreas, stomach, brain, and those involved with calcium balance, as well as the immune, endocrine, reproductive systems, skin, and tumors. A deficiency in vitamin D can increase myocardial excitability and lead to symptoms like excessive sweating.

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Written by Li Jiao Yan
Neonatology
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What are the symptoms of rickets?

The condition generally referred to as rickets is most commonly nutritional vitamin D deficiency rickets, a type of nutritional disease that is prevalent among infants and young children, particularly very young babies. It primarily manifests as changes in the bones where growth is most rapid and can also affect muscle development and changes in nervous excitability. Initially, especially within the first three months, symptoms in very young infants typically include increased nervous excitability, such as crying easily, excessive head sweating, and as a result of the sweating, frequent head shaking, irritability, restlessness, and noticeable crying and restlessness at night. These symptoms at this stage are not necessarily indicative of typical rickets. As the condition progresses, changes in the skeleton gradually become apparent. In infants under six months with rickets, the changes are mainly in the skull, typically feeling like pressing on a ping-pong ball. After six months of age, the head shape becomes squared or box-like, and the head circumference is larger than normal. Later, the characteristic beading changes of rickets appear, with beaded protrusions above the ribs, followed by the formation of blunt, circular raised areas at the wrists and ankles, referred to as wrist and ankle bracelets. Around the age of one, infants may develop a deformity resembling pigeon chest. As the child begins to stand and walk, the weight bearing on the lower limbs may lead to deformities, such as bowlegs or knock-knees, and sometimes even K-shaped deformities of the legs, and some might develop spinal deformities.

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Written by Li Jiao Yan
Neonatology
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What department should I go to for rickets?

Rickets, fully known as nutritional vitamin D deficiency rickets, is a chronic nutritional disease characterized by skeletal lesions in children caused by insufficient vitamin D leading to disturbances in calcium and phosphorus metabolism. In the early stages of rickets, the main issues are disturbances in calcium and phosphorus metabolism and low levels of vitamin D. At this time, one can consult the endocrinology department to check the child's trace elements. If sequelae have already formed, such as obvious pigeon chest or developmental deformities of the lower limbs bones, then it would be appropriate to consult an orthopedic department for corrective treatment.

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Written by Tong Peng
Pediatrics
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Will rickets lead to hunchback when grown up?

Rickets generally does not result in hunchback when one grows up, as rickets is a disease caused by a vitamin D deficiency leading to disturbances in calcium and phosphorus metabolism. If not cured before development is completed, it often leaves sequelae such as square skull, Harrison's groove, beaded ribs, as well as bow legs, knock knees, and pigeon chest. However, hunchback is mainly caused by developmental deformities of the thoracic and lumbar spine, and is not greatly related to a lack of vitamin D. However, it is also important to note that a deficiency in vitamin D can lead to osteoporosis, and if one does not maintain proper posture in daily life, such as bending the back while sitting, standing, or walking and not being able to stand straight, it may eventually lead to pathological curvature of the spine and thoracic vertebrae. Therefore, in daily life, it is still important to be conscious of using one’s lumbar and thoracic spine correctly to avoid developing a hunchback over time.