How to Get Rid of Rickets

How to Get Rid of Rickets

How to Get Rid of Rickets

Rickets is the softening of the bones in children, potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is Vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets. Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood. Osteomalacia is the term used to describe a similar condition occurring in adults, generally due to a deficiency of Vitamin D. The origin of the word "rickets" is unknown. The Greek-derived word "rachitis" (meaning "inflammation of the spine") was later adopted as the scientific term for rickets, due chiefly to the words' similarity in sound.

There are few dietary sources of Vitamin D. The best ones are fatty fish such as salmon and sardines and margarines supplemented with Vitamin D. Milk contains added Vitamin D, but for people who don't drink milk regularly, they get most of their Vitamin D from exposure of the skin to sunlight. The average person has enough Vitamin D stored in their body to last for two or three years. People who get little exposure to sunlight and don't drink lots of milk and eat foods rich in Vitamin D are most likely to suffer from rickets or osteomalacia. In particular, elderly people or latchkey children who're housebound or confined to residential or nursing homes are at most risk.

Treatment of RicketsThe treatment goals include relieving the symptoms and correcting the underlying cause to prevent recurrence. If the condition isn't corrected while children are still growing, skeletal deformities and short stature may be permanent, but if it's corrected while the child is young, skeletal deformities often reduce or disappear with time.

• Treatment involves increasing dietary intake of calcium, phosphates and Vitamin D. Exposure to ultraviolet light (sunshine), cod liver oil, halibut-liver oil and viosterol are all sources of Vitamin D. A sufficient amount of ultraviolet in sunlight each day and adequate supplies of calcium and phosphorus in the diet can prevent rickets. Darker-skinned babies need to be exposed longer to the ultraviolet rays.In particular, the replacement of Vitamin D has been proven to effectively correct rickets. Recommendations are for 200 international units (IU) of Vitamin D a day for infants and children. Simply put, children who don't get adequate amounts of Vitamin D are at increased risk of rickets. Vitamin D is essential for allowing the body to uptake calcium for use in proper bone calcification and maintenance.
• Regular daily supplements of Vitamin D and calcium—e.g., Calcichew D3 or Adcal D3—are usually used for people with simple Vitamin D deficiency, but some people have a single injection Vitamin D in the form of calciferol (Vitamin D2). This is stored in the body and can last up to a year before another injection may be needed. Biologically active form of Vitamin D could be used in people who have difficulty in converting Vitamin D to its active form, which is found in abundance in fish, liver and processed milk.
• Vitamin D3 (cholecalciferol) is the preferred form since it's more readily absorbed than Vitamin D2. Most dermatologists recommend Vitamin D supplementation as an alternative to unprotected ultraviolet exposure due to the increased risk of skin cancer associated with sun exposure.

This steroid undergoes hydroxylation in 2 steps. The first step occurs at position 25 in the liver, producing calcidiol (25-hydroxycholecalciferol), which is the circulating reserve compound. The second step occurs in the kidney at the 1 position, where it undergoes hydroxylation to the active metabolite calcitriol (1,25-dihydroxycholecalciferol), a hormone. People with Vitamin D deficiency due to intestinal problems are best treated with calciferol. Most people with osteomalacia find their pain is reduced about two weeks after the injection.

• Getting a sufficient intake of calcium is crucial to maintaining healthy bones. Your doctor can suggest an appropriate level of calcium intake depending on your age and whether you have absorption problems. The combination of increased Vitamin D intake with calcium may be enough to eliminate the effects of rickets entirely. (Learn how to get more calcium in your diet)
• Skeletal deformities could be corrected by maintaining a good posture. For some cases of bowlegs or spinal deformities, your doctor may suggest special bracing to position your child's body appropriately as the bones grow. Bracing could also help in reducing the deformities. Unfortunately, some skeletal deformities can only be fixed with surgical correction.

Prevention of RicketsAlthough most adolescents and adults receive much of their necessary Vitamin D from exposure to sunlight, infants and young children need to avoid direct sun entirely or be especially careful by always wearing sunscreen.

Vitamin D supplements: In light of these factors and because human milk contains only a small amount of Vitamin D, the American Academy of Pediatrics recommends that all breastfed infants receive 200 international units (IU) of oral Vitamin D daily beginning during the first two months of life and continuing until the daily consumption of Vitamin D-fortified formula or milk is two to three glasses or 500 milliliters (mL).

Vitamin D supplements for infants generally come in droplet form. Use only supplements that contain up to 400 IU of Vitamin D per mL or tablet. Avoid supplements containing a higher concentration of Vitamin D (some forms come in levels of up to 8,000 IU/mL), because they're unsafe for children.

Getting enough calcium: Again, calcium and phosphorus consumption are also important for bone formation in childhood. Breast milk is the best source of calcium during a child's first year of life. Most commercially available formulas also meet calcium requirements. Because of these factors, infants in the United States generally achieve 100 percent of their recommended intake of calcium.

Unfortunately, this trend stops as children grow into adolescents and adults and many fail to take in enough calcium, an essential component of skeletal formation, in their later years. This lack of calcium may lead to osteomalacia, a form of rickets in adults.

As such, recommended daily intake of calcium is as follows (serving sizes vary with age):

• 1 to 3 years of age. 500 milligrams (mg) (two servings of dairy products a day).
• 4 to 8 years of age. 800 mg (two to three servings of dairy products a day).
• 9 to 18 years of age. 1,300 mg (four servings of dairy products a day, as most bone mass production occurs during this period).
• 19 to 50 years of age. 1,000 mg a day (three servings of dairy products a day).

Milk accounts for three-fourths of the calcium in the food supply of the United States. If you're not drinking milk, be sure to find another source. Remember that low-fat can still mean high-calcium. Other sources of calcium include leafy green vegetables (spinach), fortified orange juices, fortified breakfast cereals and calcium supplements.

Causes of RicketsRickets is caused by the failure of osteoid to calcify in the growing person or animal, hence the term “osteomalacia”. On the other hand, rickets occurs when the metabolites of Vitamin D are deficient. Less commonly, dietary deficiency of calcium or phosphorus may produce rickets. Your body senses an imbalance of calcium and phosphorus in your bloodstream and reacts by taking calcium and phosphorus from your bones to raise blood levels to where they need to be. This softens or weakens the bone structure, resulting most commonly in skeletal deformities such as bowlegs or improper curvature of the spine.

If a Vitamin D or calcium deficiency causes rickets, adding Vitamin D or calcium to the diet generally corrects any resulting bone problems for the child. Vitamin D (cholecalciferol or Vitamin D3, a steroid compound) is formed in the skin under the stimulus of ultraviolet light. Ultraviolet light was the only significant source of Vitamin D until early in the twentieth century, when ergosterol (Vitamin D2), which is contained in fish liver oil or as an irradiated plant steroid, was discovered.

Symptoms of RicketsThe symptoms for osteomalacia are widespread bone pains and sometimes muscle weakness. Fractures can occur (Tips on how to heal a fracture). As for rickets, aches and pains and sometimes visible enlargement of bones at joints, such as the wrists, are common. Blood tests are most helpful in identifying osteomalacia in adults, but some patients also take a reduced bone density on bone density scanning. In children, X-rays, particularly of the wrists and knees, are useful but blood tests may also help.

An X-ray or radiograph of an advanced sufferer from rickets tends to present the condition in a classic way—bow legs (outward curve of long bone of the legs) and a deformed chest. Changes in the skull also occur, causing a distinctive "square headed" appearance. These deformities persist into adult life if not treated. Long-term consequences include permanent bends or disfiguration of the long bones and a curved back.

Basically, rickets can be prevented by exposure to sunshine, ultraviolet light or oral intake of Vitamin D. Daily Vitamin D doses for prophylaxis are 10µg or 400 IU. Ergosterol can be taken orally with good effect. Anyhow, rickets due to a genetic condition may require additional medications or specialized treatment. Some skeletal deformities caused by rickets may need corrective surgery.

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