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Causes
By Mayo Clinic staffVitamin D acts as a hormone to regulate calcium and phosphorus levels in your bones. If you don't get enough vitamin D, your body won't absorb calcium and phosphorus properly. When your body senses the imbalance of calcium and phosphorus in your bloodstream, it 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, which can result in skeletal deformities, such as bowlegs or improper curvature of the spine. Osteomalacia is the adult version of rickets.
You absorb vitamin D from two sources:
- Sunlight. Your skin produces vitamin D when it's exposed to sunlight.
- Food. Your intestines absorb vitamin D that's found naturally in the foods you eat, or added to it during processing, or from supplements or multivitamins you may take.
Rickets can also be caused by conditions that impair vitamin D absorption, such as the surgical removal of all or part of the stomach (gastrectomy) and celiac disease, in which the small intestine doesn't absorb certain nutrients from food. Additionally, conditions that impair the absorption of any fat soluble vitamin, which includes A, D, E and K, increases the risk of rickets.
Other causes of rickets include:
- Hereditary rickets (X-linked hypophosphatemia), an inherited form of rickets caused by the inability of the kidneys to retain phosphorus, or a complication of renal tubular acidosis, a condition in which your kidneys are unable to excrete acids into urine
- Lack of exposure to sunlight, which stimulates the body to make vitamin D
- Nield LS, et al. Rickets: Not a disease of the past. American Family Physician. 2006;74(4):619-626.
- Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007;357(3):266-81.
- Rauch F. Etiology and treatment of hypocalcemic rickets in children. http://www.uptodate.com/home/index.html. Accessed Aug. 19, 2008.
- Gilchrest BA. Sun exposure and vitamin D sufficiency. American Journal of Clinical Nutrition. 2008;88(2)(suppl):570S-577S.
- Rauch F. Overview of rickets in children. http://www.uptodate.com/home/index.html. Accessed Aug. 19, 2008.
- Dietary reference intakes: Vitamins. Institute of Medicine. http://www.iom.edu/Object.File/Master/54/411/DRIs.Vitamins.pdf. Accessed Aug. 19, 2008.
- Gartner LM, et al. Prevention of rickets and vitamin D deficiency: New guidelines for Vitamin D intake. American Academy of Pediatrics. http://pediatrics.aappublications.org/cgi/content/full/111/4/908. Accessed Aug. 19, 2008.
- Dietary reference intakes: Elements. Institute of Medicine. http://www.iom.edu/Object.File/Master/54/395/DRIs.Elements.pdf. Accessed Aug. 19, 2008.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 21, 2008.
