Rickets (Calcium, Phosphate, or Vitamin D Deficiency)

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Learn about rickets and vitamin D deficiency.

Rickets & Vitamin D Deficiency

Does vitamin D deficiency cause symptoms?

Yes, deficiency of vitamin D can cause bone pain and muscle weakness. However, mild vitamin D deficiency is not necessarily associated with any symptoms. Vitamin D has been referred to as the "sunlight vitamin" because it is made in our skin when we are exposed to sunlight. It can also be obtained through dietary sources, but the main source of vitamin D in our diet is foods that have been fortified to include the vitamin (such as in milk and other dairy products). Vitamin D is only found naturally in significant levels in a few foods, including fatty fish, cod-liver oil, and eggs.

Quick GuideVitamin D Deficiency: How Much Vitamin D Is Enough?

Vitamin D Deficiency: How Much Vitamin D Is Enough?

Rickets facts

  • Rickets is a bone disorder caused by a deficiency of vitamin D, calcium, or phosphate.
  • There are several different types of rickets.
  • There are different bony abnormalities associated with rickets, but all are due to poor mineralization with calcium and phosphate.
  • The active form of vitamin D is synthesized by skin cells when exposed to sunlight.
  • Vitamin D is found in small amounts in some foods.
  • Infants who are exclusively breastfed should receive vitamin D supplements.
  • Children and adolescents who do not obtain enough vitamin D though milk and foods should receive vitamin D supplements.

What is rickets?

Rickets is a bone disorder caused by a deficiency of vitamin D, calcium, or phosphate. Rickets leads to softening and weakening of the bones and is seen most commonly in children 6-24 months of age. There are several subtypes of rickets, including hypophosphatemic rickets (vitamin-D-resistant rickets), renal or kidney rickets (renal osteodystrophy), and most commonly, nutritional rickets (caused by dietary deficiency of vitamin D, calcium, or phosphate). Classic nutritional rickets is also medically termed osteomalacia.

What is the history of rickets?

Roman descriptions of individuals with rickets can be found as early as the second century, and in the 1640s, the condition was well documented as a common bone ailment across England. Unfortunately, the scientifically proven cause of rickets was not identified until the 1920s, and by the 1930s, public-health initiatives recommended fortifying milk with vitamin D and cod-liver oil as a nutritional supplement for young infants and children. This led to a near eradication of rickets in the United States and other industrialized nations. Unfortunately, rickets has made a comeback and is still common in less-developed nations. Moreover, for a variety of reasons, rickets is seen more frequently amongst infants and children living in industrialized nations, often among more affluent populations.

Medically Reviewed by a Doctor on 3/7/2016

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