Rickets Causes & Risks

Causes

Rickets and osteomalacia result when there is a vitamin D deficiency in the body. This may occur when:

• The supply of vitamin D from the diet or sun exposure is inadequate.
• The metabolism of vitamin D is abnormal.
• Tissue is resistant to the action of vitamin D.

Vitamin D regulates calcium absorption in the body. It also controls levels of calcium and phosphate in bone. Vitamin D is absorbed in the intestines from food. Vitamin D is also produced by the skin during exposure to sunlight.

Most often, rickets and osteomalacia are caused by a deficiency of vitamin D. This can result from:

• Insufficient vitamin D in the diet. In children, this may be related to:
  • Insufficient consumption of vitamin D-fortified milk
  • Insufficient intake of vitamin D supplements to children being breastfed or to children who are lactose intolerant
• Lack of exposure to sunlight.

Less often, rickets and osteomalacia can be caused by other disorders that affect vitamin D absorption, metabolism, or action in the body such as:

• Kidney problems:
  • A hereditary disorder of the kidney called vitamin D-resistant rickets
  • Renal tubular acidosis—a nonhereditary kidney disorder which causes bone calcium to dissolve
  • Chronic kidney failure
  • Long-term kidney dialysis
• Diseases of the small intestines with malabsorption
• Disorders of the liver or pancreas disease
• Cancer
• Certain drugs, such as:
  • Certain seizure medications, such as phenytoin or phenobarbital
  • Acetazolamide
  • Ammonium chloride
  • Disodium etidronate
  • Fluoride treatment
• Toxicity or poisoning from:
  • Cadmium
  • Lead
  • Aluminum
  • Outdated tetracycline

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for rickets/osteomalacia include:

• Age in children: 6 to 24 months old
  • Either the child is consuming breast milk (from a mother who is deficient in vitamin D) or milk not fortified with vitamin D.
• Age in adults: 50-80 years
• Lactose intolerance with inadequate intake of vitamin D-fortified milk
• Family history of rickets
• Race: Black, especially in association with breastfeeding