Rickets is caused most commonly by vitamin D deficiency. Rickets shows up as weak bones that do not have the normal rigidity and stiffness required to do their job. Bones that develop without enough vitamin D can bend from normal stresses, especially the weight-bearing bones such as the legs and hips. A good example is 'bowed-legs' or 'bow-legs'.

Symptoms of rickets include fractures, bone pain, and muscle weakness.

Normally, we produce our own vitamin D. Simple exposure of our skin to sunlight allows our bodies to produce an enzyme that converts something already in the body from an inactive form (25-hydroxy vitamin D) to the active form that we need and use (1,25-dihydroxy vitamin D).

The problem is, during the winter we don't get much exposure to the sun. Without sunshine on our skin, we cannot activate that enzyme process to create our own vitamin D. This is especially true in the northern climates.

This problem can occur in children, or anyone, who is confined indoors. This includes the elderly who are house-bound for health or other reasons; and people who habitually avoid the sun, cover themselves when outdoors, or use sunscreens to block the natural sunlight.

Another cause of rickets in children is a phosphate deficiency. This can be related to simple habits like drinking beverages with phosphoric acid (common soft drinks contain this); colas and other soft drinks create abnormal imbalances between calcium and phophorus in the blood, interfering with normal bone development. This calcium / phosphorus imbalance also interferes with normal hormone levels including insulin and thyroid functions.

Still another cause of rickets is related to rare genetic problems and unusual kidney malfunctions. This is also known as hypophosphatemic rickets (previously called vitamin D-resistant rickets). Hypophosphatemic rickets is a disorder in which the bones become painfully soft and bend easily because the blood contains low levels of phosphate.

Rickets in infants and children is relatively uncommon in the United States, because it can be prevented most of the time with adequate levels of Vitamin D. Dairy products have been fortified with Vitamin D for decades, and breakfast cereals, orange juice, and other common foods have vitamin D added in order to help eliminate and prevent rickets.

Nutrition is an important treatment to strengthen bones. Rickets treatment almost always includes vitamin D, although newer treatment for people with rickets uses special lamps that produce ultra-violet B light waves, or UV-B wavelength light.

Rickets, osteoporosis, and scurvy may also be related. Vitamin C must be present for the body to produce collagen, the strong net-like fiber support that bone minerals attach to. Without the collagen matrix, the calcium, phosphate and other bone minerals have nowhere to attach, and the bone produced is either too brittle or too soft.

So there is some indication that rickets may be a sign of sub-clinical scurvy, deficiency of vitamin C. That means your body still works, but your body does not work properly. In this case, bone quality is not normal because vitamin C and vitamin D are both lacking. Both must be present for optimal bone health.

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