How To Prevent Rickets With Siddha Remedies

Rickets is a condition that results in weak or soft bones in children. Symptoms include bowed legs, stunted growth, bone pain, large forehead, and trouble sleeping. Complications may include bone fractures, muscle spasms, an abnormally curved spine, or intellectual disability. Rickets occurs relatively commonly in the Middle East, Africa, and Asia. It is generally uncommon in the United States and Europe, except among certain minority groups. Siddha Spirituality of Swami Hardas Life System considers rickets is a complicated problem, hence we request our valuable readers to read this article for well-being.

Rickets Meaning 

Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. Rare inherited problems also can cause rickets. Vitamin D helps your child’s body absorb calcium and phosphorus from food.

Rickets Symptoms 

Bone tenderness 

Signs and symptoms of rickets can include bone tenderness and susceptibility for bone fractures particularly greenstick fractures. Early skeletal deformities can arise in infants such as soft, thinned skull bones – a condition known as ‘craniotabes’, which is the first sign of rickets.

Bowed legs 

Young children may have bowed legs and thickened ankles and wrists. Older children may have knock knees. Spinal curvatures of kyphoscoliosis or lumbar lordosis may be present. The pelvic bones may be deformed.

Rachitic rosary 

A condition known as rachitic rosary can result in the thickening caused by nodules forming on the costochondral joints. This appears as a visible bump in the middle of each rib in a line on each side of the body. This somewhat resembles a rosary, giving rise to its name. The deformity of a pigeon chest may result in the presence of Harrison’s groove.

Hypocalcemia, a low level of calcium in the blood can result in tetany – uncontrolled muscle spasms. Dental problems can also arise.

Deformed chest

An X-ray or radiograph of an advanced sufferer from rickets tends to present in a classic way: the bowed legs and a deformed chest. Changes in the skull also occur causing a distinctive “square-headed” appearance known as “caput quadratum”. These deformities persist into adult life if not treated. Long-term consequences include permanent curvatures or disfiguration of the long bones and a curved back.

Rickets Causes 

Vitamin D deficiency 

Maternal deficiencies may be the cause of overt bone disease from before birth and impairment of bone quality after birth. The primary cause of congenital rickets is vitamin D deficiency in the mother’s blood, which the baby shares. Vitamin D ensures that serum phosphate and calcium levels are sufficient to facilitate the mineralization of bone.

Congenital rickets may also be caused by other maternal diseases, including severe osteomalacia, untreated celiac disease, malabsorption, pre-eclampsia, and premature birth.

Osteoporosis 

Rickets in children is similar to osteoporosis in the elderly, with brittle bones. Pre-natal care includes checking vitamin levels and ensuring that any deficiencies are supplemented.

Also exclusively breast-fed infants may require rickets prevention by vitamin D supplementation or increased exposure to sunlight.

Dietary calcium intakes 

In sunny countries such as Nigeria, South Africa, and Bangladesh, there is sufficient endogenous vitamin D due to exposure to the sun. However, the disease occurs among older toddlers and children in these countries, which in these circumstances is attributed to low dietary calcium intakes due to a mainly cereal-based diet.

Who are at a higher risk of Rickets?

Those at higher risk for developing rickets include:

• Breast-fed infants whose mothers are not exposed to sunlight
• Infants (breast-fed) who are not exposed to sunlight
• Breast-fed babies who are exposed to little sunlight
• Adolescents, in particular when undergoing the pubertal growth spurt
• Any child whose diet does not contain enough vitamin D or calcium

Diseases causing soft bones in infants, like hypophosphatasia or hypophosphatemia, can also lead to rickets.

Strontium is allied with calcium uptake into bones; at excessive dietary levels, strontium has a rachitogenic i.e. rickets-producing action.

Shortage of Sunlight 

Ultraviolet light, especially Sunlight lets human skin cells convert vitamin D from an inactive to an active state. In the absence of vitamin D, dietary calcium is not properly absorbed, resulting in hypocalcemia, leading to skeletal and dental deformities and neuromuscular symptoms e.g. hyperexcitability. Foods that contain vitamin D include:

• Butter
• Eggs
• Fish liver oils
• Margarine
• Fortified milk and juice
• Portabella and shiitake mushrooms
• Oily fishes such as tuna, herring, and salmon

Cases have been reported in Britain in recent years of rickets in children of many social backgrounds caused by insufficient production in the body of vitamin D because the sun’s ultraviolet light was not reaching the skin due to the use of strong sunblock, too much “covering up” in sunlight, or not getting out into the sun.

Maternal shortage of vitamin D 

Other cases have been reported among the children of some ethnic groups in which mothers avoid exposure to the sun for religious or cultural reasons, leading to a maternal shortage of vitamin D; and people with darker skin need more sunlight to maintain vitamin D levels.

Industrial revolution 

Rickets had historically been a problem in London, especially during the Industrial Revolution. Persistent thick fog and heavy industrial smog permeating the city blocked out significant amounts of sunlight to such an extent that up to 80 percent of children at one time had varying degrees of rickets in one form or the other.

It is sometimes known “the English Disease” in some foreign languages e.g. German: ‘Die Englische Krankheit’, Dutch: ‘Engelse ziekte’, Hungarian: “angolkor”.

Evolutionary considerations 

Vitamin D natural selection hypotheses 

Rickets is often a result of vitamin D3 deficiency. The correlation between human skin color and latitude is thought to be the result of positive selection to varying levels of solar ultraviolet radiation. Northern latitudes have a selection for lighter skin that allows UV rays to produce vitamin D from 7-dehydrocholesterol. Conversely, latitudes near the equator have a selection for darker skin that can block the majority of UV radiation to protect from toxic levels of vitamin D, as well as skin cancer.

An anecdote often cited to support this hypothesis is that Arctic populations whose skin is relatively darker for their latitude, such as the Inuit, have a diet that is historically rich in vitamin D. Since these people acquire vitamin D through their diet, there is not a positive selective force to synthesize vitamin D from sunlight.

Environment mismatch 

Ultimately, vitamin D deficiency arises from a mismatch between a population’s previous evolutionary environment and the individual’s current environment. This risk of mismatch increases with advances in transportation methods and increases in urban population size at high latitudes.

Similar to the environmental mismatch when dark-skinned people live at high latitudes, Rickets can also occur in religious communities that require long garments with hoods and veils. These hoods and veils act as sunlight barriers that prevent individuals from synthesizing vitamin D naturally from the sun.

Asian immigrants living in Europe have an increased risk of vitamin D deficiency.

High rates of sun exposure

The Middle East, despite high rates of sun-exposure, has the highest rates of rickets worldwide. This can be explained by limited sun exposure due to cultural practices and lack of vitamin D supplementation for breast-feeding women.

Up to 70% and 80% of adolescent girls in Iran and Saudi Arabia, respectively, have vitamin D insufficiency. Socioeconomic factors that limit a vitamin D rich diet also plays a role. In the United States, vitamin D insufficiency varies dramatically by ethnicity.

Rickets Diagnosis

• Blood tests: Serum calcium may show low levels of calcium, serum phosphorus may be low, and serum alkaline phosphatase may be high from bones or changes in the shape or structure of the bones. This can show enlarged limbs and joints.
• A bone density scan may be undertaken.
• Radiography typically shows the widening of the zones of provisional calcification of the metaphyses secondary to unmineralized osteoid. Cupping, fraying, and splaying of metaphyses typically appears with growth and continued weight-bearing. 

Rickets Types

• Vitamin D-related rickets
  • Vitamin D-dependent rickets
    • Type 1 (25-Hydroxyvitamin D3 1-alpha-hydroxylase deficiency)
    • Type 2 (calcitriol receptor mutation)
• Hypocalcemia-related rickets
  • Hypocalcemia
  • Chronic kidney failure (CKD-BMD)
• Hypophosphatemia-related rickets
  • Congenital
    • Vitamin D-resistant rickets
    • Autosomal dominant hypophosphatemic rickets (ADHR)
    • Autosomal recessive hypophosphatemic rickets (ARHR)
  • Hypophosphatemia (typically secondary to malabsorption)
  • Fanconi’s syndrome
• Secondary to other diseases
  • Tumor-induced osteomalacia
  • McCune-Albright syndrome
  • Epidermal nevus syndrome
  • Dent’s disease

Rickets Differential diagnosis 

Osteochondrodysplasias also known as genetic bone diseases may mimic the clinical picture of rickets in regard to the features of bone deformities. The radiologic picture and the laboratory findings of serum calcium, phosphate, and alkaline phosphatase, are important differentiating factors.

Blount’s disease is an important differential diagnosis because it causes knee deformities in a similar fashion to rickets namely bow legs or genu varum. Infants with rickets can have bone fractures. This sometimes leads to child abuse allegations. This issue appears to be more common for solely nursing infants of black mothers, in winter in temperate climates, suffering poor nutrition and no vitamin D supplementation. 

Rickets Treatment

The most common treatment of rickets is the use of vitamin D. However, orthopedic surgery is occasionally needed.

Rickets Diet and sunlight 

Reference: https://en.wikipedia.org/wiki/Rickets