Does rickets affect development and intelligence?

Written by Mo Ming Hua
Pediatrics
Updated on March 18, 2025
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Rickets is primarily caused by a deficiency in vitamin D and mainly affects normal growth and development, with very little to no impact on intelligence. In the early stages of rickets, symptoms mainly include irritability, restlessness, and excessive sweating at night. The body primarily exhibits symptoms such as sweating, night terrors, and irritability, with symptoms becoming significantly more pronounced. During this period, the main manifestations are skeletal deformities, which vary in different age groups. For example, there can be softening of the skull, as well as pectus excavatum, pectus carinatum, and X-shaped or O-shaped legs. In severe cases, spinal deformities may also occur.

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Does rickets cause dry skin and an absence of sweating?

Rickets does not cause dry skin or an absence of sweat. Rickets is a disorder of calcium and phosphorus metabolism caused by a deficiency in vitamin D, and it may also be associated with bone deformities. In infants, it often presents with neurological symptoms such as being easily startled during sleep, increased night sweats, and a variety of symptoms including bald patches on the back of the head. However, an absence of sweating is often a symptom of sweat gland disorders and is not necessarily related to rickets. In some cases, babies sweat less because their sweat glands are underdeveloped, so if a child with rickets has symptoms of dry skin, they are not particularly prominent. If rickets is confirmed, it is crucial to actively supplement vitamin D, spend more time in the sun, and engage in outdoor exercise to facilitate the body's natural synthesis of vitamin D. Severe cases require oral or injected high doses of vitamin D to prevent the condition from worsening and causing bone deformities.

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Causes of Rickets

Rickets, also known as Vitamin D-deficiency rickets, implies from its name that the cause of the disease is due to insufficient intake of Vitamin D in children, leading to disorders in calcium and phosphorus metabolism and resulting in nutritional disease with skeletal deformities. The incidence of the disease is higher in the north than in the south. Currently, the incidence of mild and moderate rickets is relatively high, while severe cases are less common because people are increasingly paying attention to the supplementation of Vitamin D for children. It is recommended that full-term infants start supplementing with 400 units of Vitamin D daily two weeks after birth, which is the physiological requirement. For premature infants, twins, and extremely low birth weight infants, the daily physiological requirement of supplementation is 800 units per day. After supplementing continuously for three months, it should be adjusted to 400 units per day as per the requirement for full-term infants. With such management, the child will not suffer from rickets. However, if there is no regular supplementation after birth, the lack of Vitamin D can lead to skeletal changes in the child, and once rickets is diagnosed, it requires high doses of supplementation.

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How is rickets diagnosed?

Rickets is a chronic nutritional disease characterized by skeletal changes, resulting from insufficient Vitamin D in children, which leads to disruptions in calcium and phosphorus metabolism. Diagnosis of rickets requires a measure of Vitamin D levels, clinical manifestations, certain biochemical markers in blood, and skeletal X-ray findings. Typically, Vitamin D levels are significantly lower than usual, with the level of 25-hydroxyvitamin D3 being the most reliable diagnostic standard. However, many facilities are unable to perform this test, so some instead rely on blood biochemistry and skeletal X-rays. Currently, blood biochemistry and skeletal X-ray examinations are considered the gold standard for diagnosis.

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What is the fundamental difference between rickets and tetany?

Rickets is a type of vitamin D deficiency disease, primarily caused by insufficient vitamin D in infants, children, or adolescents, leading to disorders in calcium and phosphorus metabolism. It is a chronic nutritional disease characterized by skeletal lesions, mainly manifesting as changes in the fastest growing parts of the skeleton, such as square skull, pigeon chest, funnel chest, bow legs, and knock knees, among other symptoms. On the other hand, tetany is primarily due to hypocalcemia and its manifestations differ; it does not exhibit the skeletal changes seen in rickets but primarily presents as spasms or cramps in the hands and feet. Thus, this constitutes their fundamental difference.

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Can rickets be treated?

Rickets is a disorder caused by a deficiency of vitamin D, leading to impaired calcium and phosphorus absorption, which then results in abnormal skeletal development. It is a chronic nutritional disease. Generally, the rickets commonly mentioned is due to nutritional vitamin D deficiency, which is treatable. Typically, encouraging children to engage in appropriate physical activities while supplementing with an adequate level of vitamin D can effectively control the disease, and it can even be cured. However, if there are special circumstances, such as significant liver abnormalities, renal function abnormalities, renal failure, or abnormalities in the thyroid or parathyroid glands, including parathyroid tumors, or congenital hereditary diseases, the treatment needs to be based on the cause in order to effectively control the disease and promote normal calcium and phosphorus metabolism in the body. Congenital hereditary diseases generally make treatment more challenging. Therefore, it is crucial for children with rickets to seek timely medical examination at a hospital. If it is a common case of nutritional vitamin D deficiency, parents should supplement vitamin D promptly according to the doctor's advice for treatment.