Should I take vitamin D or D3 for rickets?

Written by Tong Peng
Pediatrics
Updated on February 05, 2025
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Rickets should be treated with D3, but strictly speaking, what we commonly refer to as vitamin D is D3, just phrased differently. Vitamin D3 helps promote the absorption of calcium by bones, preventing the occurrence of rickets symptoms. The main clinical manifestations of rickets appear in the deformation of bones, such as square skull, pigeon chest, flaring ribs, X-shaped legs, O-shaped legs, and other changes in bone status. The nervous system can show symptoms such as night sweats, nervous excitability, balding at the back of the head, poor sleep quality, and easiness to cry. For rickets, it is necessary to diagnose early, timely supplement with vitamin D to prevent symptoms from worsening, and also to get more sunlight and engage in outdoor activities, which helps the body synthesize vitamin D and absorb calcium.

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Written by Tong Peng
Pediatrics
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What are the early symptoms of rickets?

The early symptoms of rickets are mainly due to the inadequate intake of vitamin D in children, leading to disturbances in the body's calcium and phosphorus metabolism. Early signs usually appear around three months of age in infants, characterized by changes in mental state, restless sleep, frequent crying, and excessive sweating. Increased sweating is often accompanied by cradle cap, where circular bald patches appear on the back of the head. In such cases, it is important to include vitamin D-rich foods in the diet and supplement with vitamin D. Continued breastfeeding, engaging in outdoor activities, and exposure to sunlight are recommended to promote the body’s own synthesis of vitamin D. Regular physical examinations are also advised, and if symptoms of rickets occur, an appropriate increase in vitamin D intake may be necessary.

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Written by Li Jiao Yan
Neonatology
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Early symptoms of rickets

Rickets is a chronic nutritional disease primarily caused by a deficiency of Vitamin D, which leads to disturbances in calcium and phosphorus metabolism in the body, resulting in abnormal bone development. It is mostly seen in infants, especially common within the first six months, and particularly in babies younger than three months. Clinically, the symptoms are not very specific; the children may appear irritable and restless, they might cry suddenly, or become agitated and restless to the touch. Some children may exhibit excessive sweating, frequent head shaking, or even hair loss, leading to noticeable baldness at the back of the head. However, these symptoms are not very specific. Generally, blood biochemistry and Vitamin D levels need to be tested. Early X-ray findings of the bones can be normal.

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Written by Zeng Hai Jiang
Pediatrics
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Is a square skull definitely rickets?

Square skull is not necessarily rickets; square skull can be seen in rickets and congenital syphilis, especially common in rickets. It is often seen in children with rickets older than 8-9 months, due to a lack of calcium in the bones which leads to inadequate bone deposition and calcification. Under the periosteum of the child's frontal bone, parietal bone, and occipital bone, a large amount of osteoid deposition forms the square skull. Therefore, while square skull is not necessarily indicative of rickets, it is a common manifestation in rickets.

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Written by Zeng Hai Jiang
Pediatrics
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Rickets and osteoporosis are caused by a lack of what?

Rickets and osteoporosis are both caused by a lack of vitamin D and calcium. Rickets is commonly seen in infants and can present with abnormalities in skeletal development such as "ping-pong ball head", signs of wrist and ankle bracelets, square skull, funnel chest, pigeon chest, X-shaped legs, and O-shaped legs. Osteoporosis is a metabolic bone disease caused by reduced bone formation and increased bone resorption. It can be categorized according to its etiology into senile osteoporosis, postmenopausal osteoporosis, idiopathic osteoporosis, and secondary osteoporosis. Clinically, it can manifest as fatigue, bone pain, and fractures.

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Written by Mo Ming Hua
Pediatrics
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Does rickets affect development and intelligence?

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.