Rickets
1 medicine
Rickets is a bone disorder in which severe vitamin D, calcium or phosphate deficiency leaves bones soft and weak, mainly in children. It's treated by restoring vitamin D, sometimes with the activated form alfacalcidol.
Key facts
- Rickets happens when bones fail to harden properly because the body lacks enough vitamin D, calcium, or phosphate.
- It is most common in young children but can affect adults with severe or prolonged deficiency.
- Signs include bowed legs, thickened wrists and ankles, a slow-closing soft spot on the skull, muscle weakness and slow growth.
- Treatment centres on restoring vitamin D, sometimes with the activated form alfacalcidol, alongside adequate calcium intake.
Why bones weaken in rickets
Vitamin D controls how the gut absorbs calcium and phosphate, the minerals that give bone its rigidity. Without enough of it, mineralisation stalls and bones stay soft and rubbery rather than hardening normally. Weight-bearing legs often bow outward, the wrists and ankles thicken, and children may have a soft spot on the skull that takes longer than normal to close. Muscle weakness, dental delays, and slow growth are other common signs. Low dietary intake and limited sun exposure are the main drivers, though some hereditary and kidney-related forms stop the body processing vitamin D normally regardless of intake.
Treating the underlying deficiency
The cornerstone of treatment is restoring vitamin D to working levels, usually with standard vitamin D supplementation. Alfacalcidol is an activated form of vitamin D used when the body cannot convert standard vitamin D efficiently, which applies to some hereditary and kidney-related forms of rickets. General bone support, including adequate calcium intake, is maintained alongside vitamin D therapy throughout recovery. Most children improve within weeks of starting treatment, though bone deformities that have already developed may take longer to correct or need specialist follow-up.
When to see a doctor
Any child with bowed legs, delayed growth, or bone pain should be assessed by a doctor. Blood tests can confirm low vitamin D, calcium or phosphate levels and guide the dose and duration of treatment needed. Adults with unexplained bone pain or fractures from minor injuries should also get checked, since deficiency can present later in life too.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.