Dr. Michael F. Holick, Ph.D., M.D.
Dr. Michael F. Holick

Rickets and Vitamin D

Posted by admin on November 27, 2008 under Rickets, Vitamin D | 2 Comments to Read

Rickets occurs at approximately six months of age in children who are vitamin D deficient.  They can present with growth retardation, skeletal deformities including bowing of the legs or knocked knees, prominent knob like projections along the ribs next to the sternum known as the rachitic rosary and muscle weakness.  Infants with vitamin D deficiency also suffer from craniotabes which is a softening of the skull causing it to become square shaped.  They can have increase in the bone formation in the front of the head which is known as frontal bossing.


Holick, M.F.  Resurrection of vitamin D deficiency and rickets.  J Clin Invest 2006, 116(8):2062-2072..

Kreiter SR, Schwartz RP, Kirkman HN, Charlton PA, Calikoglu AS, Davenport M.  Nutritional rickets in African American breast-fed infants.  J Pediatr 2000;137:2-6.

Marksted, T., Halvorsen, S., Halvorsen, K.S., Aksnes, L., and Aarskog, D.  1984. Plasma concentrations of vitamin D metabolites before and during treatment of vitamin D deficiency rickets in children.  Acta Padiatr Scand. 73:225-231.

  • Robert Baker said,

    The web site is excellent. Regarding the NEJM article on the case of rickets, the patient had a 25-hydroxyvitamin D level of 16 ng. I’ve tested 1500 patients in 5 years at 10% are less than 10 ng. Is there an explanation of why this patient developed such severe rickets while others don’t with a lower level? Have genetic or other factors been identified?

    Robert Baker MD
    Primary Care Internal Medicine

  • Kelley Norris said,

    Dear Dr. Holick,
    I have rickets(bowed legs)..my body rejects vitamin D which I’ve been told is a rare metabolic disease. I am now 47 and have to use a wheelchair whenever there is any lengthy walking or standing involved. I can stand or walk for very short amounts.I have limited ability with my arm strength as well due to the muscle pain and weakness. I have muscle pain and weakness, bone pain, migraines,neck pain with swollen nodules, and now I am having my remaining teeth removed in December due to constant abcesses and infection. I have 2 daughters who also have this same rare condition. They were seen at Boston Children’s hospital initially. My primary doctor here on the North Shore wants to try and help me, but he knows very little. I told him to research your work and was hoping maybe you could advise him on how best to help me? Or maybe you’d be interested in seeing me as a patient? Any help would be greatly appreciated. oh my daughters are 23 and 17. My 23 year old had reconstructive surgeries on her legs at age 16, at Boston children’s to straighten them..my 17 year old hasn’t had the surgeries as yet. My concern is that although straightening the legs is great, it does nothing to address the disease it’s self. they tend to treat the symptom rather then the cause..thank you for your time..sinncerly Kelley Norris

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