I. What is vitamin D deficiency rickets?
Vitamin D deficiency causes abnormal calcium and phosphorus metabolism in the body, resulting in impaired bone growth and severe bone deformities, which is called vitamin D deficiency rickets.
The content and distribution of calcium in the body
The total amount of calcium in the body of adults is 700~1400 grams, of which more than 99.7% exists in the form of bone salts in bones and teeth, and only a small amount exists in blood, tissue fluid and cells. The normal value of calcium in the blood is 9-11 mg%, although the amount of calcium in the blood is small, the role it plays is very critical. If the blood calcium is lower than the normal value, the excitability of neuromuscular increases, thus the occurrence of convulsions and laryngeal spasms, which can be life-threatening in serious cases.
Third, the absorption and excretion of calcium
Calcium mainly comes from food, only a small part of calcium in food is absorbed by the intestine after ingestion, most of it is excreted with feces, and a small part of absorbed calcium is excreted by urine.
The absorption of calcium in the intestine is influenced by the following factors.
1, the amount of calcium in food: the more calcium in food, i.e., the higher the concentration of calcium in the intestine, the more calcium is absorbed.
2, the ratio of calcium and phosphorus in food: when the ratio of calcium and phosphorus in food is about 1:2, it is most beneficial for the intestine to absorb calcium and phosphorus.
3, vitamin D: vitamin D can promote the absorption of calcium in the small intestine, which is one of the reasons for using vitamin D to treat vitamin D deficiency rickets.
Fourth, the regulation of blood calcium and its concentration
The normal concentration of blood calcium is 9~11 mg%. Calcium absorbed from food in the small intestine first enters the blood, and then is deposited in the bones or enters the cells. However, under normal conditions, a small amount of calcium is also released from the bones into the blood. Therefore, blood calcium is actually in a dynamic balance to maintain normal physiological functions in the body.
When blood calcium decreases, more calcium is released from the bones into the blood and insufficient calcium is deposited in the bones, thus causing impaired bone growth and development.
V. Why do children get rickets?
Most of the rickets in children are caused by vitamin D deficiency. When vitamin D is deficient, the calcium absorbed by the intestine decreases, blood calcium decreases, bone calcium is then released into the blood, and the bones cannot be calcified, thus causing impaired bone growth and development.
It can be seen that the root cause of rickets in children is due to vitamin D deficiency.
VI. Why does vitamin D deficiency occur in children
Under normal circumstances, there are two sources of vitamin D: one is food, and the other is self-synthesis. Vitamin D in food comes from plants (vitamin D2) or animals (vitamin D3); human skin also contains the predecessor substance of vitamin D3, called vitamin D3 original, which is changed into vitamin D3 by ultraviolet radiation in sunlight.This is the main source of vitamin D for human. This is the main source of vitamin D for human beings. Children, especially infants, do not get enough vitamin D from food because of the small variety of food they eat; children grow fast and require relatively more vitamin D. In addition, the younger the child is, the less opportunity he or she has to be exposed to ultraviolet light outdoors, so the body itself does not synthesize enough vitamin D. Therefore, children are prone to vitamin D deficiency.
VII. What are the manifestations of rickets?
In the early stage, the main manifestations are unstable sleep, easy to wake up, crying at night, excessive sweating (not related to temperature), and occipital baldness; later on, square skull, lower edge of the rib cage outward, chicken chest, and in severe cases, bending and deformation of the legs. Teething, sitting, walking and talking are later than normal children.
Eight, how to prevent rickets
Pregnant women should pay attention to health care during pregnancy to avoid premature birth;
For premature babies, twins, artificially fed babies or newborns born in winter, vitamin D can be given orally from 1~2 weeks after birth, 500~1000 units per day, continuously. For those who cannot adhere to oral administration, vitamin D 2.1~200,000 units or vitamin D 315,000~300,000 units can be given once by intramuscular injection. It can be maintained for 2~3 months.
As long as the conditions and climate allow, try to have more outdoor activities and sunbathing (in the shade of trees in hot summer).
About calcium supplementation: Those who have sufficient milk may not need to take another calcium supplement. If the food does not contain enough calcium, or those who were born prematurely or are weak, calcium can be given 1 gram per day.
IX. How to treat rickets
At the initial stage, children often show anxious temper, excessive sweating, little sleep, night crying, etc. At this time, you can take 5000 ~ 10000 units of vitamin D orally every day, and change it to preventive amount after one month of continuous use. If you can’t take it orally, you can inject vitamin D 2.4 million units or vitamin D 3.3 million units intramuscularly, with 1 ~ 2 times, with an interval of 1 month each time.
At the extreme stage, children mostly have skeletal changes, so they can take 1000~20,000 units of vitamin D orally every day, and change to preventive amount after 1 month. If you cannot take it orally, you can inject vitamin D 2.4 million units or vitamin D 3.3 million units intramuscularly for 2 ~ 3 times with an interval of 1 month each time.
Application of calcium: take calcium gluconate orally 1 ~ 3 grams per day along with vitamin D treatment, or other calcium supplements are also available.
X. Prevention of vitamin D toxicity
Long-term high dose of vitamin D can cause poisoning, which is manifested as loss of appetite, irritability, mental discomfort, low fever, pallor, nausea, vomiting, diarrhea or constipation, excessive drinking, polyuria, and in serious cases, calcification of multiple parts of the body, such as the heart, kidneys, joints, etc. Therefore, the prevention and treatment of rickets should not be abused by vitamin D, but need the guidance of professional physicians.