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Softening of the bones

Softening of the bones: rickets and osteomalacia

The bones are not mineralized enough and out of form due to its soft and malleable bones, babies, and children from rickets, and in adults from osteomalacia. The disease is associated with other, often rather uncharacteristic, symptoms, and is usually due to a chronic Vitamin D and calcium deficiency. Other possible reason can be ruled out diseases, based on symptoms, a successful treatment mostly on a compensation of this defect. The Occurrence of rickets has gone through improved nutrition and the introduction of the Vitamin-D prophylaxis for infants.

Table of contents

A brief Overview

The following Overview presents a short summary of the below detailed information about the symptoms of osteomalacia or rickets:

  • Definition: softening of the bones is a systemic bone disease. In the age of the child you will be referred to as rickets, and, later, the term osteomalacia is used. Inadequate mineralization of bone results in this disease to a soft and deformable bone.
  • Symptoms: Often fall in adults rather non-specific symptoms, such as dull aching bone pain and muscle weakness. Later it comes to deformations of the skeleton and in the case of children, often to O – or X-legs. A rickets manifests itself in addition to many other symptoms, also through interference in the formation of bones and teeth and softened bones of the skull and ribs swelling (rickety rosary).
  • Causes: the main cause is a permanent under-supply of Vitamin D. associated with a reduced incorporation of calcium in the bones. Furthermore, there is also other reason can be diseases, or metabolic or organ malfunctions, the trigger for the disease.
  • Diagnosis: the first Point to a softening of the bones are, as a rule, different blood values are determined, as well as x-rays and skeletal scintigraphy performed. In addition, a measurement of bone density and, where appropriate, a bone biopsy may be useful.
  • Treatment: Are other basic disease, they are at the forefront in the treatment. This is not the case, be treated in the first place, the deficiency symptoms of Vitamin-D and calcium, so as to achieve a remineralization of the bones. In addition to a healthy diet, sufficient Vitamin D and calcium, can also support a variety of natural healing the healing process in addition.

Definition

The softening of the bones is a systemic disease of the bone skeleton. The disease occurs in childhood, it is referred to as rickets (“the English disease”). In adulthood, one speaks of a osteomalacia. These two diseases are associated with the group of Vitamin D-deficiency diseases, as one of the present Vitamin-D deficiency as a main cause. This deficiency, or other metabolic and functional disorders lead to inadequate mineralization of the bones, which soften then, and increasingly flexible and malleable. This is also the fundamental difference to osteoporosis, to with it a loss of strength of the bone, but to an excessive loss of bone mass. Furthermore, it is induced a tumor (to be distinguished from a General osteomalacia oncogenic) osteomalacia.

Due to improved care and nutrition of infants and young children, which also includes a Vitamin D prophylaxis in the first year of life, nutritional rickets is very rare. As a result of other underlying diseases as a trigger in you but still, as well as the higher age occurring osteomalacia.

Symptoms

In addition to the complaint, images of the possible reasons is diseases, osteomalacia manifests itself in a Grown-up rather uncharacteristic. The most common cause of the following symptoms:

  • non-specific, dull bone pain,
  • Muscle weakness,
  • fast fatigue,
  • increasing Curvature and deformation of the skeleton.

The mineralization disorder in the bones leads to fatigue and Overwork of the entire skeleton and, in particular, of the heavily contaminated areas such as the spine, hips and extremities. In the early stage of the disease, difficulty walking, not to fall rarely referred to as a so-called “waddling gait develops”, and, as a result of a muscle weakness of big gluteal muscle occur. Progressively it comes to bone deformations, which can cause, for example, the training of a hump, O-legs or X-legs (especially in children). As a complication, it also comes to the so-called “fatigue fractures”.

Other typical signs of the disease in children with rickets, the following phenomena are, among others:

  • inadequate tooth formation, tooth enamel defects and caries formation,
  • Growth delays,
  • late the skull Seal the seams,
  • Softening of the skull bones (Craniotabes),
  • visible ribs, swelling on the Breast bone between the cartilage and the bones (rickety rosary).

In addition, the nonspecific symptoms of increased irritability, Startle can be observed, especially in children, and General unrest, as well as a flabby muscles. As a significant Symptom in infants, even a flabby abdominal wall (“frog belly”). Sometimes, blockages, seizures, and excessive sweating (head welding) are beyond.

Causes

In the bone metabolic process, Vitamin D (Kalziferol) takes on an important function in that it promotes the absorption of calcium from the intestine and kidney and, therefore, the necessary deposition of calcium in the bones. This is the only way the bones get their hardness and strength that you need for everyday loads.

The main cause of osteomalacia and rickets is a demonstrable permanent lack of bone-strengthening Vitamin D, due to a lack of calcium or a reduced incorporation of calcium in the bones. In the course of the disease there is decreased bone mineralization, which the bone consists at an inflated share of the soft bone matrix.

Most commonly inadequate Vitamin D supply in the body is associated with a lack of light, as the UV-B radiation of the sunlight is for the education and training contributes significantly. Especially people, the veil, for example, for religious reasons, or only rarely in the daylight Outdoors are at risk as a consequence. A Vitamin-D deficiency is shown in this country, especially in the Winter. In addition, people with a dark skin color, living in the relatively poor Northern Europe, there is an increased risk of disease, because they are not able to produce Vitamin D in sufficient quantity.

In addition to reduced sun exposure and metabolism, or dysfunction of some organs as a trigger for a softening of the bones in question. Plenty of sun is guaranteed no radiation, are primarily the skin, the liver, the intestine and the kidney in the production of the so-called bone vitamin involved.

A possible disorder in the digestive tract, the syndrome of Malabsorption, wherein a Splitting and Recycling of certain elements from the food is prevented, and with a softening of the bones. In addition to other reason, inflammatory bowel disease disorders, renal dysfunction or liver cirrhosis as causes should be considered. This affects mostly older people.

In the case of children is brought, among other things, the Existence of rickets, with congenital disease called phosphate diabetes. In this disease there is an increased phosphate excretion and, consequently, low Phosphate levels in the blood, which leads to the mineralization disorders of bone.

But also some nutritional and enzyme deficiencies (for example phosphatase deficiency), enzyme defects, and certain drugs used for epilepsy are associated with the deficiency of Vitamin D or calcium. In addition, mild symptoms of osteomalacia can occur during pregnancy and lactation.

Diagnosis

The first references to the Existence of osteomalacia or rickets, the General medical examination. In the patient survey (medical history) should be clarified, whether it has been in the family already there were cases of softening of the bones.

By means of a blood examination in the disease is due to different values. In General, increased evidence for the enzyme alkaline Phosphatase and the parathyroid hormone (parathyroid hormone). Usually, the laboratory results low levels of Vitamin D and calcium levels, and possibly also a decreased Phosphate levels (kidney disease).

In order to examine the bones and their structure and condition better, there are procedures such as x-rays and skeletal scintigraphy. In the x-ray image of the diseased, softened, and deformed bones appear with a “washed-out” structure. The scintigraphy of the bone points, mostly on an elevated bone metabolism. The low proportion of minerals in the bone matrix can be determined by a measurement of bone density. Under certain circumstances, a bone biopsy from the iliac crest to the other Diagnostic coverage may be helpful.

Treatment

In General, an early diagnosed osteomalacia is considered to be treatable. The earlier the disease is detected, the less the consequential damages are to be expected. Are neither basic reason is encountered diseases known to still have strong bones deformations, is the primary goal of any therapy on the remineralization of diseased bone. This is achieved primarily through a sufficient intake of Vitamin D and calcium.

According to the Robert Koch Institute in each of North Europeans should be enough in the Sunny months from spring to autumn for a replenishment of Vitamin D storage. In this regard, the General recommendation is for a daily stay in the open, about 15 to 20 minutes. At least the face and arms to the sun unprotected will be exposed to. Whether sufficient Vitamin D can be produced, but this depends on various factors.

On medical advice, where appropriate, also Vitamin D supplements or injections may be useful. In 2012, the German society for nutrition has increased their recommendation and talks currently for a daily Vitamin D intake of 20 µg, respectively, in the first year of life of 10 µg. In addition to prophylaxis in the first year of life (or until the second Winter of life) should, therefore, also young people and adults, appropriate amounts of Vitamin D as a dietary Supplement.

In principle, on a Vitamin D-and calcium – rich diet should be taken. Important food for certain species of fish, dairy products, eggs, various mushrooms, Avocados, Kale, broccoli, legumes, millet and whole-grain products are in this context. Even alkaline foods can have a positive impact.

Basic diseases such as liver diseases, diseases or the intestine, kidney disease, these therapist are in the foreground. It leads to phosphates in the case of renal dysfunction, among other things, and alkalizing substances.

Naturopathic Treatment

In particular, malfunctions that lead to decreased absorption of calcium through the intestinal mucosa and thus to a softening of the bones require, in the Natural medicine into account. To do this, food intolerances, gut dysbiosis, Leaky count-Good-syndrome and fungal infections, which are often also each other.

Even if can not be expected that osteomalacia or rickets biochemical therapies with natural healing treatable, yet offer different natural remedies to be a promising support for the healing process. The light therapy (daylight lamp, UV-B-lamp), for example, the application or the homeopathy.

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Furthermore, the application of schüssler salts are used, the different physical processes associated with the Vitamin D-the budget boost. In particular, the salts (Calcium fluoratum) and number two (Calcium phosphoricum) can be applied, among other things, in the case of softening of the bones and disturbances in the bone formation process. Often a combination of these two salts with the number eleven (Silicea) – is; a salt that regulates, among other things, the calcium metabolism – in osteomalacia and rickets. (jvs, cs; updated on 10.12.2018)

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