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How can vitamin D deficiency lead to rickets in children?

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Infographic showing estimated lives saved by childhood vaccinations worldwide from 1974 to 2024, with syringe-shaped bars for each disease. Measles tops the list at 93.71 million lives saved, followed by tetanus, whooping cough, and others, for a total of 153.84 million lives saved. — childhood disease and disorder Vaccines and the estimates of lives saved over the period 1974–2024.

Vitamin D is essential for maintaining bone rigidity because its active form, calcitriol, stimulates the small intestine to absorb calcium and phosphate, which are then deposited in the bones as calcium phosphate.1

When vitamin D is deficient, the body cannot efficiently absorb these minerals. This leads to low serum calcium levels, which triggers the parathyroid glands to secrete parathormone. While this hormone helps restore blood calcium levels by liberating calcium from the bones, it also promotes the excretion of phosphate through the kidneys.12

Consequently, although the body continues to produce the protein matrix (osteoid) for bone growth, this matrix remains poorly calcified. This lack of mineralization results in the softening of bones characteristic of rickets, leading to abnormal bone growth, skeletal deformities, and stunted stature in children.12