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home:diseases:rickets [10.17.2018] – [Further reading] sallieqhome:diseases:rickets [09.14.2022] (current) – external edit 127.0.0.1
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 ===== Role of phosphorous ===== ===== Role of phosphorous =====
  
-In a 2007 study, Harvard Medical School researchers engineered mice without vitamin D receptors (VDRs). Since vitamin D can have no effect on the body unless it can bind to the VDR, the mice could use no vitamin D whatsoever in their bodies. The researchers found that if the mice were given a diet high in calcium and phosphorous they did not develop rickets and their bones were just as strong as normal mice with active Vitamin D Receptors.(({{pubmed>long:17332234}}))+In a 2007 study, Harvard Medical School researchers engineered mice without vitamin D receptors (VDRs). Since vitamin D can have no effect on the body unless it can bind to the VDR, the mice could use no vitamin D whatsoever in their bodies. The researchers found that if the mice were given a diet high in calcium and phosphorous they did not develop rickets and their bones were just as strong as normal mice with active Vitamin D Receptors.(({{pmid>long:17332234}}))
  
  
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-A second study by the same research team at Harvard corrected rickets by replacing calcium and phosphate ions in the bloodstream of mice without Vitamin D Receptors, thereby confirming the results. The team concluded that rickets is not caused by a deficiency of vitamin D but instead results from hypophosphatemia, a condition where the level of phosphorous in the blood is too low.(({{pubmed>long:16831920}}))+A second study by the same research team at Harvard corrected rickets by replacing calcium and phosphate ions in the bloodstream of mice without Vitamin D Receptors, thereby confirming the results. The team concluded that rickets is not caused by a deficiency of vitamin D but instead results from hypophosphatemia, a condition where the level of phosphorous in the blood is too low.(({{pmid>long:16831920}}))
  
-This work is also echoed by Schubert and De Luca who found that muscle weakness in hypophosphatemic rats could be corrected with supplementation of phosphorus, and that hypocalcemia together with vitamin D deficiency did not produce muscle weakness.(({{pubmed>long:20515645}})) +This work is also echoed by Schubert and De Luca who found that muscle weakness in hypophosphatemic rats could be corrected with supplementation of phosphorus, and that hypocalcemia together with vitamin D deficiency did not produce muscle weakness.(({{pmid>long:20515645}})) 
  
 ===== Role of calcium ===== ===== Role of calcium =====
  
-According to a 2000 paper by Goswami //et al.//, "Despite abundant sunlight, rickets and osteomalacia are prevalent in South Asian countries. The cause of this paradox is not clear."(({{pubmed>long:10919943}})) Interestingly, the paper goes on to say that subjects who are at risk for rickets had low dietary calcium consumption and significantly low calcium consumption.+According to a 2000 paper by Goswami //et al.//, "Despite abundant sunlight, rickets and osteomalacia are prevalent in South Asian countries. The cause of this paradox is not clear."(({{pmid>long:10919943}})) Interestingly, the paper goes on to say that subjects who are at risk for rickets had low dietary calcium consumption and significantly low calcium consumption.
  
 Along with phosphorous, low calcium plays a role in rickets. Diminished levels of calcium cause an increase in parathyroid hormone, which subsequently causes the body to excrete too much phosphorous. This causes the level of phosphate in the body to drop, leading to the altered bone formation seen in rickets. Along with phosphorous, low calcium plays a role in rickets. Diminished levels of calcium cause an increase in parathyroid hormone, which subsequently causes the body to excrete too much phosphorous. This causes the level of phosphate in the body to drop, leading to the altered bone formation seen in rickets.
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 //**Joyce Waterhouse, PhD**// </blockquote> //**Joyce Waterhouse, PhD**// </blockquote>
  
-Other studies have confirmed that a low level of calcium can lead to rickets. One team assessed the absorption of calcium in 15 Nigerian children with active rickets. They found that all 15 children had resolution or improvement of rickets after six months of treatment with calcium supplements. (({{pubmed>long:15531695}}))+Other studies have confirmed that a low level of calcium can lead to rickets. One team assessed the absorption of calcium in 15 Nigerian children with active rickets. They found that all 15 children had resolution or improvement of rickets after six months of treatment with calcium supplements. (({{pmid>long:15531695}}))
  
-This paper is acknowledged by the {{https://www.ars.usda.gov/research/publications/publication/?seqNo115=169216|Children's Nutrition Research Center: Houston, TX}}+This paper is acknowledged by the  [[https://www.ars.usda.gov/research/publications/publication/?seqNo115=169216|Children's Nutrition Research Center: Houston, TX]]
  
 <blockquote>**Interpretive Summary**: Rickets in toddlers is a large problem in parts of Africa, especially Nigeria. It is not due to vitamin D deficiency but is caused by not having enough calcium in the diet. We wanted to know whether there was a problem with absorbing calcium in children in Nigeria. We measured how much calcium was absorbed in a group of children with rickets and compared that with how much was absorbed by children that did not have rickets. We found that children with rickets were able to absorb calcium normally. This means that it is probably another factor in the diet or an overall lack of calcium that causes the rickets rather than an inability of some children to absorb the calcium that is in their diet. </blockquote> <blockquote>**Interpretive Summary**: Rickets in toddlers is a large problem in parts of Africa, especially Nigeria. It is not due to vitamin D deficiency but is caused by not having enough calcium in the diet. We wanted to know whether there was a problem with absorbing calcium in children in Nigeria. We measured how much calcium was absorbed in a group of children with rickets and compared that with how much was absorbed by children that did not have rickets. We found that children with rickets were able to absorb calcium normally. This means that it is probably another factor in the diet or an overall lack of calcium that causes the rickets rather than an inability of some children to absorb the calcium that is in their diet. </blockquote>
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 <blockquote>Persons with a 25(OH)D<sub>3</sub> concentration <20 nmol/L probably have rickets or osteomalacia. <blockquote>Persons with a 25(OH)D<sub>3</sub> concentration <20 nmol/L probably have rickets or osteomalacia.
  
-//**Dr. Anthony Norman**//(({{pubmed>long:18689389}})) +//**Dr. Anthony Norman**//(({{pmid>long:18689389}})) 
 </blockquote> </blockquote>
  
-However, a randomized double-blind placebo-controlled trial at Creighton University Medical Center found no beneficial effect of vitamin D on calcium absorption in older women.(({{pubmed>long:22855333}}))+However, a randomized double-blind placebo-controlled trial at Creighton University Medical Center found no beneficial effect of vitamin D on calcium absorption in older women.(({{pmid>long:22855333}}))
 ==== Marshall Protocol patients ==== ==== Marshall Protocol patients ====
  
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 <blockquote>We did not see any cases of rickets in any of the 80 study participants; as such, there was no evidence that universal supplementation of vitamin D in breast-fed infants is either necessary or efficacious for rickets prevention in southern Louisiana.... This suggests that the current recommendations for universal vitamin D supplementation of breast-fed infants throughout the United States may need to be revised. <blockquote>We did not see any cases of rickets in any of the 80 study participants; as such, there was no evidence that universal supplementation of vitamin D in breast-fed infants is either necessary or efficacious for rickets prevention in southern Louisiana.... This suggests that the current recommendations for universal vitamin D supplementation of breast-fed infants throughout the United States may need to be revised.
  
-//**Tulasi Ponnapakkam, PhD** (({{pubmed>long:20724336}}))//</blockquote>+//**Tulasi Ponnapakkam, PhD** (({{pmid>long:20724336}}))//</blockquote>
  
  
 ==== Nigerian children ==== ==== Nigerian children ====
  
-Thacher //et al// conducted a case-control study to determine factors associated with rickets in Nigerian children. The study compared 123 Nigerian children who had rickets with matched control subjects. Of the 134 subjects with rickets, only 46 subjects (37%) had 25-hydroxyvitamin D values <30 nmol/L (12 ng/mL).(({{pubmed>long:10969262}})) The team concluded:+Thacher //et al// conducted a case-control study to determine factors associated with rickets in Nigerian children. The study compared 123 Nigerian children who had rickets with matched control subjects. Of the 134 subjects with rickets, only 46 subjects (37%) had 25-hydroxyvitamin D values <30 nmol/L (12 ng/mL).(({{pmid>long:10969262}})) The team concluded:
  
 <blockquote> <blockquote>
 Vitamin D deficiency appears unlikely to be the primary etiologic factor of rickets in African children. Moreover, low dietary calcium intake alone does not account for rickets. Insufficient dietary calcium probably interacts with genetic, hormonal, and other nutritional factors to cause rickets in susceptible children. Vitamin D deficiency appears unlikely to be the primary etiologic factor of rickets in African children. Moreover, low dietary calcium intake alone does not account for rickets. Insufficient dietary calcium probably interacts with genetic, hormonal, and other nutritional factors to cause rickets in susceptible children.
  
-//**Thacher** et al.// (({{pubmed>long:10969262}})) </blockquote>+//**Thacher** et al.// (({{pmid>long:10969262}})) </blockquote>
  
  
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 //**Marie Demay**, personal communication//</blockquote> //**Marie Demay**, personal communication//</blockquote>
  
-As a nod to this molecular evidence, the [[http://arsserv0.tamu.edu/research/publications/publications.htm?SEQ_NO_115=169216|US Department of Agriculture]] has said, “Rickets in toddlers is a large problem in parts of Africa, especially Nigeria. It is not due to vitamin D deficiency but is caused by not having enough calcium in the diet.”+As a nod to this molecular evidence, the [[https://arsserv0.tamu.edu/research/publications/publications.htm?SEQ_NO_115=169216|US Department of Agriculture]] has said, “Rickets in toddlers is a large problem in parts of Africa, especially Nigeria. It is not due to vitamin D deficiency but is caused by not having enough calcium in the diet.”
  
  
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 Robins (2009) notes that nearly half of all African Americans are classified as vitamin-D deficient and yet show no signs of calcium deficiency, which would be a logical result of vitamin D deficiency. Indeed, they “have a lower prevalence of osteoporosis, a lower incidence of fractures and a higher bone mineral density than white Americans, who generally exhibit a much more favourable vitamin D status.” He also cites a survey of 232 black (East African) immigrant children in Melbourne, Australia, among whom 87% had levels below 50 nmol/L and 44% below 25 nmol/L. None had rickets—the usual sign of vitamin-D deficiency in children (McGillivray et al., 2007). Robins (2009) notes that nearly half of all African Americans are classified as vitamin-D deficient and yet show no signs of calcium deficiency, which would be a logical result of vitamin D deficiency. Indeed, they “have a lower prevalence of osteoporosis, a lower incidence of fractures and a higher bone mineral density than white Americans, who generally exhibit a much more favourable vitamin D status.” He also cites a survey of 232 black (East African) immigrant children in Melbourne, Australia, among whom 87% had levels below 50 nmol/L and 44% below 25 nmol/L. None had rickets—the usual sign of vitamin-D deficiency in children (McGillivray et al., 2007).
  
-//**Peter Frost, PhD**, [[http://evoandproud.blogspot.com/2009/07/african-americans-and-vitamin-d.html|African Americans and vitamin D]]// </blockquote> +//**Peter Frost, PhD**, [[https://evoandproud.blogspot.com/2009/07/african-americans-and-vitamin-d.html|African Americans and vitamin D]]// </blockquote> 
  
 ===== Reexamining the cause of rickets ===== ===== Reexamining the cause of rickets =====
  
-The role of calcium is being reexamined in North America as well. DeLucia //et al.// emphasize that “Nutritional calcium deficiency may occur in North American infants and is not limited to the setting of developing countries.”(({{pubmed>long:12915633}})) Some attribute a recent small increase in rickets in North America to an increase in breast feeding, claiming that this is due to breast milk being low in vitamin D. However, breast feeding is also often accompanied by a diet low in calcium, particularly after weaning (e.g., juices rather than milk). Also, in recent years, more people have begun to avoid milk due to a greater awareness of lactose intolerance.+The role of calcium is being reexamined in North America as well. DeLucia //et al.// emphasize that “Nutritional calcium deficiency may occur in North American infants and is not limited to the setting of developing countries.”(({{pmid>long:12915633}})) Some attribute a recent small increase in rickets in North America to an increase in breast feeding, claiming that this is due to breast milk being low in vitamin D. However, breast feeding is also often accompanied by a diet low in calcium, particularly after weaning (e.g., juices rather than milk). Also, in recent years, more people have begun to avoid milk due to a greater awareness of lactose intolerance.
  
-Trevor Marshall, PhD has suggested that rickets may be related to Th1 inflammation, as a number of patients on the [[home:protocol|Marshall Protocol]] with [[home:pathogenesis:th1spectrum|Th1 illnesses]] and their close relatives report having had rickets as children. Proponent of vitamin D supplementation claim that vitamin D added to the food supply was responsible for a historical decrease in rickets. But the history of rickets shows that a typical rickets case often had a history of smallpox, measles, or whooping cough.(({{pubmed>long:4862158}})) Plus, a 1997 study in Ethiopia found a high association between pneumonia and rickets.(({{pubmed>long:9269215}})) This provides more suggestive evidence that infection, either obvious and acute, or subtle and chronic, may play a role in the development of rickets and may exacerbate the effects of a low calcium diet.+Trevor Marshall, PhD has suggested that rickets may be related to Th1 inflammation, as a number of patients on the [[home:protocol|Marshall Protocol]] with [[home:pathogenesis:th1spectrum|Th1 illnesses]] and their close relatives report having had rickets as children. Proponent of vitamin D supplementation claim that vitamin D added to the food supply was responsible for a historical decrease in rickets. But the history of rickets shows that a typical rickets case often had a history of smallpox, measles, or whooping cough.(({{pmid>long:4862158}})) Plus, a 1997 study in Ethiopia found a high association between pneumonia and rickets.(({{pmid>long:9269215}})) This provides more suggestive evidence that infection, either obvious and acute, or subtle and chronic, may play a role in the development of rickets and may exacerbate the effects of a low calcium diet.
  
  
 ===== Further reading ===== ===== Further reading =====
  
-  * [[http://www.ncbi.nlm.nih.gov/pubmed/22837003|ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation]] – In their 2012 //Nature// study, Hashimoto //et al.// provide a molecular explanation for how malnutrition promotes inflammation, "rogue" bacteria, and in the process diarrhea and other hallmarks of the condition.(({{pubmed>long:22837003}}))+  * [[https://www.ncbi.nlm.nih.gov/pubmed/22837003|ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation]] – In their 2012 //Nature// study, Hashimoto //et al.// provide a molecular explanation for how malnutrition promotes inflammation, "rogue" bacteria, and in the process diarrhea and other hallmarks of the condition.(({{pmid>long:22837003}}))
  
  
  
 {{tag>disease no_current_patients}} {{tag>disease no_current_patients}}
 +<nodisp>
 ===== Notes and comments ===== ===== Notes and comments =====
  
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   * include link to this article in the list of diseases   * include link to this article in the list of diseases
   * Legacy content   * Legacy content
-    * http://www.marshallprotocol.com/forum39/8687.html +    * https://www.marshallprotocol.com/forum39/8687.html 
  
 <blockquote>Marshall Protocol patients <blockquote>Marshall Protocol patients
 In fact, many of the patients on the Marshall Protocol have been avoiding consumption of vitamin D – some of them for several years – to the point where most patients in later stages of the treatment have 25-D levels below the detectable threshold. Yet, there has not been a single reported case of rickets.</blockquote> The above should be removed as it gives no meaning in light of the fact that olmesartan is vitamin D, sort of.   In fact, many of the patients on the Marshall Protocol have been avoiding consumption of vitamin D – some of them for several years – to the point where most patients in later stages of the treatment have 25-D levels below the detectable threshold. Yet, there has not been a single reported case of rickets.</blockquote> The above should be removed as it gives no meaning in light of the fact that olmesartan is vitamin D, sort of.  
  
-===== References =====+===== References =====</nodisp> 
home/diseases/rickets.txt · Last modified: 09.14.2022 by 127.0.0.1
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