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What is growth hormone?

Growth hormone (GH) is a substance in the body that helps children grow and develop as they should. It is made by the pituitary gland, located at the base of the brain.

What is a growth hormone deficiency?

A growth hormone deficiency is when the body does not make enough growth hormone for a child to grow at a normal rate.

There are two types of growth hormone deficiency:

• Congenital growth hormone deficiency: This is the type of deficiency that some babies are born with. They may also have problems with other hormones. Although born with this condition, some babies appear to be growing normally until they are 6 to 12 months old.
• Acquired growth hormone deficiency occurs when the body stops making enough growth hormone to grow normally. It can start at any time in childhood.

What are the signs and symptoms of a growth hormone deficiency?

Doctors measure children’s height at regular checkups . Over time, doctors can see how fast a child is growing. If a child is growing much more slowly than most children her age, this is called growth retardation .

One of the most visible signs of stunting is a child who is much shorter than most other children his or her age. This is known as short stature . But some children can be stunted even without being short.

Other signs and symptoms of a growth hormone deficiency include the following:

• appear much younger than other children of the same age
• have a high-pitched voice
• have very fine hair
• teeth coming in later than normal
• slow or late puberty
• in boys, reduced penis size

Causes of growth hormone deficiency

Doctors often don’t know why a child has growth hormone deficiency. When the cause is found, it is usually related to problems with the pituitary gland or other parts of the brain around it. Brain tumors , head injuries, and radiation therapy to the brain can also cause growth hormone deficiency.

How are growth hormone deficiencies diagnosed?

If your child has delayed growth or short stature, even in the absence of any other signs or symptoms, the doctor may refer them to a pediatric endocrinologist . This is a doctor who specializes in hormones and the growth of children.

The endocrinologist will study your child’s growth and examine him closely. The doctor will order some tests for your child to detect possible growth hormone deficiency, such as the following:

• Blood test. There are no simple tests to measure growth hormone levels. This is because this hormone changes concentration over time. It is manufactured in short downloads. This makes measuring it very complicated, because there is no way of knowing when the discharge will occur. Since there is no easy way to directly measure growth hormone levels, doctors measure the levels of two proteins that work together with growth hormone:
  • insulin-like growth factor I (IGF-I)
  • insulin-like growth factor-binding protein 3 (IGFPB-3)
• Bone age radiographs. These are X- rays of one of his son’s hands and wrists. An expert compares the X-rays of his son with those of other children his age, and gives his bones an age in years. If your child’s bone age is much younger than her actual age, it may be a sign of growth hormone deficiency.
• Growth hormone stimulation test. This test is done when other tests suggest that a child might have growth hormone deficiency. Doctors will first ask the child not to eat or drink for a certain number of hours, usually at night. This is called fasting. The doctor will give the child a medicine that should make him give off a burst of growth hormone. A nurse will then draw your blood at several different times to measure your growth hormone levels. Obtaining low levels of this hormone serves to confirm the diagnosis of growth hormone deficiency.
• Brain magnetic resonance imaging (MRI). This detailed brain image helps doctors see if there is a problem with the pituitary gland or surrounding parts of the brain that could be causing growth hormone deficiency.

How are growth hormone deficiencies treated?

Treatment of growth hormone deficiencies consists of receiving a daily injection of this hormone. Parents learn to give these injections at home so they don’t have to go to the doctor’s office every day to get them for their children.

The endocrinologist will tell you how often your child should be checked when treatment begins. At each visit, the doctor:

• monitor your child’s growth
• order tests to see how your child’s body is responding to the medicine
• adjust the dose, if necessary

Side effects are rare when using typical doses to treat growth hormone deficiency. Tell the doctor if your child has  a headache , vision changes, or a limp.

Treatment is usually done until growth is complete, usually in late adolescence.

What else should I know?

Growth hormone can speed up growth in a child with growth hormone deficiency. Children who start treatment with this hormone early are often better able to catch up with children their age than those who start later.

Many children with growth hormone deficiency who have no other medical problems and who are treated with daily injections of growth hormone no longer need them as adults. Most of them begin to make this hormone normally. Those who don’t start making it themselves may still need those injections as adults.