Using Growth Hormone in Short Kids

Therapy May Be Indicated Under Certain Conditions

Boy stands next to ruler on wall to measure height
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Parents sometimes worry if a child, especially a son, is substantially shorter than other children. While this may cause distress, either to you or the child, in most cases it is not a problem insofar as the child’s health is concerned.

There are times, however, when a parent’s concerns are warranted, particularly if the rate of growth has suddenly and inexplicably slowed. This slowness of growth may be associated with a genetic disorder, an underactive thyroid gland, or even certain illnesses.

In other instances, the child may be diagnosed with a condition called idiopathic short stature, meaning shortness occurring for no known reason.

Under certain conditions, parents may opt to treat their child with growth hormone therapy. It a long-term treatment meant to stimulate growth in children who either have a specific hormonal deficiency or diseases that impede growth.

Understanding Growth Hormone

Hormones are chemicals produced by certain organs of the body, most predominately the endocrine and pituitary glands. The pituitary gland is the one responsible for producing hormones that promote the growth of body tissues.

Growth hormone (GH), also known as somatotropin, is one such hormone. It stimulates growth by raising the concentration of glucose, free fatty acids, and IGF-1 (a protein central to childhood growth). By doing so, cells are able to regenerate and build muscle, bones, and other vital tissues.

Other hormones produced by the pituitary gland include:

  • thyroid stimulating hormone (TSH) which causes the thyroid gland to produce hormones key to body metabolism and growth
  • adrenocorticotropic hormone (ACTH) which causes the adrenal gland to produce adrenaline (the excess of which can stunt growth)
  • follicle stimulating hormone (FSH) and luteinizing hormone (LH) which causes the sex organs to produce hormones key to growth spurts during puberty

    The inhibition or overproduction of these hormones can impact growth in children, sometimes profoundly.

    In 2003, The U.S. Food and Drug Administration (FDA) approved the use of GH for children in the bottom one percent for height for their age group or failure to grow due to chronic kidney disease, Prader-Willi Syndrome, Turner's Syndrome, Noonan Syndrome, and other medical disorders.

    Determining If Your Child Needs Growth Hormone

    Pediatricians are not usually concerned if a child is short. Where it become a problem is when the child is developing at a certain rate but then suddenly falls off the growth curve.

    For example, if your son is on the fifth percentile in height (meaning that 95 percent of boys his age are bigger than him), that is not considered a problem in and of itself. If, however, the boy suddenly drops from the fifth to the first percentile, that sudden slowing would certainly warrant investigation.

    To do so, a doctor would typically perform a physical exam and run a series of blood tests to identify hormone deficiencies or any other conditions associated with slowed growth. X-rays may be also be taken to compare see how bone development compares to the child’s chronological age.

    A child with GH deficiency will typically be short with a chubby build and an immature face. Unlike achondroplasia, a type of dwarfism, the child will be small but proportionate.

    Growth Hormone Treatment in Children

    Growth hormone is typically given on a daily basis by injection. Certain conditions may reduce the frequency to as few as three shots per week. Treatment is typically prescribed over the course of years and can go on for as long as there is a potential for growth.

    In addition to GH, other hormones may need to be prescribed to ensure that hormonal levels are all balanced and that the child has the best opportunity for normal growth.

    In terms of response, parents will not likely see any growth spurts in the short- to medium-term. Most, however, will notice an increase in a child’s appetite accompanied by a loss of body fat.

    It’s important that parents have reasonable expectations with regards to the child’s growth potential. On average, a child will add anywhere between one to three inches by the approach of adulthood.

    A Word From Verywell

    If considering GH therapy for your child, it’s important to discuss your expectations with your doctor. This not only includes discussing how tall your child might get but how you and your child feel about shortness in general. It is often these attitudes that decide whether or not treatment is appropriate, especially if the child is healthy.

    If your feelings are negative, no amount of growth hormone can alter those perceptions. If treatment is pursued, it should alway incorporate skill-building tools to better promote self-esteem in the child.

    It is also important to consider the cost of therapy which can run anywhere from $10,000 to $40,000 per year. Few health insurance providers will cover the cost unless it is associated with a serious medical condition. Even then, it will require specialist motivation (and significant arm twisting) to gain approval for long-term treatment.

    Sources:

    Grimberg, A.; DiVall, S.; Polychronakos, C.; et al. “Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency.” Horm Res Paediatr. 2016; 86:361.

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