Growth hormone deficiency
When a doctor says that a child has growth hormone deficiency (GHD), it means that the child’s body does not make enough growth hormone. Growth hormone is a natural protein produced by the pituitary gland. This gland is the size of a walnut and is found at the base of the brain. A child needs growth hormone for growth and body development during childhood and maybe also later in life.
How will this condition affect a child’s height?
Without treatment a child with GHD will usually grow less than 4–5cm (~2 inches) a year. Quite often, the child will grow normally until the age of 2 or 3 and then growth begins to slow down. It’s important to realise that a child may be smaller than average, but will have normal body proportions. In other words, children with GHD tend to seem younger and have more body fat than children of the same age who are growing normally.
How is GHD diagnosed?
Doctors normally test children for GHD when other causes of lack of growth have been ruled out. A child may have to take a special medicine to stimulate the pituitary gland, which is where growth hormone is produced within the body. In children with GHD, the pituitary gland releases far less growth hormone than normal in response to this stimulation.
The importance of early treatment
The earlier the diagnosis of GHD in a child, the earlier treatment can be started and hence the better the prospects of their eventually reaching normal adult height. Children who are shorter than normal are often seen by a paediatric endocrinologist, who is a doctor specialising in treating children with growth problems.
Treating growth hormone deficiency
Once a child is diagnosed as having GHD, daily growth hormone injections can help the child catch up with the growth of other children of the same age during early childhood. Continuing the injections helps maintain normal growth later in childhood, with the final aim of achieving an adult height within the normal range.
The response to growth hormone treatment varies from one individual to another, but most children who receive treatment over several years will reach a normal or near normal adult height.
Growth hormone injections are normally given once-daily in the evening. At the beginning parents are trained to give these injections if the child is very young. Later on, children can inject themselves when they feel confident enough. Devices are now available that make injecting growth hormone much simpler, more comfortable and less painful. This has been achieved through advances in design such as automated needle insertion and the use of very fine needles. There is a wide choice of devices available, and whilst some require mixing before use and refrigeration once opened, others do not.
To help the doctor select an injection device that matches your requirements, it may help to read the page discussing the features of the various devices.
Meeting the challenge of growth problems
If a child doesn’t grow as fast as other children, this can have an impact on the whole family. Many children who are shorter than their schoolmates may experience emotional problems, bullying and difficulties with daily activities such as sports. For these reasons, it’s important to explain to a child that things will improve once the growth hormone treatment has been working for a while. In the meantime, remember to act towards a child according to the age they actually are, not the age they look.
How long does a child need treatment?
In most cases treatment with growth hormone is needed until the end of puberty. However, if a child has severe GHD, it is important to continue treatment until the child develops muscles and bone mass with the same strength as other children. This normally means treating until the age of 25. It is very important to keep in mind that many people will benefit from growth hormone treatment for many years after that.
To learn more about GHD, explore Growth Hormone: An Inside Look. This interactive educational resource for growth hormone patients and their relatives illustrates how growth, growth hormone deficiency, and growth hormone treatment function inside the human body.
APROM ID# 3070. May 2011.