GHDA

Growth hormone deficiency in adults




For adults who are new to growth hormone treatment


When your doctor says that you have growth hormone deficiency (GHD), it means that your body does not make enough growth hormone. This hormone is a natural substance produced by the pituitary gland that is needed to maintain tissues such as bone, fat and muscle in healthy balance.

How will this condition affect your body?

Without treatment, GHD can cause various problems such as decreased vitality and lower ability to exercise, as well as poor memory. GHD can also have adverse effects on your body composition. These include:

  1. An increased amount of body fat, especially around the middle of the abdomen
  2. An increase in total cholesterol circulating in the blood, leading to a greater risk of heart and arterial disease
  3. A decrease in muscle mass, meaning that you are less able to exercise
  4. A weakening in the structure of your bones, resulting in a condition called osteoporosis

How is GHD diagnosed?

Adults with GHD often go to their doctor because of low energy levels and decreased ability to exercise. They may also have become more anxious and less able to get to sleep. To test for GHD, doctors often use a special medicine which stimulates the pituitary gland, which is where growth hormone is produced within the body. In people with GHD, the pituitary gland releases far less growth hormone than usual in response to this stimulation.

What are the causes of GHD?

Growth hormone deficiency that first appears in adulthood is called acquired GHD. This can be the result of damage to the pituitary gland due to disease, head injury or blockage of the blood supply. Damage may also result from previous surgical or radiotherapy treatment of the pituitary gland.

Restoring a healthy balance in growth hormone deficiency

If you are starting growth hormone therapy for the first time as an adult, you can expect to feel more energetic and ready to face life after 2–3 weeks of growth hormone therapy. As your doctor adjusts the dose of growth hormone in order to find exactly the right level for you, you should find that your treatment is restoring your body to its normal healthy balance. Within 6 months you should see a reduction in the amount of body fat, especially around your abdomen, and there should also be an increase in your muscle mass. After 5 years of treatment, bone mineral density has been found to improve by up to 10%, indicating a significant increase in bone strength. Continued therapy with growth hormone should help you live a more normal and healthy life.



For adults who’ve been treated with growth hormone since childhood


You’ll already know how important growth hormone treatment is for helping you reach an adult height that is similar to other people of the same age. However, as you reach adulthood, this hormone is also needed to maintain tissues such as bone, fat and muscle in healthy balance.

How can GHD affect your health in adulthood?

Without treatment, GHD can cause various problems such as decreased vitality and lower ability to exercise, as well as poor memory. GHD can also have adverse effects on the proportion of fat, muscle and bone in your body. This can have the following results:

  • An increase in the amount of body fat
  • A rise in your blood cholesterol value
  • A reduction in your muscle mass, making it more difficult to exercise
  • A weakening in structure of your bones

Why does your growth hormone treatment have to be reassessed?

After puberty the production of the body’s own growth hormone from the pituitary gland decreases rapidly until you are in your mid-20s. As you reach adulthood, your doctor will have to test the function of your pituitary gland to find out whether your body is still not producing enough GH for your age and whether your GHD still needs long-term treatment. If you are on GH treatment at the moment, your treatment may be stopped for 1–3 months while you are being reassessed. At some stage you may find that a specialist called an adult endocrinologist takes over your treatment in place of the paediatric endocrinologist who has been concerned with your growth over the years.

Will you still have to be treated with growth hormone when you reach adulthood?

If your GHD is classed as severe, your doctor may recommend that you continue with growth hormone treatment at least until you are aged 25, in order to avoid the affects of growth hormone deficiency on:

  1. Bone and muscles
  2. Overall body composition
  3. Physical development

When you are 25 years old, your doctor may carry out further tests to help him decide whether you need to continue with growth hormone injections indefinitely.

Maintaining a healthy balance in growth hormone deficiency

If you are continuing growth hormone therapy from adolescence into adulthood, the injections will help maintain a healthy body composition by keeping the right balance of fat and muscle while building up your bone strength. The treatment will also help maintain your vitality and energy levels so that you can enjoy life to the full.

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 when 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.



APROM ID# 1503. December 2009.