Growth Hormone Deficiency
When a child's body doesn't make enough growth hormone (GH), it's called growth hormone deficiency (GHD). It can start before birth or happen later in childhood. Growth hormone deficiency affects how much a child grows, and it can cause other symptoms. Growth hormone deficiency, by itself, does not affect a child’s brain or mental abilities.
What causes growth hormone deficiency?
Congenital growth hormone deficiency: Growth hormone is made by the pituitary gland. This is a tiny gland located at the base of the brain. It’s attached to a part of the brain called the hypothalamus. In some people, the pituitary or hypothalamus may not form correctly before birth.
Acquired growth hormone deficiency: GHD may develop during childhood or in adulthood after a process damages the pituitary gland or the surrounding brain area. This can be from a traumatic or surgical brain injury, a tumor, or an infection, or as a side effect of radiation treatments to the brain. When this happens, a person can develop growth hormone deficiency.
Growth hormone deficiency may also be caused by genetic syndromes. In most cases, the cause remains unknown.
What are the symptoms of growth hormone deficiency?
Symptoms can be different in each child, and can include:
How is growth hormone deficiency diagnosed?
The symptoms of growth hormone deficiency are like those of some other health conditions. Because of this, your child’s health care provider may need to look for other problems first. They will ask you about your child’s past health. Your child will have a physical exam and may have blood tests. The provider may advise an imaging test of the pituitary gland. They may also advise an X-ray of the left hand (called a bone age test).
A GH stimulation test may be done. During this test, the child is given medicines that stimulate the pituitary to release GH. If GH levels in the blood don’t rise to a certain level, it can mean that the pituitary isn't making enough GH.
The provider will also track your child’s growth over a period of time. They will likely refer your child to a specialist in hormone problems (pediatric endocrinologist).
How is growth hormone deficiency treated?
Growth hormone deficiency is treated with daily growth hormone shots (injections) under the skin at bedtime. More recently, sustained-release GH has become available as a weekly injection. But not all children respond to the treatment. Treatment should start when the child is as young as possible. It should continue until growth slows to less than 1 inch per year.
The length of time each child receives the shots varies. Some may get shots for the rest of their lives. They should keep being tested to make sure the shots are still needed. Talk with your health care provider about possible side effects and when they should be reported.