Growth Hormone Deficiency Explained

Kids and teens grow and go through puberty at different times. For girls, puberty usually begins between ages 8 and 13. For guys it often begins a bit later - between 10 and 15. You must have observed some teens develop a lot earlier, whereas others develop much later than other people of the same age. There's a medical reason why some people grow more slowly than usual.

Reasons of slow growth:

• Genetic Reason: If you're short, you may just have familial (genetic) short stature. Like short parents tend to have short children.

• Lack of Nutrition: Not getting adequate amounts of protein, calories, and other nutrients in your diet can also cause growth to slow, as well as a number of other chronic medical conditions such as kidney, heart, lung, and intestinal diseases.

• Sickle cell anemia: People with sickle cell anemia may also grow and develop more slowly. Sickle cell anemia is a blood disorder that affects hemoglobin the protein found in red blood cells (RBCs) that help to carry oxygen throughout the body. Sickle cell anemia occurs when a person inherits two abnormal genes (one from each parent) that cause their RBCs to change shape.

• Constitutional growth delay: These teens grow at a normal rate when they are younger kids, but they lag behind and don't start their pubertal development and their growth spurt until after most of their peers.

• Dwarfism: Dwarfism results from abnormal growth of the bones and cartilage in the body. In many forms of dwarfism the person has abnormal body proportions, such as noticeably short limbs.

• Hormones: Many diseases of the endocrine system, which is made up of the glands that produce hormones, can affect growth. Hormones are secreted by the endocrine glands and carried throughout the body in the bloodstream. The hypothalamus (part of the brain) controls the pituitary gland, which in turn releases some of the hormones that control growth and sexual development. Estrogen and testosterone are important hormones that drive sexual development and function and also play a role in growth.

• Hypothyroidism: This can cause slow growth because the thyroid gland isn't producing enough thyroid hormone which is responsible for proper growth.

• Turner syndrome: This is a genetic condition (due to a problem with a person's genes) that occurs in girls. It is caused by a missing or abnormal X chromosome. Girls with Turner syndrome tend to be short and don't usually undergo normal sexual development because their ovaries don't mature and function normally.

Growth Hormone Deficiency (GHD): One growth disorder that is specific to the hormones that govern growth is called growth hormone deficiency. This condition involves the pituitary gland, the small gland located at the base of the brain that produces growth hormone and other hormones. If the pituitary gland doesn't produce enough hormones for normal growth, growth slows down or stops.

Important Facts of Growth Hormone Deficiency:

• This occurs at any age.

• The most common sign in kids and teens is a slowing of growth to less than 2 inches (5 centimeters) a year.

• Kids with this disorder usually have normal body proportions.

• Growth hormone deficiency does not affect intelligence or brain function.

• Growth hormone deficiency usually affects only one person in a family and isn't generally passed on from parents to children.

Causes: In most cases, though, the cause of growth hormone deficiency is simply unexplained.

• Underdeveloped, damaged, or malfunctioning pituitary gland.

• Hypothalamus: This can happen before or during birth or can be caused later by an accident or trauma or certain diseases.

• Tumors near the pituitary gland, like craniopharyngioma, can also damage the hypothalamus and pituitary gland and affect growth.

Symptoms:

• Growth in Height: Affected children have an abnormally slow growth rate.

• Head: Head circumference increases normally in GHD.

• Adiposity: Due to deficient breakdown of fats, patients have a much higher level of adipose tissue than normal for their age, especially around the waist.

• Muscle: Due to poor protein synthesis, lean body mass, reflected particularly in muscle development, is correspondingly lower than normal for age.

• Genitals: Males are underdeveloped for their age, even when gonadotropin secretion is apparently normal.

• Blood Sugar Levels: Due to inadequate breakdown of glycogen into glucose, hypoglycemia can occur and seizures may arise if this is severe and untreated.

• Phenotypic Appearance: The above signs and symptoms lead to a "typical" phenotypic appearance for the GHD patient. Thus, as well as short stature, patients have a chubby appearance, and usually a high-pitched voice. They may seem precocious because their appearance suggests a younger child but their speech and abilities are that of an older child.

Treatment:

• Self Care: As growth hormone deficiency can cause a lack of energy and strength, patients should eat a balanced diet, get regular exercise, and get plenty of sleep.

• Medications: The doctor may prescribe growth hormone,also called somatropin (Humatrope, Genotropin). The drug is given as a shot a few times a weekthat is injected underneath the fat of the patient's skin.

• Hormone Therapy: Children and some adults with growth hormone deficiency will benefit from growth hormone therapy.The goals of treatment are to increase growth in children and restore energy, metabolism, and body composition.

Tips for the parents:

1. Treat your child according to age, not size. Also inform their teacher about the correct age.
2. Encourage your child to participate in physical activities he or she enjoys.

3. Increase your child's comfort at home by making sure that important items are within reach, such as the radio, television, stereo, books, etc.

4. If necessary, obtain professional counseling for yourself and/or your child.

5. Self-esteem reflects perceptions or feelings about oneself. Teasing and bullying can have a negative effect on any child's self-esteem. Keep the lines of communication open. Encourage your child to discuss any situations or circumstances that may be troubling him or her.

It can be tough having a growth disorder as a teen because it can affect a person's body image and self-esteem. Talking with a mental health professional is one way some people deal with feelings and concerns about their growth.

(Sources: emedicinehealth.com, kidshealth.org, lilly.ca)