Growth Hormone Deficiency in Children FAQs

Growth hormone deficiency occurs in roughly 1 in 7,000 births. The condition is also a symptom of several genetic diseases, including Turner syndrome and Prader-Willi syndrome.

If your child doesn’t meet height and weight growth standards, you may be worried. Children who are diagnosed early usually recover very well. If left untreated, the condition can cause below-average height and delayed puberty.

We understand that when your child is diagnosed with a growth hormone deficiency, you may have many questions. Is it dangerous? Will it affect my child in the long term? What do we do next? We tried to give some answers to these questions here and our experts can fully explain your child’s situation.

Growth Hormone Deficiency (GHD)

Growth hormone deficiency (GHD) is a rare condition where the body does not produce enough growth hormone (GH). Growth hormone is a protein produced by the pituitary gland located near the base of the brain and linked to the hypothalamus (part of the brain that helps regulate the pituitary gland).

The pituitary gland, a small pea-sized gland located at the base of the skull, is responsible for producing GH. If the pituitary gland or hypothalamus is malformed or damaged, it could mean that the pituitary gland is unable to produce growth hormone. If there is no more than one pituitary hormone in the pituitary gland, the condition is called hypopituitarism.

How would you define “normal” growth?

Growth rates vary significantly from child to child. However, when measured in height, average “normal” growth is often defined as:

• 0-12 months: about 10 inches per year
• 1-2 years: about 5 inches per year
• 2-3 years: about 3 inches per year
• From 3 years to adolescence: about 2 to 2 inches per year

If your child is less than the 3rd percentile for a child their age, this could be a red flag for growth hormone deficiency.

Complications

Some research suggests additional complications from growth hormone deficiency, including:

• decreased bone mineral density
• increased cardiovascular risk factors
• reduced energy level

Causes

Children with cleft lips or cleft palate are more likely to have GHD because of poorly developed pituitary glands.

GHD that is not present at birth can be caused by a tumour in the brain. These tumours are normally found in the pituitary gland area or in the nearby hypothalamus region of the brain.

Damage to the pituitary gland or the hypothalamus may be the result of an abnormal formation that occurred before your child was born (congenital) or something (acquired) that occurred during or after childbirth.

Congenital growth hormone deficiency may occur if there are mutations in genes for factors important in pituitary gland development or in receptors and factors (including growth hormone) along the growth hormone pathway; however, to date the cause of most of these cases is unknown.

Acquired causes of GHD include:

• a brain tumour in the hypothalamus or pituitary
• head injury
• radiation therapy for cancers if the treatment area includes the hypothalamus and pituitary.
• Diseases that infiltrate into the hypothalamus or its connection with the pituitary gland, such as histiocytosis
• an autoimmune condition (lymphocytic pituitary)

It is also important to remember that GHD is just one of many conditions that can affect your child’s growth. Your child’s short stature may be caused by other syndromes, and growth failure may be due to reduced nutritional intake, gastrointestinal disorders, diseases that increase metabolic demand, or hypothyroidism.

Symptoms

Because growth occurs over the years and children grow at different rates, it can be difficult to detect growth hormone deficiency symptoms. In addition to noticeably slow growth in normal body proportions, symptoms can include:

• immature appearance compared to peers
• chubby body build
• a prominent forehead
• an underdeveloped nasal bridge

Frequently Asked Questions

Q: What is growth hormone deficiency?

A: Growth hormone is a protein produced by the pituitary gland located near the base of the brain and linked to the hypothalamus (part of the brain that helps regulate the pituitary gland). If the pituitary gland or hypothalamus is malformed or damaged, it could mean that the pituitary gland is unable to produce growth hormone.

If there is no more than one pituitary hormone in the pituitary gland, the condition is called hypopituitarism.

Q: What causes a growth hormone deficiency?

A: Damage to the pituitary gland or hypothalamus may be the result of an abnormal formation that occurred before your child was born (congenital) or something (acquired) that occurred during or after childbirth.

Your child’s short stature may also be caused by other syndromes and may be due to growth failure, decreased nutritional intake, medications, gastrointestinal disorders, diseases that increase metabolic demand, or hypothyroidism.

Q: Can growth hormone deficiency be treated?

A: Treatment for GHD includes regular injections of synthetic human growth hormone. Children are given daily injections. Treatment usually takes several years, but results are usually seen three to four months after the injections start.

The sooner growth hormone deficiency treatment is initiated, the better the child’s chances of reaching normal or near-normal adult height. However, not all children respond well to growth hormone therapy.

Q: How safe is the treatment for growth hormone deficiency?

A: While there are many potential side effects, researchers generally agree that treatment with human growth hormone is safe and effective, especially if growth hormone is used to treat children who do not have a true hormone deficiency.

Q: Will the growth hormone deficiency affect my child’s intelligence?

A: Growth hormone deficiency has no effect on a child’s intelligence.

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