Growth Hormone Therapy
Growth hormone therapy (GHT) is a medical treatment used to stimulate growth in children with growth hormone deficiency (GHD) and other conditions impacting growth. By providing recombinant human growth hormone, the therapy aims to promote height, improve body composition, and support overall development in children with inadequate growth hormone levels.
Uses of Growth Hormone Therapy
Growth hormone therapy is prescribed for several pediatric conditions, including:
- Growth Hormone Deficiency (GHD): A condition where the pituitary gland produces insufficient growth hormone, resulting in delayed growth and shorter stature.
- Turner Syndrome: A genetic disorder affecting girls, often resulting in short stature and ovarian insufficiency.
- Chronic Kidney Disease (CKD): Children with CKD may experience stunted growth, which GHT can help address.
- Prader-Willi Syndrome (PWS): A genetic condition that can cause poor muscle tone, developmental delays, and short stature.
- Idiopathic Short Stature (ISS): For children who are significantly shorter than peers with no identifiable medical cause.
How Growth Hormone Therapy Works
Recombinant human growth hormone (rhGH) is a synthetic version of the natural growth hormone that the pituitary gland produces. Administered through daily injections, GHT promotes growth by:
- Stimulating bone lengthening and muscle growth.
- Increasing protein synthesis and fat metabolism.
- Supporting the development of lean body mass.
Administration and Dosage
- Injection: Growth hormone is injected subcutaneously, usually once a day in the evening.
- Dosage: The dose is tailored to each child’s age, weight, growth rate, and specific condition. Regular assessments are required to adjust dosing as the child grows.
Monitoring and Side Effects
- Monitoring: Regular visits are necessary to monitor growth rates, IGF-1 levels (a marker of growth hormone activity), and possible side effects. Bone age and body composition assessments help gauge therapy effectiveness.
- Side Effects: Common side effects include headaches, joint pain, fluid retention, and insulin resistance. Rare but serious side effects include slipped capital femoral epiphysis (a hip problem) and increased intracranial pressure.
Benefits of Growth Hormone Therapy
- Improved Height: GHT generally leads to a faster growth rate and helps children reach a height closer to their genetic potential.
- Better Body Composition: Increased lean body mass and reduced body fat can improve strength, agility, and confidence.
- Psychological and Social Impact: Achieving a taller stature and normalized body proportions can enhance self-esteem and social experiences.
Considerations and Limitations
- Cost and Accessibility: GHT can be costly and may not always be covered by insurance, especially in cases of idiopathic short stature.
- Commitment: Daily injections and frequent monitoring require commitment from the child and family.
- Effectiveness: Growth outcomes vary, with better results when therapy starts early and is consistently maintained.