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Overview

Growth Hormone Deficiency: Treatment, Procedure, Cost and Side Effects

What is the treatment?

The most common treatment required to treat Growth Hormone Deficiency is Growth Hormone Therapy which involves inducing growth in children and restoring energy, body composition and metabolism. GHD may be a birth defect or may also begin during childhood. Poor growth in children may be due to several medical cause like Turner’s syndrome- a genetic syndrome affecting girl’s development, chronic kidney disease, Prader-Willi syndrome causing low levels of sex hormones, constant feeling of hunger and poor muscle tone and children born small for gestational age. Affected ones, mostly older adults, may also experience frequent fractures due to reduced bone strength. They feel a lack of stamina and fatigue more often and also are quite sensitive to changes in temperatures. The other symptoms include poor memory, lack of concentration, spells of anxiety and emotional distress and depression. They also have increased fat and cholesterol level in their blood due to low metabolism with an increased risk for heart disease and diabetes. Somatropin is prescribed by the doctors as shots several times a week, injecting it in the fatty tissues of the patient. Growth hormones are secreted from the Pituitary gland located in the brain. So, a surgery of such a tumour in the pituitary may also be required for the treatment. If the tumour removal is not accomplished safely, the patient may also require radiation therapy. There are cases where people cannot be treated with the therapy as it does not work for every affected person and may opt for support groups and counselling that help them cope with the deficiency and the self-esteem issue effectively. If left untreated, it causes other deficiencies like thyroid hormone production deficit, deficit in the production of sex hormones, water imbalance in the body and reduced DHEA and cortisol production from adrenal glands.

How is the treatment done?

In the therapy for GHD, doctors prescribe injection of somatotropin (Genotropin, Humatrope) once a day, in the fatty tissues of the patient as in the thighs, buttocks or in the back of the arms by the patient him/herself or the parent having received appropriate training. It is needed to see the doctor every 4 to 8 weeks for proper monitoring of the condition. The progress is tested and blood tests are performed to determine the need for more growth hormone. The doctor also monitors the blood sugar level, cholesterol level and the bone density while administering of GH injections is on. Some children who have congenital form of this disease are treated for longer term, that is, until they reach puberty or even for their entire life as determined by the doctor. A prompt increase in growth may be visible in 3-4 months once the treatment starts which is quite faster than normal and normally declines over time. If there is deficiency of other hormones like sex hormones, cortisol and thyroid hormone, they can be replaced with appropriate medications. After the commencement of the treatment, the child’s appetite may go up and the body fat may start to reduce. In cases where a tumour has developed in the pituitary, a surgery for its removal is necessary and if surgery too is not sufficient for the removal of tumour, radiation therapy may be required for the treatment. Good nutrition along with proper rest are also key to normal growth.

Who is eligible for the treatment? (When is the treatment done?)

.Children with abnormally short height than their peers or with physical defects like cleft palate or cleft lip may be affected with decreased growth hormone level. Children with short stature, slow and flat growth rate with normal body proportions but chubby looks appearing younger than other children of same age. Their puberty normally come late or even may not come at all. GHD in many teens cause a short stature and sluggish maturing rate. So, such young men have voices not as par their peers and young women may have underdeveloped breasts. Older adults who experience frequent fractures in their bones and also lack stamina are eligible for GHD treatments.Also adults who had pituitary gland damage like haemorrhage or tumour or even their treatment like surgery or radiation therapy may also cause Acquired GHD

Who is not eligible for the treatment?

There are people who suffer from GHD but cannot be treated for the disease because of their tumours or any type of cancer. Also, if they have breathing problems and multiple injuries due to a trauma, they should not get treated with growth hormone injections.

Are there any side effects?

Despite being reasonably effective and safe, growth hormone injections do cause some side-effects, which are although not so serious. Side-effects like redness at the injection spot, muscle and joint pains, swelling and numbness, headaches, slippage of hip bones, curving of spine (scoliosis) and fluid retention are most common. The somatotropin Genotropin causes side-effects in GHD affected children like injecting site bleeding, reactions, scarring, rash or lumps, fat loss, blood in the urine, slight increase in the blood sugar level and low thyroid activity. Genotropin when induced in children born small for gestational age produced side-effects like abnormal jaw growth, increased number of moles, early puberty, increased pressure in brain etc. it also caused inflammation of nose and throat, mood changes aggressiveness and hair loss.

What are the post-treatment guidelines?

Once the treatments have started, doctors determine whether the treatment for an individual has to be a short-term or a long one. Depending upon these determinations the doctor decides by regular monitoring of hormone levels in the blood whether the person needs the injections anymore or not. Regular monitoring of growth hormones, blood sugar level, cholesterol level, thyroid hormone level, sex hormones level and bone density are required even after the treatment or when the treatment is on. In order to incorporate growth hormones naturally into ones lifestyle, counsellors also help patients deal with self-esteem, how to cope with growth hormone deficits, help them get enough sleep, regular exercises and a proper balanced diet.

How long does it take to recover?

In some, the results are visible within a few months or days. Patients with decreased eyesight feel vast improvement after six months of treatment with gradual progress from the second month of the treatment; stamina is seen increasing every month with the commencement of the treatment, an increased optimism and a better sense of humour is also noticed every month, by the end of the third month there is an improvement in the bone density, muscle mass starts showing improvement from the second month itself, better skin tone and texture are also noticeable from the second month of the treatment.

What is the price of the treatment in India?

The cost of treatment for growth hormones deficit can differ depending upon the type of skin, its scheme, volume and depth along with other facilities like height, body muscle mass etc. The cost of injections vary from about Rs. 1,500 to about Rs. 15,000 with consultation fees ranging from Rs. 400 to Rs. 2000 depending upon location in India, the physician himself and his experience and the number and type of services required.

Are the results of the treatment permanent?

Yes, the results of the treatment are usually permanent, although some individual do require treatment all through their life.

What are the alternatives to the treatment?

Alternative to the treatment is mental and emotional therapy that helps children affected with GHD tackle children teasing them. A psychologist talks through one’s feelings and helps how to cope with the deficit. They also help them get enough sleep, the importance of regular work outs and eating a balance diet.

Safety: Condition Effectiveness: Medium Timeliness: High Relative Risk: High Side Effects: Low Time For Recovery: Medium Price Range:

Rs. 500 to Rs. 15,000

Popular Health Tips

Lack of Growth Due To Insufficient Hormones!

MBBS, Post Graduate Diploma In Diabetology (PGDD)
Endocrinologist, Thane
Lack of Growth Due To Insufficient Hormones!

The pituitary gland, a small gland located at the base of the brain, is responsible for producing growth hormones. When the growth hormones are not produced sufficiently by this gland, then the rate of growth is slower. In children, the hormone needs to be adequate to ensure the right amount of growth. To maintain the right amount of fats in the body, adults need this hormone. The hormone is also required to maintain muscles and bones in the body. Lack of the growth hormones can cause an emotional disturbance, tiredness, and motivation issues in adults. When the pituitary tumors are treated, cholesterol levels, too, are affected because of insufficient hormonal production. This deficiency can occur at any age in children and adults.

Symptoms in children and adults: When one is affected by slow growth hormone production, a number of symptoms may manifest. The most important symptom is the short stature. Growth velocity for the corresponding age is also lower, and puberty is also delayed. One can also see the mid-area accumulating more fat in the body. In children, this deficiency can make them look much younger for their age. The tooth development is much delayed and they do not stick to their developmental milestones. Adults find it difficult to do exercises or they have low endurance when the growth hormones are insufficient. The skin becomes thick and dry, and they are also prone to anxiety, depression, and other emotional disorders.

Diagnosis: A hypoglycemia test is conducted to confirm the diagnosis. The individual is administered insulin through an intravenous line. The growth of hormone level is measured after 30 minutes. If the result is less than 10 mcg per mL in children, then it is considered that there is growth hormone deficiency. An adult is considered deficient in growth hormones when the level is less than 3 mcg per mL.

Treatment methods: As low growth hormones can lead to stress and fatigue, it is important for the people who are affected by this condition to get enough sleep. They should also concentrate on taking healthy foods. The cholesterol and triglyceride levels are already increased in people who have low growth hormone levels. So, avoiding fatty and oily foods is necessary. Doing physical exercises every day is also recommended.

Growth hormone therapy is one of the ways to improve the growth hormone levels in the affected individuals. The treatment not only aims at improving this hormone levels but it also ensures that the metabolism is maintained in a healthy way. The drugs for this condition are injected under the layers of fat in the skin. The drug is given via injection once in a week throughout the treatment duration. If the disorder is because of tumors in the pituitary gland, then it can be treated only with a surgery. For the same condition, radiation therapy is also given, if the tumor is not removed successfully with the surgery. People with low levels of growth hormones are advised to lose fat and avoid eating a heavy meal before bedtime. Intermittent fasting is also recommended.

10 people found this helpful

5 Signs of Growth Hormone Deficiency

MD - General Medicine, DM - Endocrinology, MBBS
Endocrinologist, Delhi
5 Signs of Growth Hormone Deficiency

Growth hormone is one of the many hormones secreted by master endocrine gland i.e. pituitary gland. As its name suggests, growth hormone has a central role in the overall growth of human being. It plays a much more important role during childhood than adulthood. Growth hormone also controls our metabolism. Deficiency of growth hormone results in poor growth (short height) during childhood and also disorders of metabolism.

Growth hormone deficiency can be caused by abnormal development of pituitary gland, head injury, intra cranial tumors etc. or it can be idiopathic (reason not known). It is very important to identify the problem as early as possible because results are very good when treatment is started early. And also, because growth hormone deficiency can be caused by serious underlying disorders, for example - intracranial tumors. Following are few hints to possible diagnosis of growth hormone deficiency.

  1. If your child shows any of these signs, take him/her to an endocrinologist (hormone specialist) for assessment of his/her growth
  2. If your child is frequently mistaken for being much younger for his/her age.
  3. If your child is being teased or bullied by his/her friends due to short height.
  4. If your child is fitting into same clothes or shoes for more than 2 years.
  5. If your child is much shorter than children of same age and sex. If your child is growing less than 4 cm in a year.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3312 people found this helpful

Short In Height - Should You Be Worried About Your Child?

MAMC, MRCPCH, MD - Paediatrics, MBBS
Pediatrician, Noida
Short In Height - Should You Be Worried About Your Child?

Out of the many things a parent can be worried about their child, physical growth and development are the major ones. Height development is indeed a very crucial part of the overall development of a child's body. But how will you know whether your child is short and should you worry if he or she is short?

When is a child categorised as being short?
A child is said to be of short stature when the height is two standard deviations less than the mean height for the specific age and sex. However, it does not signify that your child is sick or has some deformity.

What are the causes of being short?
The most common reasons that need not be worried about are:

  1. Ancestry: Your child short height could be a result genetics. If his/her parents belong from a short family stature, then, the child is most likely to follow the same. Being said that, their body performs in a normal way and they do not face any medical issue despite being short.
  2. Delay in Growth: In case a child faces a severe growth delay between the age of 6 months and up to 2 years, then it may lead to him/her staying short. Such children usually grow at a much slower pace, compared to other children of the same age without any development issues. However, no medical treatment is required as the child usually catches up with the height of their friends of the same age, once they become adults.

What are the medical Conditions behind the short stature?
For children who show an excessive delay in growth, doctors can find out whether they are going through any serious medical condition that needs attention or not. Some of the medical conditions which can cause short height are:

  1. Malnutrition: For those who do not receive proper nutrition on a daily basis, tend to face physical health issues.
  2. Chronic Illness: Any congenital disease or something that affects the major organs of one's body might slow down the height growth.
  3. GHD: Growth Hormone Deficiency is a common condition in children. When the pituitary gland does not produce enough hormones, such a condition occurs.
  4. Mental Stress: When a child faces stress from a very little age, often he or she becomes mentally and physically hampered.
  5. Genetic Problems: A condition known as Turner’s syndrome can cause growth failure in a girl child.
  6. Hormonal Imbalance: For those who suffer from improper production of hormones, they might face obstruction in case of height growth.
  7. Endocrine diseases: Endocrine diseases disrupt hormone production thus resulting in a delay in growth.

For every 100 children of a particular age, 3 tend to be shorter. However, unless your child suffers from a medical problem, short stature is not to be worried, and it is recommended that they have a proper and balanced nutrition to ensure a proper height development. In case you have a concern or query you can always consult an expert & get answers to your questions!

4052 people found this helpful

Is My Child Short?

MBBS, MD - Paediatrics, FRACP - Pediatrc Endocrinology, SCE, Endocrinology
Endocrinologist, Kanpur
Is My Child Short?

Growth is the most important aspect of childhood, one that distinguishes children from adults. Growth is affected by a number of diseases and growth failure is often the first sign of a serious disease. Unfortunately children with growth failure present very late when no help is possible. 

Why to worry?

Growth is the best marker of health and growth failure may be caused by a seious disease. Moreover children with short stature have lower self esteem. 

When to worry? 

Plot the height of your child in the growth chart and if it is below the lower limit visit a doctor. Alternatively if your child's height is less than the formula (Height = Age in years x 6 + 77 cm) it may be a cause of concern. Growth stops at the age of 14 years in girls and 16 years in boys. Hence the child should be reviewed latest by 10 years for girls and 12 years for boys. 

What causes growth failure? 

Growth failure can be due to a number of causes including poor nutrition, lack of physical activities and low genetic potential with parents being short. Short stature can also be caused by a number of diseases like thyroid problems, growth hormone deifiency and celiac disease (wheat allergy). 

How can I improve my child's growth?

Please encourage your child to play for atleast 1 hour a day. It is important to restrict screen time including television, computer, tablets and mobiles to less than an hour. Increased protein and calcium intake with more milk, pulses and vegetables also helps in improving growth. Growth hormone is produced during sleep. Sleeping for at least eight hours a day is therefore essential for a child to achieve good growth. 

What can be done if my child is very short? 

Please consut a doctor to identify the cause of short stature. Most conditions are readily treatable. Children with growth hormone deficiency respond dramatically to growth hormone. Growth hormone is also being used now in children with turner syndrome, familial short staure, small size at birth and kidney disease

If you wish to discuss about any specific problem, you can consult a Endocrinologist.

3213 people found this helpful

Growth Hormone Deficiency - Tests That Can Help Diagnose It!

MD - General Medicine, CCEDM, Fellowship In Neurology & Stroke, Post Graduate Diploma in Clinical Endocrinology & Diabetes
Internal Medicine Specialist, Navi Mumbai
Growth Hormone Deficiency - Tests That Can Help Diagnose It!

Growth hormone or somatropin is responsible for cell growth as well as reproduction. But insufficient somatropin production by the pituitary gland may result in lack in height. It is mostly caused by a serious brain injury, any prevalent medical condition or might occur as a birth defect.

Types:

  1. Congenital GHD - This form of GHD appears from at the time of birth itself.
  2. Acquired GHD- GHD can be acquired during later life as a result of trauma, infection, tumor growth within the brain or radiation therapy.
  3. Idiopathic GHD- Idiopathic GHD is the third, and comparatively worst kind of GHD since it has no treatment.

GHD is mostly permanent, but can also be transient. Read on to know how to detect whether you or your child is suffering from growth hormone deficiency(GHD).

Symptoms:
Childhood onset

  1. Restricted height- Compared to other children of your child's age, he/she may be of shorter height, which is a rather conclusive sign to detect somatropin deficiency.
  2. Chubby and comparatively younger appearance- Your child may have a proportionate body, but if he/she is unnaturally chubby and has a baby-face compared to other children, he/she may be suffering from GHD.
  3. Late puberty- Your child's puberty maybe later than usual or even not appear at all, depending upon the gravity of the GHD.
  4. Hypoglycemia and exaggerated jaundice- Low blood sugar is amongst the most primary manifestations of GHD, along with extended duration of jaundice.
  5. Micro-penis- Micro penis condition is one of the incident signs of GHD, which later escalates to growth deficit as the infant gets older.

Adult onset:

  1. Fatigue- Adults with GHD may experience extreme tiredness throughout the day, with reduced muscle strength.
  2. Osteoporosis- Osteoporosis, along with bodily deformities, is a common sign in adults with GHD.
  3. Lipid abnormalities- A test of your lipid profile may reveal abnormalities in LDL cholesterol, insulin resistance, and impaired cardiac functions.

Tests to determine GHD:

  1. Physical test- A chart is drawn to determine the proportion of height and weight with respect to your age to detect anomalies.
  2. Hand X-ray- A hand X-ray can determine whether the age of bones are at par with your age.
  3. MRI-MRI scan can determine the health of your brain and pituitary gland.
  4. Test for other hormones- Growth Hormone may not be solely responsible for your health condition, so it is important to determine if other hormone levels are all normal.

Treatment:

  1. Hormone supplements- Hormone supplements like corticosteroids (hydrocortisone or prednisone), Levothyroxine (levoxyl, synthroid, etc), and others work to replenish the deficiency of pituitary hormones.
  2. Growth hormone injection- GH is injected beneath your skin, to cure GDH. This is a long-term treatment and requires constant monitoring.
6088 people found this helpful

Popular Questions & Answers

Hello, I am 22 years old girl. But I really look underage. I didn't take proper nutrition during my childhood or teenage and never exercised. And now I am very concerned about my looks. I don't feel confident while I walk or communicate. I started doing yoga classes but I am unable to eat more. I have heard about human growth hormone injections. Can I get any benefit from it or is there any other treatment to make my body look better. Please help.

MD - Paediatrics
Pediatrician,
First of all more details are required, because based on your height and weight (5 feet 1 inch and 46 Kgs) you seem fairly average by Indian standards Your menstrual history needs to be mentioned For Growth hormone treatment you need to consult a Endocrinologist. My feeling is that you have low self esteem and no physical short comings. I would advise you to meet friends (people who like you and who spend time with you. That should result in you feeling better about yourself.
2 people found this helpful

Only my hips are growing but my hands are thinning at an alarming rate that they look like skeleton Why is this imbalance of growth My upper body from face to breast shows no sign of growth while ans hips and thighs are increasing.

MBBS, M.S. General Surgery, M.R.C.S. England, M.Ch. Surgical Oncology, DNB Surgical Oncology, FEBS Surgical Oncology, DNB General Surgery, MNAMS, FMAS, FIAGES, FAIS, FICS, FEBS Breast Surgery, FACS, Fellowship IFHNOS & MSKCC USA, Fellowship in breast and oncplastic Surgery
Oncologist, Mumbai
The obesity is females is usually Pear shaped while in males we call it Apple shaped This is because females have a broader pelvis and narrow shoulders and when the fat accumulates, it is more in the hips and thighs, leading to the classical pear shaped obesity. In males the hips are narrow with broader shoulder and main fat accumulation during obesity is around the abdomen, leading to the Apple shaped obesity. Only truncal obesity sometimes with associated hirsuitism may be a sign of Cushing syndrome due to steroid hormone excess due to any cause. Better to see an endocrinologist who may ask for Thyroid function and cortisol levels to rule out the hormonal causes of obesity. If you want to discuss your problems further, feel free to contact me.

Hello, Is there possibility treatment for growth hormone at age 30. What type of tests and medication is there?

Bachelor of Naturopathy & Yogic Sciences (BNYS), M.sc in yoga and naturopathy, Bachelor of Ayurveda, Medicine and Surgery (BAMS), Bachelor of Physiotherapy
Ayurveda, Delhi
Hi Lybrate user, Since Human growth hormone is needed to a lesser extent as men grow older, less and less of the hormone is found within the body. In general, men begin to experience a 10 – 15% loss of HGH in their blood after the age of 30. When HGH is not properly produced and secreted from the pituitary gland, growth hormone deficiency occurs. As men age, HGH levels naturally decline; however, external factors such as poor diet, stress, a sedentary lifestyle, inadequate sleep, head trauma, brain tumors, and certain illnesses can further decrease the amount of HGH in the body. You have to have a blood test hgh test for testing the growth hormone.
1 person found this helpful

I am 18 year old .but my weight and height is below the others .So what should I do?

MBBS
General Physician, Mumbai
do various sports activity like playing football, cycling, skipping and can also take calcium and protein rich food and Few diet tips - Not to eat fried food items and Can eat All green vegetables, moong , chana , Dal , rice etc And to apply ghee over chappati and don’t apply oil over chappati And to drink milk mixed with turmeric powder twice a day And If possible eat eggs on alternate days And If possible in breakfast eat atleast one bajra ka rotla And Eat seasonal fruit
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?