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