A growth hormone deficiency (GHD) occurs when the pituitary gland doesn’t produce enough growth hormone. It affects children more often than adults.
The pituitary gland is a small gland about the size of a pea. It’s located at the base of the skull and secretes eight hormones. Some of these hormones control thyroid activity and body temperature.
GHD occurs in roughly 1 out of 7,000 births. The condition is also a symptom of several genetic diseases, including Prader-Willi syndrome.
You may be concerned that your child isn’t meeting height and weight growth standards. But if it’s GHD, it’s important to know that it’s treatable. Children who are diagnosed early often recover very well. If left untreated, the condition can result in shorter-than-average height and delayed puberty.
Your body still needs growth hormone after you’ve finished puberty. Once you’re in adulthood, the growth hormone maintains your body structure and metabolism. Adults can also develop GHD, but it isn’t as common.
GHD that isn’t present at birth may be caused by a tumor in the brain. These tumors are normally located at the site of the pituitary gland or the nearby hypothalamus region of the brain.
In children and adults, serious head injuries, infections, and radiation treatments can also cause GHD. This is called acquired growth hormone deficiency (AGHD).
Most cases of GHD are idiopathic, meaning that no cause has yet been found.
Children with GHD are shorter than their peers and have younger-looking, rounder faces. They may also have “baby fat” around the abdomen, even though their body proportions are average.
If GHD develops later in a child’s life, such as from a brain injury or tumor, its main symptom is delayed puberty. In some instances, sexual development is halted.
Many teens with GHD experience low self-esteem due to developmental delays, such as short stature or a slow rate of maturing. For example, young women may not develop breasts and young men’s voices may not change at the same rate as their peers.
Reduced bone strength is another symptom of AGHD. This may lead to more frequent fractures, especially in older adults.
People with low growth hormone levels may feel tired and lack stamina. They may experience sensitivity to hot or cold temperatures.
Those with GHD may experience certain psychological effects, including:
Adults with AGHD typically have high levels of fat in the blood and high cholesterol. This isn’t due to poor diet, but rather to changes in the body’s metabolism caused by low levels of growth hormone. Adults with AGHD are at greater risk for diabetes and heart disease.
Your child’s doctor will look for signs of GHD if your child isn’t meeting their height and weight milestones. They’ll ask you about your growth rate as you approached puberty, as well as your other children’s growth rates. If they suspect GHD, a number of tests can confirm the diagnosis.
Your levels of growth hormone fluctuate widely throughout the day and night (diurnal variation). A blood test with a lower-than-normal result isn’t enough evidence in itself to make a diagnosis.
One blood test can measure levels of proteins which are markers of growth hormone function but are much more stable. These are IGF-1 (insulin-like growth factor 1) and IGFPB-3 (insulin-like growth factor binding protein 3).
Your doctor may then go on to a GH stimulation test, if screening tests suggest that you have a GH deficiency.
Growth plates are the developing tissue at each end of your arm and leg bones. Growth plates fuse together when you’ve finished developing. X-rays of your child’s hand can indicate their level of bone growth.
If a child’s bone age is younger than their chronological age, this might be due to GHD.
If your doctor suspects a tumor or other damage to the pituitary gland, an MRI imaging scan can provide a detailed look inside the brain. Growth hormone levels will often be screened in adults who have a history of pituitary disorders, a brain injury, or who need brain surgery.
Testing can determine whether the pituitary condition was present at birth or brought on by an injury or tumor.
Since the mid-1980s, synthetic growth hormones have been used with great success to treat children and adults. Before synthetic growth hormones, natural growth hormones from cadavers were used for treatment.
Growth hormone is given by injection, typically into the body’s fatty tissues, such as the back of the arms, thighs, or buttocks. It’s most effective as a daily treatment.
Side effects are generally minor, but may include:
In rare cases, long-term growth hormone injections may contribute to the development of diabetes, especially in people with a family history of that disease.
Children with congenital GHD are often treated with growth hormone until they reach puberty. Often, children who have too little growth hormone in their youth will naturally begin to produce enough as they enter adulthood.
However, some remain in treatment for their entire lives. Your doctor can determine whether you need ongoing injections by monitoring hormone levels in your blood.
Make an appointment with your doctor if you suspect that you or your child is deficient in growth hormones.
Many people respond very well to treatment. The sooner you start treatment, the better your results will be.