Growth hormone deficiency is a rare, treatable condition that causes short stature in children. It is less common in adults.
Growth hormone deficiency (GHD) occurs when your 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 your skull and releases eight hormones. Some of these hormones control thyroid activity and body temperature.
GHD occurs in roughly 1 in 4,000 to 1 in 10,000 children and 2 to 3 in 10,000 adults.
GHD is also a symptom of several genetic conditions, including Prader-Willi syndrome.
You may be concerned if your child isn’t meeting height and weight growth standards. But if your child has GHD, it’s important to know that the condition is treatable. Children who receive a diagnosis 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, growth hormone maintains your body’s structure and metabolism. Adults can also develop GHD, but it isn’t as common in adults as in children.
GHD that isn’t present at birth may be caused by a tumor in the brain. These tumors are normally located on the pituitary gland or in the nearby hypothalamus region of the brain.
Serious head injuries, infections, and radiation treatments can also cause GHD in both children and adults. In these cases, the condition is called acquired growth hormone deficiency (AGHD).
Most cases of GHD are idiopathic, meaning that no cause has been found.
Children with GHD are shorter than their peers and have younger-looking, rounder faces. They may also have “baby fat” around their abdomen, even if their body proportions are average.
If GHD develops later in a child’s life, such as from a brain injury or tumor, the main symptom is delayed puberty. In some cases, 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’ voices do.
Reduced bone strength is a sign of AGHD and may lead to more frequent fractures, especially in older adults.
People with low growth hormone levels may feel tired and have low stamina. They may also be sensitive to hot or cold temperatures.
Possible psychological effects of the condition include:
- depression
- difficulty concentrating
- difficulties with memory
- bouts of anxiety or emotional distress
Adults with AGHD typically have high levels of fat in their blood and high cholesterol levels. This isn’t due to dietary habits 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 during puberty and the growth rates of any other children you have. If the doctor suspects GHD, they can order tests to help confirm the diagnosis.
Growth hormone levels fluctuate widely throughout the day and night. 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 that are markers of growth hormone function but are much more stable: insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3).
If screening tests suggest that you have GHD, your doctor may order a GH stimulation test.
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, GHD may be the reason.
If your doctor suspects a tumor or other damage to the pituitary gland, an MRI scan can provide a detailed look inside your brain. Growth hormone levels will often be screened in adults who have a history of pituitary disorders, have a brain injury, or need brain surgery.
Testing can determine whether the pituitary condition was present at birth or was brought on by an injury or tumor.
Since the mid-1980s, synthetic growth hormones have been used with great success to treat GHD in 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, the thighs, or the 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.
Long-term treatment
Children with congenital GHD are often treated with growth hormone until they reach puberty. Often, people 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 has GHD.
Many people respond very well to treatment. The sooner you start treatment, the better your results will be.