Growth Hormone Deficiency

What is growth hormone deficiency?

Growth hormone (GH) deficiency is when the pituitary gland doesn't make enough growth hormone. GH is needed to stimulate growth of bone and other tissues. This condition may occur at any age.

What causes GH deficiency?

The pituitary gland hangs from the bottom of the brain and produces GH. The pituitary gland controls the other endocrine glands throughout the body. GH deficiency can result from malformation or damage to the pituitary gland or the hypothalamus. Such injuries can occur before birth (called congenital, since they are present at birth), or during or after birth (called acquired). 

In rare instances, GH deficiency can be part of a genetic syndrome. In many cases, the cause of GH deficiency remains unknown (called idiopathic).

What are the symptoms of GH deficiency?

The main symptom of GH deficiency is noticeably slow growth (less than 3.5 cm, or about 1.4 inches) a year after a child's third birthday, despite normal body proportions. The child with GH deficiency may also have:

  • An immature face, looking much younger than his or her peers

  • A chubby body build

  • Impaired hair growth

  • Delayed puberty

It is important to note that GH deficiency does not affect the child's intelligence. The symptoms of GH deficiency may look like other problems or medical conditions. Always consult your child's doctor for a diagnosis.

How is GH deficiency diagnosed?

Before diagnosing GH deficiency, your child’s doctor must rule out other conditions. These include normal variations of growth (familial short stature) and other disorders (for example, thyroid hormone deficiency or kidney disease). In addition to a complete medical history and physical exam, other test may include:

  • Monitoring the child's growth over time (usually at least 3 months)

  • Blood tests 

  • Special scan of the brain to detect potential abnormalities, especially in hypothalamic or pituitary regions

How is GH deficiency treated?

Specific treatment for GH deficiency will be determined by your child's doctor often in consultation with a pediatric endocrinologist. 

Once GH deficiency has been diagnosed, treatment involves daily injections of man-made growth hormone. Although results are often seen as soon as 3 to 4 months after treatment starts, therapy lasts several years, usually until the conclusion of growth during late puberty. The earlier the treatment for GH deficiency is started, the better the chances are that the child will attain a normal or near-normal adult height consistent with the familial pattern. However, not all children respond well to growth hormone treatment. Remember that GH therapy does not make a person taller than his or her parents, but it can help truly GH-deficient children attain a height consistent with their genetic potential. Otherwise normal children who are simply shorter than socially desired should not receive GH therapy.