Not a commonly publicised condition, growth hormone deficiencies can be either a total or partial condition and result in impaired physical development. Growth hormones are created y the pituitary gland (hypophysis) which is a small gland found on the underside of the brain. The amount of hormone produced is controlled by other hormones which are released by a different part of the brain. When this hormone is secreted into the bloodstream, it stimulates the liver to secrete yet another hormone, which develops an insulin-like growth factor – primarily IGF-1. As we age, we naturally produce less growth hormones compared to young adults. There are various reasons for this problem, including an insufficient release of the stimulatory hormone from the hypothalamus, an insufficient production of the growth hormone by the pituitary gland, a decrease in the IGF-1 hormones, as well as problems caused by defects in the receptors which absorb the hormone in the body’s cells. Some people may have a deficiency due to a genetic birth defect, or because it is hereditary, or they may have had a lack of oxygen at birth. Some studies suggest that diseases in the pituitary gland can lead to a defect, as well as abnormalities in the hormone receptors. For most people, though, there is no clear reason – it simply occurs.
If a patient has a total hormone deficiency, it will often be discovered in a child’s infancy. This is because an infant’s height and weight are normal at the time of birth, but between three and nine months the growth rate will be reduced in children with a growth hormone deficiency – this is known as growth disturbance. There will be signs later in life too, including weight diminishing, delayed teeth development, and they may also develop a thick layer of fat under the skin. However, this symptom won’t always be visible if there is just a partial growth hormone deficiency. Although everyone can measure and weigh their children, there will be regular growth examinations carried out by your health visitor and GP, who will follow specific guidelines to check that your child is developing at a normal rate. If you’re worried about your children’s growth rate though, you should seek the advice of your GP. Your GP will measure and weigh your child, then draw growth curves – they will take the parents’ height and weight as adults, at puberty and as infants into account. They will also ask questions about the child’s diet, their appetite, patterns of defecation, exercise habits, and any social problems so as to rule out other health problems. They will be examined for signs of disease, as well as puberty and tooth development if need be. They may also suggest an x-ray of the left hand and wrist, to examine the bone development. If there is a growth hormone deficiency, the ‘bone age’ may be lower than the child’s genuine age.
If this problem is not treated, it can lead to severe growth impairment, particularly their height. However, if the problem is treated in the early phase then it is likely that the child will gain several extra centimetres which will bring them into a normal range for their age. Treatment tends to rely on synthetic growth hormones being injected each day until the child stops growing, and this is done at specialised paediatric units. Parents will be trained to administer the injections so that the correct amount is provided. Though side effects are rare, the child will be monitored closely so that no risks are taken with their health.