Growth hormone deficiency

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Overview

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.


Symptoms

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:


depression

lack of concentration

poor memory

bouts of anxiety or emotional distress

A higher level of body fat, especially around the waist.

Anxiety and depression.

Decreased sexual function and interest.

Fatigue.

Feelings of being isolated from other people.

Greater sensitivity to heat and cold.

Less muscle (lean body mass)

Causes

A lack of growth hormone is usually caused by damage to the pituitary gland or the hypothalamus, a part of the brain that controls the pituitary gland. The damage may be due to a tumor; to surgery or radiation used to treat the tumor; or to problems with the blood supply to the pituitary gland.

Growth hormone deficiency may be present at birth. Growth hormone deficiency may be the result of a medical condition. Severe brain injury may also cause growth hormone deficiency. Children with physical defects of the face and skull, such as cleft lip or cleft palate, may have decreased growth hormone level.

Risk factors

Unlike many other chronic health conditions, the risk factors for pediatric growth hormone deficiency are not related to lifestyle. Factors like diet, exercise, and adherence to medical advice do not affect the risk of developing growth hormone deficiency.

Childhood Cancer 

Survivors of childhood cancer are at high risk of having short stature in adulthood. Studies estimate that 10% to 20% of cancer survivors experience impaired growth.7

A cancer diagnosis puts children at higher risk for pediatric growth hormone deficiency because of the side effects of treatment. High-dose radiation is known to cause hypopituitarism, where the pituitary gland is lacking in multiple pituitary hormones. Radiation of the spine can also impede growth and lead to short stature in adulthood.8

When a child’s cancer affects the brain, the disease itself could lead to growth hormone deficiency as well. Brain tumors such as craniopharyngioma affect the function of the pituitary gland and can lead to hypopituitarism.



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Complications

Absent or delayed sexual development during puberty. Increased urination and amount of urine. Excessive thirst. Facial abnormalities can be present in a small group of children with GHD, typically caused by pituitary defects.

Prevention

Some cases of GHD can be treated with the use of synthetic growth hormone under the supervision of a pediatric endocrinologist. If other hormone deficiencies exist, other hormones can be given in addition to synthetic growth hormone.

If your child is diagnosed with a GH deficiency, their doctor may recommend giving them GH injections. The injections can usually be done at home by a parent, typically once a day. This treatment will likely continue for several years as your child continues to grow.