Dr. Henry CliffGrowth hormone deficiency or GHD as the name spells is the deficiency or absence or lack of natural growth hormone produced by the pituitary gland to stimulate growth and development of an individual. Growth hormone deficiency may take place during childhood or later as well.
Growth hormone deficiency takes place when the pituitary gland doesn’t produce much growth hormone in the body. The causes may include infections, trauma, genetics, radiation therapy and tumors. Genes which may be involved include BTK, GH1 or GHRHR.
To understand well, first you need to know what pituitary gland is. The pituitary gland is a pea sized, small gland that is responsible for production of natural growth hormone in the body. This gland is located at the base of the brain and secretes 8 hormones in total. Some of the hormones control body temperature and thyroid function.
Your body needs growth hormone even after you enter adulthood. But unfortunately, the amount of GH produced in the body after your teens decrease considerably, leading to a lot of health issues and sometimes GHD. When in adulthood, the GH maintains your metabolism and body structure. Even the adults can develop GHD, but it is not as common as it is in children.
So, what is normal growth?
Growth rates differ significantly from one child to another. But measured in height, the average normal growth is taken to be as:
- 0-12 months- 10 inches per year
- 1-2 years- 5 inches per year
- 2-3 years- around 3 ½ inches per year
- 3 years to puberty- 2 to 2 ½ inches per year
In case the child is less than the third percentile in height for a normal child of his age, then this can be a serious thing and may indicate a red flag towards growth hormone deficiency.
Causes of growth hormone deficiency
GHD in children has no identifiable causes as such and adult-onset GHD is mainly due to the pituitary tumors and their subsequent treatment. More causes may include:
- Mutations of some specific genes
- Congenital malformations that involve the pituitary like posterior pituitary ectopia, septo-optic dysplasia etc.
- Auto-immune inflammation
- Chronic renal deficiency
- Congenital diseases like Turner syndrome, Prader-Willi syndrome
- Ischemic infraction from low blood pressure
- Damage to pituitary from radiation to the head, from trauma, from some surgery or even from intracranial disease
There are indeed a lot of rare diseases that resemble growth hormone deficiency like facial appearance, growth failure, delayed bone age, low IGF etc. GH testing elicits high or normal levels of growth hormone in the blood, showing that the issue is not because of a deficiency of growth hormone but rather to a low sensitivity to action. Insensitivity to growth hormone is termed as Laron dwarfism but for about 15 years or so, a lot of different types of GH resistance have been seen, mainly involving mutations of GH binding receptors.
Symptoms of growth hormone deficiency
Children with growth hormone deficiency are shorter in height than their peers and have young, round faces. They can be chubby as well or have the baby fat around their belly. But of GHD develops later in the life of a child, like from some tumor or brain injury, its main sign will be delayed puberty. In some cases, even the sexual development is halted.
A lot of teens who face GHD experience low confidence and self esteem because of developmental delays like slow maturing rate and short stature. For instance, the young women may not develop fully grown breasts and young men’s voice my not change.
Decreased bone strength is yet another sign of AGHD. This may result in frequent fractures and that too in older adults. Those with low GH may feel fatigued or lack strength and stamina. They may also experience sensitivity to cold and hot temperatures. Adults who face growth hormone deficiency have high levels of fat in their blood as well as high cholesterol. This is not mainly because of poor diet, but due to changes in the metabolism caused by low GH levels. Adults with GHD are at high risk of facing issues like heart disease and diabetes.
It is also crucial to know and understand that not all with GHD will have same or similar symptoms. While some may have just 1-2 signs, others can have multiple issues.
Diagnosis for GHD
Before a GHD diagnosis can be done, the doctor may have to rule out other health disorders like short stature, thyroid hormone deficiency etc. Apart from a detailed physical examination and medical history, diagnostic processes for GHD may include-
- Monitoring the growth of a child for some time
- Blood tests
- Scanning the pituitary to detect the abnormalities
A blood test can let you know the level of GH in your body. But your levels of GH fluctuate a lot through the day and night. So, a blood test with lower than average result will not be an enough evidence to make the right diagnosis. Even the thyroid and kidney function tests can show how the body is using and producing hormones.
Treatment for growth hormone deficiency
Since the 1980s synthetic GH has been used with a lot of success to treat children as well as adults. Before the synthetic GH, natural growth hormone was used from the cadavers for treating GHD.
Growth hormone is given through injection, mainly into the fatty tissues of the body like at the back of your arms, buttocks or thighs. It is effective when taken as a daily treatment. But as injections have their own set of side effects, HGH supplements come to rescue. These supplements are safe and natural, and they have great list of benefits for the users.
Home care
As growth hormone deficiency can cause lack of strength and energy, patients should take a balanced diet, do regular exercise and have plenty of sleep. Follow up care with the endocrinologist (a doctor that studies hormones) is advisable. Finally, it is recommended that you start with the growth hormone deficiency as soon as you are diagnosed with it because sooner the treatment, you will get better results and your health will improve in no time.