The Debate over Growth Hormone Therapy
Tens of thousands of children in the United States are afflicted with some kind of growth hormone deficiency, according to the Human Growth Foundation of Falls Church, Virginia. Growth hormone is a protein that is produced by the pituitary gland and is vital for normal growth. Several hormones are involved in regulating growth. Some act directly on target organs, while others act by triggering the production of other hormones, which activate specific organ functions necessary for growth. This finely tuned system can malfunction in several ways, causing abnormal growth, according to the foundation.
Dr. Brown recommends that any child falling below the three-to-five percent mark on a growth chart should “at the very least have a workup” to check for growth deficiency or some other medical problem such as Crohn’s disease, inflammatory bowel disease, or cystic fibrosis. He says these and other disorders have been discovered in children referred to his clinic for growth failure. “Growth failure itself can be a clue of some underlying problem,” he says.
Legitimate growth problems are actually under-diagnosed by pediatricians, believes Dr. Brown. “One problem is that primary care physicians don’t see this as a priority. Pediatricians do a sub-optimal job of referring to endocrinologists.”
In addition to hormone deficiency, there are over 100 other kinds of growth disorders, according to The MAGIC (Major Aspects of Growth in Children) Foundation of Oak Park, Illinois. A national, non-profit organization that supports families with children afflicted with growth problems, the 14,000-member foundation offers medical information in layman’s terms and the opportunity to network with others in similar situations, says its executive director, Diane Tamburrino. The group was started in 1989 by five mothers with children suffering from growth disorders. Today, the son of one of those mothers is the CEO of New Heights Medical Center, a pediatric growth clinic in the Chicago area.
Deno Andrews says his personal experience as a child afflicted with growth hormone deficiency motivates him to help others with similar problems. He stresses that his clinic focuses on all growth issues, not just growth hormone deficiencies. He credits his mother’s tenacity in the 1970s and 1980s for his adult height of nearly five feet, seven inches.
The first doctor she took me to said I’d never reach four feet tall, and there was nothing that could be done,” he recalls. His mother eventually found a doctor who put him on hormones. Andrews emphasizes, though, that he does not believe every child with a growth problem should be on hormones.
“It depends a lot on bone age,” he says. “If a child is 10, but has a five-year-old’s bone age, that’s called a constitutional delay and [the child] has the potential to catch up. But a 10-year-old with 10-year-old bones who is very short will never catch up.”
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