Some children are short due to a medical condition known
as growth-hormone deficiency. And some children are short, but
otherwise healthy, because of genetics and other normal factors. In
either case, many parents treat their children with human growth
hormone. The FDA's 1985 approval of growth hormone, combined
with looser a definition of deficiency has resulted in a surge of
HGH usage for children.
By Colleen Egan
At 9 months, Jennifer Chambers's daughter Calliope started dropping off the growth charts. At 17 months, Calli had just five teeth, and the soft spot on her head was still open. Jennifer got comprehensive testing for Calli, and her daughter was diagnosed with a growth-hormone deficiency at age 2. Since Calli's diagnosis more than two years ago, she's been successfully treated with six-day-a-week shots of growth hormone. In Calli's case, it was clear she had a growth-hormone deficiency, but the solution isn't always as obvious.
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Defining Growth Issues
According to the Nemours Foundation, "Some children who are under the 3rd percentile or over the 97th percentile, or who are growing a lot slower or faster than most other kids, may have a growth problem." Dr. Steven Dowshen, chief medical editor for KidsHealth.org and a pediatric endocrinologist for Nemours, says that kids with growth-hormone deficiency are often short, they grow at a slower rate than other kids, and they fall even further behind other kids.
Growth-hormone therapy is the accepted treatment for children who have growth-hormone deficiencies, and this treatment is usually covered by insurance. However, not all short children have a growth-hormone deficiency. Instead, some kids fall into the category of idiopathic short stature (ISS).
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The International Journal of Pediatric Endocrinology "statistically defines [ISS] as height less than –2 standard deviations (SD) of the age- and sex-matched population as evident by a complete evaluation by a pediatric endocrinologist including stimulated-GH levels." Or, as the Magic Foundation—an organization for growth-related disorders—says, idiopathic short stature "is a big name to describe children who are short with no known cause."
According to the Journal, "Since unlimited supplies of [recombinant human growth hormone (rhGH)] became available beginning in 1985, the definition of [growth hormone deficiency] has been greatly liberalized and has led to the inclusion and rhGH treatment of countless numbers of normal short children." In addition, the FDA approved the use of rhGH for ISS treatment in 2003. Wider availability of growth hormone and a looser definition of deficiency have created a greater market for treatment.
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"There are parents now who are bringing kids in who have already been told by their primary-care physicians or pediatricians that their child probably doesn't have growth-hormone deficiency but that the child might benefit from being treated with growth hormone anyway," Dowshen says. "In the U.S., the FDA has approved the use of growth hormone for otherwise normal short children—they've approved growth-hormone therapy for boys who aren't projected to make it to an adult height of five-foot-four and for girls who aren't going to make it to four-foot-eleven. The FDA has approved use of growth hormone for those kids; however, that doesn't necessarily mean that insurance companies are going to pay for that therapy. It's controversial."
Continue reading about kids and human growth hormone therapy...
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