Everything Parents Need to Know About Growth Hormone Deficiency and Their Child’s Development
Every child’s growth and development is individual and unique. Some grow quickly, others are late bloomers. Some are naturally tall while others are naturally short. In most cases, the child’s developmental rate is completely healthy. However, for one in 7,000 children, their delayed growth is caused by a growth hormone deficiency.
Growth hormone deficiency (GHD) is a medical condition that happens when the pituitary gland doesn’t produce and secrete enough growth hormone. It can present in newborns or it can occur later in childhood.
Causes
There are several causes of GHD such as an under formed pituitary gland, lower production of other hormones produced in the pituitary gland, genetics, infections, a cyst or tumor on the pituitary gland, trauma, radiation therapy in the area or a combination of factors.
Signs and symptoms
Signs and symptoms can vary, depending on the age of the child. Newborns can have hypoglycemia or other physical features. In older children, the most prominent sign is slower or delayed growth. Other signs and symptoms can include:
• Shorter stature
• Absent or delayed puberty sexual development
• Headaches
If there are other pituitary hormone deficiencies along with the growth hormone deficiency, signs and symptoms may include:
• Increased urination frequency and amount
• Excessive thirst
• In small children, midline facial differences like a cleft palate
However, these symptoms don’t necessarily mean a child has a growth hormone deficiency. Dr. Krishnamoorthy from the Montreal’s Children’s Hospital recommends parents ask their primary doctor to measure and chart their child’s height and growth on the growth curve if they are concerned. This helps doctors determine if the child is following the curve or further investigation is needed.
Diagnosis and treatment
To diagnose a GHD, doctors will first look at the patient’s medical history and do a physical exam to measure the patient’s height, weight as well as the length of arms and legs and compare it to the growth curve.
If a child’s growth is falling off the curve, a doctor will order tests like basic bloodwork, a possible hand X-ray, an MRI, and other imaging tests as needed to assess bone age. Depending on results, the doctor can also request more extensive testing and may look for other conditions like celiac disease, thyroid issues, or chronic illness.
The most common treatment for patient’s with a proven hormone deficiency is growth hormone replacement therapy. This injectable synthetic hormone comes in daily or weekly dose formats. Other hormone therapies can also be prescribed if the child is deficient in more than one hormone.
Dr. Preetha Krishnamoorthy sees patients all the time about growth concerns. She advises parents not to worry or stress out if their child has a smaller stature. “All children grow and develop in their own time,” she reassures. “While some may be due to a growth hormone deficiency, other children could have a naturally smaller stature but be healthy.”
About Dr. Krishnamoorthy
Dr. Krishnamoorthy is a pediatric endocrinologist. She completed her pediatric medical residency at the Montreal Children’s Hospital in 2000. She then completed a fellowship in Pediatric Endocrinology she has also been working as a staff in the Division of Pediatric Endocrinology since 2003.
She received the Paige and Bernard Kaplan Award for Excellence in Clinical Teaching in 2004 and the Osler Award by McGill Medicine graduating class of 2012 of 2022, and the Faculty Honour List for Educational Excellence in 2012.
Dr. Krishnamoorthy is also actively involved in undergraduate and postgraduate education levels at McGill University and is the Director of Pediatric Undergraduate Education.
As a pediatric endocrinologist, she enjoys the privilege of being part of a child’s life and developing a relationship with the patient and their parents over time.
