Delayed puberty and growth hormone injections

[Anonymous]

Has anyone done testosterone injections for constitutional delay of growth in their son? My guy is 15.5 and is 5’4”. No visible signs of puberty. There are no underlying health issues and I’m 5’9” and his dad is 6’0”. My brothers are 6’3. He’s finishing up his freshman year and is one of the smallest in his class. He’s very athletic and is becoming increasingly despondent about his size in terms of how it’s limiting his success in the sports he loves. We are seeing a pediatric endocrinologist in June but I wanted to do some research first and see if anyone here has done growth hormone injections for their son, and what the outcome was. Were there any side effects? How much do they cost? How long was the course of treatment? And was there noticeable growth?
Any insight would be extremely helpful and much appreciated! Thanks in advance for taking the time to respond!

[Anonymous]

OP-Forgot to mention, his bone age as evidenced by a hand X-ray is about 15 months behind his chronological age and his dentist says his dental age appears to be 24-30 months behind.

[Anonymous]

My 15 year old is taking growth hormone injections. It has been hugely helpful and no side effects. There was a lengthy process to go through to have them covered by insurance and with insurance the shots are free.

[Anonymous]

My son started growth hormone injections at age 10 and just finished taking them at 16 3/4 years old. He grew along the 50th percentile for height until about age 7 when he started dropping off the curve. He was around the 15th percentile at age 10. Now he above the 99th percentile for height. (FWIW, his mom is 5'11" and his father is 6'5".) He was diagnosed with hypo-pituitarism around age 5, so we knew that he would probably need the injections at some point. He has been taking thyroid medicine since age 5 and will continue that for his whole life. The growth hormone was used during the prime growing years to give him the chance to grow to his "genetic potential."

[Anonymous]

Is he in adhd medication? It can delay puberty.

[Anonymous]

As a pediatrician, I don't know why anyone would recommend growth hormone injections for constitutional growth delay. It's just delayed puberty -- CGD itself doesn't have any effect on final height. They just reach it later.

Are you sure you don't mean "familial short stature?"

[Anonymous]

Is he vegetarian? If so, get him on meat.

[Anonymous]

Anonymous wrote:As a pediatrician, I don't know why anyone would recommend growth hormone injections for constitutional growth delay. It's just delayed puberty -- CGD itself doesn't have any effect on final height. They just reach it later.

Are you sure you don't mean "familial short stature?"

If it’s delayed puberty won’t he get a growth spurt later? My brother left high school at 5’10” and soon after got to his full height of 6’2”.

[Anonymous]

Anonymous wrote:

Anonymous wrote:As a pediatrician, I don't know why anyone would recommend growth hormone injections for constitutional growth delay. It's just delayed puberty -- CGD itself doesn't have any effect on final height. They just reach it later.

Are you sure you don't mean "familial short stature?"

If it’s delayed puberty won’t he get a growth spurt later? My brother left high school at 5’10” and soon after got to his full height of 6’2”.

He will. It just means that his "constitution" is programmed to hit the growth spurt later, and usually one or both of his parents did the same. But it's not a deficiency of growth hormone or even of adult height.

More information is coming out about the risks of additional growth hormone over and above normal levels (not really relevant to true growth hormone or pituitary deficiency, which are separate diagnoses from constitutional growth delay). This issue isn't settled yet, but GH isn't without risks. And if the child is going to reach normal height, just later, I'm not sure why someone would pursue this.

https://www.webmd.com/children/news/20140813/children-prescribed-growth-hormone-may-face-stroke-risk-later-study
Children, Growth Hormone, & Possible Risk Later

https://www.nytimes.com/2021/03/29/well/live/growth-hormones-short-children-height.html
Weighing the Use of Growth Hormones for Children: New research has linked growth hormone treatment to serious adverse health effects years later

[Anonymous]

Have you had him evaluated for growth hormone deficiency? Has his growth dropped off over the years or is he staying steady on the curve?

I would think that if your son is truly still at stage 1 or early stage 2 on the Tanner scale and has no growth hormone deficiency an endocrinologist would want to give him a few months of testosterone shots to jump start puberty. Has a doctor ever told you what stage he is in?

[Anonymous]

Our DS was just like this as a HS Freshman and we saw a pediatric endocrinologist. He was still on the normal side of the scale, just delayed. Now as a college freshman he’s over 6 ft tall. No hormone shots. He also got his teeth late and lost his teeth late.

[Anonymous]

I mean he is much taller than many 15-year-olds with actual constitutional growth delay. Including my DS at that age. We did bone age scan, saw endo and nutritionists and got him to eat more.
He is now over 5'10" as an adult and there was absolutely not talk from any specialist about growth hormone.

[Anonymous]

I’m the PP. forgot to say explicitly that there is a big difference between growth hormone injections and testosterone injections.

Growth hormone is for kids who are deficient in growth hormone and they take it nightly until they’re done growing.

Testosterone is to jump start puberty and kids often get a shot per month for a few months. It’s for constitutional delay of puberty. Sounds like you are talking more about the latter than growth hormone.

[Anonymous]

Anonymous wrote:OP-Forgot to mention, his bone age as evidenced by a hand X-ray is about 15 months behind his chronological age and his dentist says his dental age appears to be 24-30 months behind.

DS was 5'3" at 15. He had delayed puberty (runs in the family). At almost 18, he's a bit over 5'10", and the doctor said he is still on the upward trajectory of growth. He'll probably reach 6'.

It doesn't seem like he needs growth hormones. His growth is just delayed. He'll get there.

FWIW, my DD 14.5, hasn't started her period yet. Pediatrician isn't concerned until 15.5. Again, delayed puberty runs in the family.

Does late puberty run in your family?

[Anonymous]

Anonymous wrote:I’m the PP. forgot to say explicitly that there is a big difference between growth hormone injections and testosterone injections.

Growth hormone is for kids who are deficient in growth hormone and they take it nightly until they’re done growing.

Testosterone is to jump start puberty and kids often get a shot per month for a few months. It’s for constitutional delay of puberty. Sounds like you are talking more about the latter than growth hormone.

OP here- yes, this is specifically what I’m talking about, testosterone shots. I didn’t realize they were different from growth hormone shots, sorry for the confusion. What my pediatrician had mentioned was a few months of injections to kickstart puberty and we are headed to a pediatric endocrinologist in July to explore that further. According to my pediatrician, she thinks he will attain his full height potential at some point but possibly not until college. We are worried about the emotional and psychological implications of this since we see him becoming hyper focused on his lack of growth and increasingly depressed. I am trying to weigh the pros and cons of getting the shots and the risks inherent within vs letting him arrive at puberty naturally but risk having him become mentally unwell. Thanks to all who have responded- it’s a hard topic to research as a lot of the information online is contradictory and confusing, so I really appreciate all of the responses!