Human Growth Hormone Deficiency

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am the one posting about our 13.9 year old son who is going thru testing. I do want to clarify there are those testing or considering HGH to get taller because they don’t want to be short. And those who are considering hormone treatment because of medical situation.
Or son was sent to endocrinologist beacause he has only grown 1.5 inches in 19 months. The average for his age is 2-3 inches a year so he has failed three 6month growth tests.
Since he’ll be 14 in October, the specialist is concerned about his lack of growth this late in the game. I’m 5 7 and my husband is 6 ft— so we are both fairly tall. We weren’t even really cognizant of problem— primary doc just noticed lack of growth reviewing his chart at physical and some low levels of hormone in blood test.
I don’t think he’ll qualify because expected height is still 5”9 but he meets the two other criteria- so we”ll know more after some all day blood draw (every 30 min while giving some drug to test for hormone)—end of the month.

Can you share what other criteria? I'm concened about my son, who is falling off his growth curve at age 12. My DH is 6'2", and I'm 5'8". DS is currently at 40%, but when he was born and shortly after he was 75%. He's now tracking to be 5'10" or less. It's not that I'm bothered by that, but it doesn't seem like that is quite where he should be. Our ped sucks, they don't notice anything. On doing research, DS has is also VERY delayed in tooth loss...so I' mworried. I also can't get an appt with a pediatric endo before end of Sept, unless someon can recommond their Pediatric Endocrinologist for this?

FWIW... going from 75% to 40% is not "falling off" his growth curve. Your endocrinologist should check his growth hormone levels as well as other pituitary hormone levels (thyroid, prolactin, cortisol). If things look a little problematic, then the endo would order a growth hormone stimulation test (where they spend the morning in the hospital getting blood drawn every 30 minutes). Likely, your son is fine. 5'10" is average and would not be unusual given your heights (include your father, your father-in-law, any brothers, uncles into your thoughts about genetic height potential).

Another consideration is where your DS is in puberty. The standard growth charts don't take into effect where kids are in puberty and they can appear to be dropping on the curve when it could just be delayed puberty (my DS's issue). In addition to blood tests, an endo will do orders for a hand and wrist x-ray to assess bone age. It may simply be constitutional delay of growth and puberty.

My DS's bone xray showed 18-24 months behind his actual age. If you plotted him on the growth charts based on his actual age (12 1/2), he was 15-20%. If you did it based on his bone age (11), he was 50%.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am the one posting about our 13.9 year old son who is going thru testing. I do want to clarify there are those testing or considering HGH to get taller because they don’t want to be short. And those who are considering hormone treatment because of medical situation.
Or son was sent to endocrinologist beacause he has only grown 1.5 inches in 19 months. The average for his age is 2-3 inches a year so he has failed three 6month growth tests.
Since he’ll be 14 in October, the specialist is concerned about his lack of growth this late in the game. I’m 5 7 and my husband is 6 ft— so we are both fairly tall. We weren’t even really cognizant of problem— primary doc just noticed lack of growth reviewing his chart at physical and some low levels of hormone in blood test.
I don’t think he’ll qualify because expected height is still 5”9 but he meets the two other criteria- so we”ll know more after some all day blood draw (every 30 min while giving some drug to test for hormone)—end of the month.

Can you share what other criteria? I'm concened about my son, who is falling off his growth curve at age 12. My DH is 6'2", and I'm 5'8". DS is currently at 40%, but when he was born and shortly after he was 75%. He's now tracking to be 5'10" or less. It's not that I'm bothered by that, but it doesn't seem like that is quite where he should be. Our ped sucks, they don't notice anything. On doing research, DS has is also VERY delayed in tooth loss...so I' mworried. I also can't get an appt with a pediatric endo before end of Sept, unless someon can recommond their Pediatric Endocrinologist for this?

FWIW... going from 75% to 40% is not "falling off" his growth curve. Your endocrinologist should check his growth hormone levels as well as other pituitary hormone levels (thyroid, prolactin, cortisol). If things look a little problematic, then the endo would order a growth hormone stimulation test (where they spend the morning in the hospital getting blood drawn every 30 minutes). Likely, your son is fine. 5'10" is average and would not be unusual given your heights (include your father, your father-in-law, any brothers, uncles into your thoughts about genetic height potential).

+1 Note there are strict standards on being able to get HGH therapy. I understand the criteria is set by the FDA. Full costs can be over $120k a year, so insurance is very careful (though I suppose you maybe able to pay out of pocket but not sure an endocrinologist would prescribe outside of FDA guidelines). Usually they are looking at multiple criteria including one being an outcome of being medically short - which I understand is 4'11 in women, 5'3 in men - as well as clear lab tests, bone age tests, etc. Also in terms of growth curves, they don't look at where you are born to age 12 (as long as there is no failure to thrive), but as I understand usually age 3/4 on and how much is dropping off curve by each year. A true growth curve drop - (which often includes complete stoppage of growth), does need to be examined not just from an endocrinology perspective but also for other medical conditions such as IBD, celiac, etc. whose symptoms may not be apparent. Bone age - can sometimes show that they may enter puberty later and grow later.