Reply to Delayed puberty and growth hormone injections

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=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?"[/quote]

Our endo told us the same thing (in that, why start him on medication just to give him medication) in our DS' case.

I'm 5'7", ex-dh is 6'4". DS is 15.5, bones measure about 2/3 years behind (we didn't have his teeth examined). ADHD and on meds since 2nd grade. He's finally showing signs of puberty now so his was really delayed but based on his bone age scans (we've been discussing this situation for the last two years with his endo) he has a lot of room to grow so she pretty much [i]released us[/i] from seeing her. Last year he grew 4 inches in total so I think it's all finally happening.

That said, I feel you OP on the sports thing. Even now with his 4" of growth last year he's still on the smaller side in his grade and this year, for the first time since t-ball, he didn't want to try out for the baseball team because he felt he couldnt keep up size wise or strength wise which made me sad for him because he was so committed to his sport. [/quote]

What your endo says doesn’t  make sense? Why give him meds just to give him meds? You have been giving him ADHD meds since 2nd grade. That is most likely the cause of delayed puberty and height.

So many boys are affected. Kids at my boys school now ask boys in 9th and 10th grade who haven’t gone through puberty if they have ADHD. [/quote]

ADHD meds do not cause delayed puberty.  In some kids, they can decrease appetite, but if your child has been gaining weight each yr and seems to eating normally it doesn’t affect height or puberty [/quote]

Yeah, they absolutely can delay puberty! I wish we were given this information but none of the doctors ever mentioned it. It happened to our son and several of the boys that we know are in adhd meds. Obviously not everyone who takes adhd meds is affected and eventually boys go through puberty but the delay was absolutely brutal for our son. And we never ever would have had him on adhd meds while approaching puberty had we known!

Here is one study-

https://onlinelibrary.wiley.com/doi/full/10.5694/mja12.10931

Main outcome measures: Subjects’ growth parameters before treatment were compared with controls aged 7 or 8 years; growth parameters and longitudinal changes on treatment to ages 12.00–13.99 and 14.00–15.99 years were compared with controls reviewed at 13 and 15 years of age, respectively. The subjects’ pubertal staging and height velocity were related to their treatment history.

Results: Sixty-five subjects were recruited; mean duration of treatment was 6.3 ± 1.9 years. At baseline, their growth parameters were not significantly different from those of the controls after adjusting for age. Compared with the controls, after adjusting for current age and baseline growth parameter z score, subjects aged 12.00–13.99 years had significantly lower weight and body mass index (P < 0.01), and those aged 14.00–15.99 years had significantly lower height and weight (P < 0.05). At 12.00–13.99 years of age, the subjects were comparable to the controls in their pubertal development adjusted for age, but those aged 14.00–15.99 years reported significant delay (mean Tanner stage, 3.6 for subjects v 4.0 for controls; P < 0.05). The dose of medication was inversely correlated with the height velocity from baseline to 14.00–15.99 years of age (P < 0.05).

CONCLUSION: Prolonged treatment (more than 3 years) with stimulant medication was associated with a slower rate of physical development during puberty. To maintain adequate height velocity during puberty, we recommend keeping the dose as low as possible.[/quote]

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