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]

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”.   [/quote]

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[/quote]

Speaking as an adult who had delayed puberty, it’s not just about height. Delayed puberty sets you back socially for years; many people completely miss the boat on normal adolescent development like dating in high school or college. It can take another decade to grow into your sexuality, and if that Carrie’s into one’s 20s it has domino effects on dating for marriage. [/quote]

I agree with this somewhat, yet also disagree somewhat. Maybe it depends on the degree of delay.  My DH had delayed puberty and our oldest DS did/does also. I see how socially difficult it is and has been for my DS (currently 16)- although he has (finally) started, most would guess he is 14ish at most. On the other hand- my DH had a similar experience but was dating by senior of HS, had girlfriends in college etc. It was the worst in middle school through mid high school and then got better from there. It hurt DH in sports for sure (which in HS seemed like a big deal, and hurt socially in terms of making friends)- but he switched to a no-cut sport and busied himself with other things. My DS is doing the same.

Not disagreeing that it is really really tough, but I honestly don’t think the effects last into adulthood for most. [/quote]

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