Q: What are the current recommendations about human growth hormone for children with short stature? Are there any long-term studies on side effects?
A: Using human growth hormone for children who have no medical reason for being short (called idiopathic short stature) is controversial.
It does appear to help, but:
It doesn't help much. The most height children gain from the treatment is 2 to 3 inches.
It doesn't help everyone. Everybody responds to growth hormone differently.
Some children would have grown more anyway. Most children with short stature have "catch-up" growth during puberty without any treatment at all.
At high doses, growth hormone can have serious side effects, including swelling, heart problems, diabetes and an increased risk of cancer. At the low doses generally used for treating short stature, growth hormone appears to have minimal side effects.
Before you start thinking "can't hurt, might help," consider that:
It's uncomfortable. Treatment involves daily injections for months on end.
It's expensive. On average, treatment costs about $50,000 per inch of gained adult height, something insurers are reluctant to pay for—especially in the absence of any real medical problem.
Being short isn't bad. Many studies have shown that people who are short do just as well psychologically and in other areas of their lives as tall people.
Treatment can backfire psychologically. By treating a child with growth hormone, you are saying there is something wrong with his or her height. This can be damaging to a child's self-esteem, especially when the treatment may not increase height much at all.
Because of all this, specialists recommend that growth hormone treatment only be considered for children whose predicted adult height is more than 2.25 standard deviations below the mean—for boys, that's 63 inches; for girls, 59 inches—and only for children for whom there is real evidence of current or future psychosocial problems from being short.
With support, love, and in some cases counseling, most psychosocial problems can be avoided, making treatment unnecessary.
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