Growth hormones: it’s a treatment some parents think about when they see their children are shorter than their peers. Doctors call this short stature. Short stature can be inherited. But sometimes, kids are low on growth hormones, the stuff that makes us grow.

Parents of a child with short stature may worry how being short will affect their child. They may be concerned that a child who is shorter than his friends will be teased. This is especially true for parents of boys. Being tall may be seen as being masculine and strong. A short boy’s parents may worry their child will be seen as a wimp—that being short will somehow hold their child back from fulfilling his potential.

Research shows that tall people do have some advantages. Tall people tend to have higher salaries. Some studies show that people prefer taller partners. And when faced with a choice of two presidential candidates, voters lean toward the taller of the two.

Weighing all this research, a parent might come to the conclusion that being short is a disadvantage. A parent might fear that a child will feel somehow less than his peers, not quite up to scratch. And yet, that’s not the case.

Growth Hormones: An Ethical Dilemma

Most children of short stature feel just fine about themselves and do just as well as their taller friends. And short children grow up to do just as well as their colleagues. Parents should therefore weigh whether their desire to treat a child with short stature is based on their own concerns or on the child’s.  If the child doesn’t mind being short, treatment may not be the right path to take.

Growth Hormones For A Healthy Child?

Also, parents of a child with short stature would be wise to look at the bigger picture. Are the parents short? Is the child healthy, as is usually the case in children of short stature? In such a case, it might be reasonable to let the child be, and not begin treatment. If, on the other hand, the child’s short stature is due to a medical condition, for instance, an underactive thyroid, treatment may be important.

Growth Hormone: Weighing The Risks

There are other reasons why treating a child with a mild case of short stature might not be the right thing to do. There are ethical concerns. For one thing, growth hormone treatment is not risk-free. Should a parent treat a child for short stature because of worries about the child’s psychological well-being, when treatment brings serious health risks?

One study, for instance, found that the risk for stroke was doubled in young  adults who’d had growth hormone treatment as kids. Worse yet, the risk for a type of stroke that causes bleeding in the brain, hemorrhagic stroke, was seven times that of the general population.  Meantime, a 2012 study found that the risk for early death was higher after growth hormone treatment.  Finally, children treated with growth hormones may be six times as likely to develop type two diabetes.

And those are only the risks we know about.

A parent who want to treat a child with short stature might want to weigh whether a child’s self-esteem is worth the very real risks to that child’s life. Is it a little difficult for the child to reach things on a high shelf? Or is the child so short that he or she is pretty much disabled?

The thing is, not all kids are just short. Some are really, really short. And with the lack of height comes some very real issues. These are issues that make it reasonable to consider treatment, in spite of the risks. Because the risks of not taking treatment can be serious, too.

A driver who isn’t even 5 feet tall, for instance, is going to have shorter legs and arms. That means he or she will have to pull the car seat forward to reach the steering wheel, brakes, gas pedal, and clutch. That puts the driver at risk of injury or death for being too close to the air bag in the event of an accident. In other words, a driver of very short stature runs the risk of being killed by an air bag during a car accident.

How Effective Is Growth Hormone Treatment?

Many parents look to growth hormone therapy, hoping their very short children will be as tall as their friends. In actual fact, some kids will grow as much as 2 inches with growth hormone therapy, with about half those treated growing somewhat more or less than that. A slightly higher dose of  growth hormones may yield a child an extra   3-4 1/2 inches. But a higher dose may come with greater risks.

Then there’s cost.  Health insurance may cover part or all of the treatment. That varies. There may be copayments. But the actual cost of growth hormone shots can come in anywhere from $10,000 to $60,000 a year. Which means we’re talking about paying  a whopping  $52,000 per inch. But if your child is  4′ 11″, still growing, but with low natural levels of growth hormones, an inch or two could make all the difference.

Evaluation And Growth Hormone Treatment

In considering whether or not to begin treatment with growth hormones, your child’s doctor will want to evaluate whether or not there is a true growth disorder. There are many causes of short stature. The doctor will examine your child and based on his or her findings, will decide which on which tests to order. Blood tests may be ordered to look for hormone and chromosome irregularities. An x-ray may be ordered to see your child’s bone age. A child’s bone age may be different than the child’s actual age.  An x-ray can tell the doctor whether the child’s bones are still growing.

Other imaging scans may be used to get a look at the child’s pituitary gland. The pituitary gland makes and stores some hormones; stimulates the body to make others; and is responsible too, for how the body uses these hormones. A good working pituitary gland is necessary for growth.

Sometimes the doctor will decide to do a growth hormone stimulation test. This involves the doctor giving the child medications that make the pituitary gland produce growth hormones. The doctor will take blood samples from time to time to measure the child’s growth hormone levels.

If the tests show the child is a good candidate for growth hormone treatment, the child will likely have daily injections. Some children will receive only six injections  per week, while still others will have treatment only three times a week. Parents and child may see a quick spurt of growth within 3 or 4 months. The speed of the child’s growth during treatment will tend to become slower over time.

Treatment  for short stature is continued over the course of several years, until the child reaches a height considered acceptable, or until he’s reached the maximum height he can achieve. The rate of growth may seem very slow to parent and child after the initial growth spurt. Here it is important to have realistic expectations of what growth hormone treatment can achieve.

Other Reasons For Poor Growth

Sometimes tests may reveal a child has other hormone deficiencies that can affect growth. The child may be deficient in thyroid hormone, cortisol, or sex hormones. There are medications available to replace all of these hormones. Here, balance is very important. Only when all of these important hormones are at good levels, can a child achieve normal growth. For this reason, taking the medications exactly as directed, is important.

While the rest of us tend to think of growth as an automatic process, for children of short stature, it is no such thing. In the fight for gaining height, even the smallest tools can make a difference. That’s why in addition to taking medication to replace deficient hormones, children need to eat a healthy, balanced diet and get enough rest. Good nutrition and sleep habits are important for all children, even more so for children who are struggling for normal growth.

Does your child have short stature? Have you considered having him tested and treated? Do you feel confident you’ve made the right choice?

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