1. Does joint pain or myalgia appear after a period of injection?
Answer: a. It may appear after strenuous exercise or sudden increase of exercise, and the amount of exercise should be reduced and moderate exercise can be done. b. It may be caused by the strong physiological effect of sodium and water retention of growth hormone, and the symptoms will disappear after a few days without treatment if the pain is mild.
2.What is hypothyroidism and how to deal with hypothyroidism during GH treatment?
Answer: The diagnosis of subclinical hypothyroidism is made based on laboratory tests, when the patient has not yet shown obvious clinical symptoms or signs. Subclinical hypothyroidism is defined as serum TSH levels exceeding the upper limit of normal (0.45-4.5 mlU/L) while serum free T4 (FT4) concentrations are normal. The need for treatment depends on the specific laboratory values of the child. Treatment is mostly oral levothyroxine sodium, and thyroid function will return to normal after discontinuation of GH.
3.Is there a rise in blood sugar during GH treatment?
Answer:Generally, it is a transient increase in blood glucose, and it will return to normal soon; if the blood glucose is persistently high, it should be reviewed in hospital, and insulin treatment is needed if the blood glucose is higher than 10mmol/l. If the blood glucose cannot be effectively controlled with more than 150IU/d insulin, GH should be stopped.
4.What about edema during GH treatment?
Answer: a. Symptoms of edema: edema of eyelids, face, back of hands, back of feet, lower limbs, intracranial hypertension (such as headache, nausea, vomiting); b. If you can tolerate it, continue to use GH, usually the symptoms disappear within 3-7 days; if you cannot tolerate it, you need to reduce the dose of growth hormone or stop the drug, and resume the drug after the symptoms disappear.
5.Will GH treatment accelerate bone age?
Answer: The relevant medical institutions and literature at home and abroad report that GH treatment will not accelerate bone age.
6.Will GH treatment affect the fertility of children?
Answer: Because GH is secreted by the normal human body itself, which is necessary for human growth and development; for women in the reproductive period, GH has the effect of promoting ovulation; for men in the reproductive period, GH has the effect of promoting sperm maturation; therefore, GH treatment will not affect fertility.
7.Will GH make the child fat?
Answer:GH is a protein, not a glucocorticoid, so it will not cause fat; moreover, it has the effect of local fat reduction.
8.Will GH treatment cause diabetes?
Answer:At present, the relevant literature at home and abroad reports that GH treatment will not cause diabetes.
9.Does GH treatment increase the risk of tumor recurrence?
Answer:a. For those whose tumors have been cured, the current data do not indicate that GH treatment will increase the risk of tumor recurrence; b. For those who are suffering from tumors and are receiving treatment, the incidence of original tumors and secondary tumors will increase significantly; c. The risk of new tumors: it will not increase the incidence of new tumors such as leukemia.
10. What is the weight gain of the child after GH treatment?
Answer: a. Whether there is occult edema (with occult edema weight gain >500g/w); b. Because GH promotes anabolism, height growth will be accompanied by weight gain.
11.Can I get vaccination during GH treatment? Can the medication be used in the treatment of general medical diseases?
Answer: Because GH is secreted by the normal body itself, so GH can be used for vaccination during treatment; GH can also be used during treatment of general medical diseases.
12.Do I need to stop GH when treating the cold?
Answer:The general medicine for cold and flu does not affect the efficacy of GH.
13.Do I need to use GH for children with asthma or allergic rhinitis?
Solution: The dosage of glucocorticoids should be adjusted under the guidance of a professional pediatric endocrinologist. Note: Glucocorticoids are GH antagonist drugs, which will affect the efficacy of GH.
14. How long does it take for GH to take effect?
Answer: GH should be used for 3 months as a course of treatment, so it is necessary to review height, weight, nail function and blood glucose in hospital after 3 months of GH treatment in order to evaluate its efficacy.
15.What are the reasons for the poor efficacy of GH treatment?
Answer: a. whether GH dose is enough; b. GH powder produces antibodies; c. low thyroid function; d. using glucocorticoids; e. epiphyseal plate closure; f. inaccurate measurement; g. having systemic chronic diseases; h. GH treatment is ineffective; i . Whether the resident child is adherent to G H.
16. How old can GH treatment be discontinued until bone age?
Answer: When girls BA 14 years old, boys BA 15-16 years old, the general growth rate is less than 2cm/y, in order to reduce the economic burden of parents can stop the use of GH.
17.What is the age of bone that can not use GH?
Answer: At the first visit, when a girl is 14 years old and a boy is 15 years old, the growth rate is less than 2cm/y; at this time, the child’s growth space is very limited, so GH treatment is generally not recommended.
18.Will growth hormone inhibit its own secretion?
Answer: For children who cannot secrete or under-secrete growth hormone, exogenous supplementation is needed; secondly, since the amount of supplementation is 0.1-0.15IU/kg/d, which is the smallest effective dose, it will not form a negative feedback effect and inhibit its own GH secretion; 0.15-0.2IU/kg/d will not inhibit its own GH secretion either.
19.When to stop the combination of GnRHa and GH in children with CPP?
Answer: If BA ≥ 12.5 years old for girls and 13.5 years old for boys, GnRHa should be stopped and only GH should be used.
20.What is the situation that GnRHa is not suitable for children with first diagnosis of CPP?
Answer: a. Bone age ≥ 12.5 years for girls and BA ≥ 13.5 years for boys; b. 1 year after menarche for girls or after ejaculation for boys; GH alone should be used in the above cases.
21. Why did the child have a low fever when GH was injected?
Answer: a. Foreign literature reports that GH treatment can make very few children susceptible to upper respiratory tract infection and otitis media, and develop low fever, but the symptoms are generally mild; they will disappear with the prolongation of medication.
22.Why does the child show hyperthyroidism symptoms when injecting GH?
Answer: a. It is reported in foreign literature that a very small number of children with hyperthyroidism in GH treatment have hyperthyroidism, which is an autoimmune disease. The treatment plan for these children should be carried out under the guidance of an endocrinologist.