I. Does growth hormone inhibit or replace the hormones naturally secreted by the body, forming a dependency? Will it grow naturally after discontinuation?
For children with growth hormone deficiency, growth hormone treatment is to make up for the shortage of secretion in the body, which is in line with the growth pattern of children. The half-life of the drug is very short, so there is no need to consider the problem of suppressing one’s own growth hormone.
For non-growth hormone deficient children, long-term, high dose use of the drug may inhibit pituitary function and affect the child’s own growth hormone secretion. This is not a dependency problem, and there are not a large number of clinical cases that can prove it. However, for such children, we recommend that they use growth hormone 6 days a week and then stop for 1 day.
In addition, I do not recommend that people who are short grow to a normal height range and want to be “taller” to continue using medication. Especially for non-growth hormone deficient patients, you should stop taking the medication when you reach the normal height range.
2. Will I get fat with growth hormone?
There are hundreds of hormones in the human body. Different hormones have different effects. For example, the most common clinical glucocorticoid is secreted by the adrenal cortex, which has the function of regulating the biosynthesis and metabolism of sugar, fat and protein, as well as anti-inflammatory and anti-toxic effects. The familiar estrogen is also a hormone, which is an important hormone for maintaining female physical beauty. Androgens, on the other hand, promote masculine physical characteristics, beard growth, muscle growth and body hair growth.
Growth hormone, as its name implies, promotes growth, has an effect on fat and sugar anabolism, and promotes fat dissolution and muscle production. It is listed as a banned substance in international sports competitions. Therefore, after the use of growth hormone, the child’s weight gain may not be fattening, but may be more developed muscles.
Third, will the use of growth hormone cause precocious puberty?
Growth and development are two different concepts. Growth refers to the growth of organs, and the smaller individuals grow bigger, taller and gain weight. Development is another concept, which refers to the perfection and maturation of the function of an individual or an organ. Growth hormone is a growth promoter, not a gonadotroph.
Normal physiological doses of growth hormone injections do not lead to early development. Whether high-dose, long-term injections of growth hormone will have an early effect on development is not easy to say because there is insufficient evidence so far. However, a large number of clinical cases show that most early development is not caused by growth hormone.
At the same time, parents will notice problems with their child’s height at different points in time. For example, some are noticed when they start nursery school; some are noticed when they start school; and some wait until puberty to develop. In particular, it is not uncommon for children aged seven or eight to enter prepubertal development or to enter puberty after using growth hormone for a period of time, coinciding with their pubertal development. Therefore, before diagnosing growth hormone deficiency or using growth hormone due to short stature, doctors should carefully record the height and development so that they can compare before and after treatment.
Can tumors be induced by using growth hormone?
There have been cases in Shanghai where tumors were found after 3 months of using growth hormone. However, we know that a tumor does not change from a cell to a mass of cells or become a lump within 3 months. A tumor is an effect that accumulates over a long period of time. This case is most likely because the doctor did not check thoroughly and especially neglected to screen for tumors before starting treatment.
A survey of hundreds of thousands of patients treated with growth hormone worldwide found that the incidence of tumors was no higher in those using growth hormone than in normal people. However, on an individual basis, if you have a family history of tumors, you should tell your doctor, who should also do some appropriate tumor marker tests and review them regularly throughout the treatment process.
V. Does it affect brain development?
Growth hormone has no effect on intellectual development, so parents need not worry.
Will the use of growth hormone lead to early skeletal closure?
Bone closure is a natural growth process. During growth hormone treatment, epiphyses continue to grow and mature, and the growth potential is constantly depleted. However, growth hormone differs from sex hormones in that the latter can significantly promote epiphyseal closure, while the former has an insignificant effect in this regard.
VII. What should be emphasized to parents and patients regarding the use of growth hormone?
It is important to remind parents that if they think their child’s height is not at a normal level or if they have doubts about its development, they should go to a regular hospital with a pediatric endocrinology specialty for treatment. These are mostly tertiary hospitals. Generally, secondary and primary hospitals do not establish pediatric endocrine specialist clinics, but only child health departments. In addition, you should never go to so-called “developmental centers” or “dwarf centers” for consultation according to the propaganda in newspapers and radio. These institutions may not be hospitals, doctors, or drugs.