1. How to deal with bleeding at the injection site after the patient has been injected with growth hormone?
Answer: When there is only extracutaneous bleeding at the eye of the needle after the syringe is pulled out, it means that the small capillaries of the skin were pierced during the injection; parents and patients should not be nervous because it will not cause harm to the child’s body and will not affect the efficacy of growth hormone; when there is extracutaneous and subcutaneous bleeding at the eye of the needle after the syringe is pulled out, it means that the small capillaries of the skin were pierced during the injection; the next day, use a warm towel to apply hot compresses for 5-10 min (in summer, hot compresses are not needed). Parents and patients should not be nervous because it will not cause harm to the child’s body and will not affect the efficacy of growth hormone; because the tip of BD needle is thicker and longer than that of Novo and pen, there are slightly more cases of bleeding at the injection site when BD needle is injected, but they are relatively rare; after the injection, the speed of needle extraction is too slow and easy to bleed. The needle should be pulled out quickly.
2.How to deal with the bulging of the skin when the patient injects growth hormone?
Answer: When patients inject growth hormone, because the angle of the needle is too small, the drug is injected into the skin, so there is no need to deal with it and let the skin absorb the drug on its own, which will not affect the efficacy of growth hormone and will not cause harm to the child’s body; the correct angle of the needle is 45 degrees when injecting growth hormone and injecting into the skin; the needle enters the skin, but the speed of injecting growth hormone is too fast, so it is easy to bulge the bag, and each injection takes 3-5 minutes.
3. Does joint pain or muscle pain appear after a period of injection?
Answer: It may occur after strenuous exercise or sudden increase in the amount of exercise, so the amount of exercise should be reduced and moderate exercise can be done; it may be caused by the strong physiological effect of sodium storage of growth hormone.
4.What is hypothyroidism? How to deal with hypothyroidism when it occurs during growth hormone 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 growth hormone.
5. Is there an increase in blood sugar during growth hormone treatment?
Answer: Generally, there 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 if the blood glucose is higher than 10 mmol/l, insulin treatment is needed.
6.Does edema appear during growth hormone treatment?
Answer: Symptoms of edema: edema of eyelids, face, back of hands, back of feet and lower limbs, intracranial hypertension (such as headache, nausea and vomiting); if tolerated, continue to use growth hormone, and generally the symptoms will disappear within 3-7 days; if not tolerated, the growth hormone dose should be reduced or discontinued, and the medication should be resumed after the symptoms disappear.
7. Will growth hormone treatment accelerate bone age?
Answer: Domestic and foreign medical institutions and literature report that growth hormone therapy does not accelerate bone age.
8. Will growth hormone treatment affect the fertility of children?
Answer: Growth hormone is secreted by the normal human body and is necessary for human growth and development; for women in their reproductive years, growth hormone has the effect of promoting ovulation; for men in their reproductive years, growth hormone has the effect of promoting sperm maturation; therefore, growth hormone treatment will not affect fertility.
9. Will growth hormone make children fat?
Answer: Growth hormone is a protein, not a glucocorticoid, and will not cause obesity; moreover, it has the effect of local fat reduction.
10.Why should each injection site be two centimeters apart from the previous injection site when injecting growth hormone?
Answer: Growth hormone treatment can locally degrade subcutaneous fat, especially the fat in the abdomen and large intestinal omentum is sensitive to catecholamine-mediated lipolysis (e.g. GHD has increased subcutaneous fat, especially abdominal fat accumulation, and growth hormone treatment can make abdominal fat ablate). Growth hormone increases muscle tissue at the same time as fat reduction. Because growth hormone can degrade subcutaneous fat, the injection site should be changed frequently.
11. Can growth hormone treatment cause diabetes?
Answer: At present, the relevant literature at home and abroad reports that growth hormone therapy does not cause diabetes.
12.Does growth hormone therapy increase the risk of tumor recurrence?
Answer: For people whose tumors have been cured, current data do not indicate that growth hormone therapy increases the risk of tumor recurrence; for people who are suffering from tumors and are receiving treatment, the incidence of original tumors and secondary tumors increases significantly; the risk of new tumors: it does not increase the incidence of new tumors such as leukemia.
13.Can growth hormone be used for vaccination during treatment? Can the drug be used during the treatment of general medical diseases?
Answer: Since growth hormone is secreted by the normal human body itself, it can be used for vaccination during growth hormone treatment; growth hormone can also be used during the treatment of general medical diseases.
14.Do I need to stop taking growth hormone when treating colds?
Answer: General cold treatment drugs do not affect the efficacy of growth hormone.
15. Is growth hormone used for children with asthma or allergic rhinitis?
Answer: The dosage of glucocorticoids should be adjusted under the guidance of a professional pediatric endocrinologist. (Note: Glucocorticoids are growth hormone antagonist drugs, which will affect the efficacy of growth hormone.)
16.Will the efficacy of growth hormone be affected if the child forgets to inject it on a certain day? Do I have to make up for the missed injection?
Answer: Forgetting to inject growth hormone once in a while for one day will not affect the efficacy of the treatment, and there is no need to make up for the missed injection; try to avoid interruption of medication.
17. At what age should growth hormone not be used?
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 growth space of the child is very limited and growth hormone therapy is generally not recommended.
18. Will growth hormone inhibit its own secretion?
Answer: For children who cannot secrete or have insufficient secretion of growth hormone, exogenous supplementation is required; 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 the secretion of its own growth hormone; 0.15-0.2IU/kg/d will not inhibit the secretion of its own GH either.
19.The child has redness, pain, fever and itching at the injection site, with the area varying from peanut to egg size?
Answer: rhGH is produced by secretory gene expression technology of E. coli, and the purity of growth hormone is very high, so there is usually no allergic reaction; the above situation is mostly caused by allergy to sterilization methods such as alcohol or iodophor, and the solution is to change to a non-allergic sterilization method.
20. Why did the child have a low fever when injecting growth hormone?
Answer: Foreign literature reports that growth hormone treatment can make a very small number of children susceptible to upper respiratory tract infection and otitis media and develop low fever, but the symptoms are generally mild and will disappear with prolonged medication.