Concerns in growth hormone injection therapy, the most important issues for parents (I)
I. Will growth hormone suppress the child’s own secretion function?
A: It will not affect. The secretion of growth hormone is related to the hypothalamic-pituitary growth axis, and growth hormone replacement therapy will not affect the function of the hypothalamic-pituitary growth axis.
Second, growth hormone is a “hormone”, so it will be harmful to the child’s body, right?
A: What we usually call “hormone” generally refers to glucocorticoid hormone, which will make children gain weight with long-term use. However, growth hormone is very different from glucocorticoids in terms of physiological effects, secretion and regulation. In children, the role of growth hormone is to promote the linear growth of bones and make the body taller. In addition, it also promotes protein synthesis and accelerates lipolysis. It is safe and effective to use growth hormone for treatment under the guidance of a doctor.
3. Will growth hormone treatment make children gain weight?
A: Generally speaking, growth hormone will not cause children to become obese. If children become fat, it may be related to excessive nutritional intake, and it is recommended to do more vertical jumping exercises, which is good for weight control and also beneficial for promoting the development of height.
4. Will the use of growth hormone treatment for girls with short stature lead to infertility?
A: At present, there is no information showing that it can lead to infertility. On the contrary, there are relevant medical studies confirming that growth hormone can be used as an adjunctive treatment for certain infertility conditions.
V. Will growth hormone cause diabetes?
A: Growth hormone does not cause diabetes. However, growth hormone can cause a transient increase in blood sugar. Patients with a family history of familial diabetes need to be highly cautious and have their children’s blood sugar checked before treatment, and if growth hormone is used, regular blood sugar testing is required.
Will growth hormone treatment cause precocious puberty? Will it cause early puberty?
A: Growth hormone therapy will not cause precocious puberty. The mechanism of growth hormone is to promote the linear growth of epiphysis, and only sex hormones promote sexual development. Growth hormone therapy will not cause early puberty.
7. Will growth hormone therapy cause tumors?
A: A large number of medical studies have been done abroad, and medical literature suggests that growth hormone therapy does not increase the risk of leukemia and tumor development in children without potential tumor risk factors, but caution should be exercised when applying long-term supraphysiological doses of growth hormone to children who have had tumors, have a genetic tendency to develop tumors in their families, or have malformation syndromes. The IGF-1 level should be closely monitored during the treatment process, and should be temporarily discontinued for those who exceed the normal reference value of +2SD.
VIII. Will growth hormone make the hands and feet bigger?
A: Generally speaking, if the child’s bone age is small and the treatment is carried out according to the doctor’s recommended dosage, the phenomenon of enlarged hands and feet will not occur. However, for children with closed epiphyses who are short, if they continue to use growth hormone in excessive physiological doses for a long time to promote growth, it may cause acromegaly. Therefore, growth hormone treatment is prohibited for patients with closed epiphyses.
Concerns about growth hormone injections and the most important concerns of parents (II)
I. Will the application of growth hormone reduce the child’s resistance?
A: It will not affect immunity. On the contrary, basic medical research has confirmed that growth hormone can improve immunity.
B. How can we know whether growth hormone injection therapy is effective?
A: The clinical judgment of the effectiveness of growth hormone is that the annual growth rate after treatment increases by more than 2 cm/year compared to that before treatment. Growth hormone can be tried for 3 months, and if it can grow by more than 2 cm in 3 months, then it is effective.
Is there a treatment course for growth hormone therapy?
A: There is no such thing as a course of treatment for growth hormone. The duration of use should be determined by the indications of the child, the difference in height from the normal standard, the age of the bones, and the family’s financial situation. It is important to listen to the advice of the treating doctor and follow the medical advice.
IV. What kind of review is needed after growth hormone treatment?
A: After growth hormone treatment, height should be measured every three months, and bone age can be reviewed every six months or once a year according to the actual age of the patient. Generally, thyroid function and blood sugar need to be checked, and MRI is not necessary if there is no problem. Monitoring of IGF-1 and IGF-BP3 should be considered 3 months after medication, depending on the advice of the treating physician.
It is generally not necessary to redo the growth hormone stimulation test. Complete growth hormone deficiency is rarely self-recovered, except for partial deficiency that is critically normal and may remit with puberty.
V. What is the best age to inject growth hormone for dwarfism treatment?
A: The earlier the treatment, the better. Pre-pubertal treatment is the best time for treatment. If the diagnosis is clear, treatment can be started after the child is 3 weeks old.
Under what circumstances is it necessary to stop using growth hormone treatment?
A: Criteria for discontinuing growth hormone deficiency.
1. Epiphyseal closure.
2. Obvious side effects to growth hormone therapy (e.g. hyperglycemia, abnormal liver function)
3.Reaching the height target expected by parents.
4.The treatment is not effective and fails to achieve the goal of height improvement
7. Can children with hepatitis B and C who have short stature be treated with growth hormone?
Answer.
1. Hepatitis B and C are at high risk of liver cancer, and IGF-I has the function of promoting cell mitosis and inhibiting apoptosis, so growth hormone therapy is generally not recommended;
2. Hepatitis B and C in the active stage must not be treated with growth hormone;
3. If hepatitis B and C are in the stable stage with normal AST and ALT, they can be treated with growth hormone.