1. Why is it recommended to treat patients with growth hormone deficiency (GHD) for more than 1-2 years with the application of growth hormone therapy?
When there is a lack of proper GH in the body, it will affect your growth and metabolism. Only by raising GH to normal level and maintaining it in the normal range can clinical symptoms be improved. Nowadays, using growth hormone treatment can make him/her grow much taller every year, 10-14cm in the first year, 8-9cm in the second year and 7-8cm in the third year, so long-term or even lifelong treatment is needed. Otherwise, GHD patients will have the following harmful effects.
1. Short stature in childhood.
2. Abnormal metabolism, poor heart function, low muscle strength and lung capacity, so GH treatment can not only improve height, but also improve metabolism.
3, GHD is lifelong basic, it can combine with central hypothyroidism, gonadal dysplasia, hypoadrenocorticism, dyslipidemia, and low heart function. Therefore, GHD treatment needs to be long-term treatment, which can improve metabolism in addition to augmentation.
2. What is the efficacy assessment of patients after medication?
Over the years, experience has shown that different ages, bone age, developmental level, nutritional status and family genetic height affect the efficacy of children, so the efficacy of each child will be different. Don’t be in a hurry to see the effect of the treatment, growth hormone is a panacea, but the effect of the treatment will only be known after 3 months of observation and testing. 3 months is the shortest course of observation, and the bone age will be reviewed every 6 months, then the adult height prediction before and after the treatment can be compared and the size of the difference between the current height and that of children of the same age can be compared to evaluate the effect of the treatment.
The average growth for a normal child before the age of 12 is 5-7 cm per year. There is no significant relationship between the growth during GH application and the seasons, and the effect is not better in the spring than in the summer.
3.When do patients need to be rechecked after using growth hormone treatment? What are the items that need to be reviewed? Why do I need a follow-up?
It depends on the age of the patient. Generally speaking, the first month should be a follow-up visit to determine whether the parents’ injection method is correct, whether the child tolerates it, whether the medication is extracted correctly, and to do some specific tests, such as nail function and IGF-1, to see the compliance with the medication and early adverse reactions. The field is generally three months to review, the parents trust high if soon to review will have an opinion.
1, height, weight (depending on the growth of the child);
2, IGF-1, IGF-BP3, IGF-BP3 is not very instructive, but the ratio of the two has significance (response to GH, safety);
3, and free T4 (to see the thyroid function). Bring your previous test results with you to your follow-up appointment, as the items may not be the same each time. The purpose of the follow-up visit is twofold. First, the doctor wants to know whether the child has grown taller or not, that is, whether the medicine is working for your child. If your child is gaining weight, you should adjust the dosage of the medication. If the previous dose is used, the effect will not be good. The second thing is to monitor whether it is safe, we want the child to grow taller in a safe way, this is the most important thing. You can come once in the summer and once in the winter, and then choose one day in each semester to come back for a follow-up.
4. How do you think about the safety of the growth hormone treatment process?
1. Growth hormone is a very safe drug, first of all in terms of the history of its use. It has been used in foreign countries since the 1950s and 1960s, but in our country, it has been used since 1985. Whether it is used early or late, we are all very concerned about its side effects. From some foreign clinical studies or some domestic clinical applications, the overall is very safe, so far no serious adverse reactions reported.
2, our body itself will also secrete growth hormone, the main role of this hormone is to promote the growth and metabolism of our body. If growth hormone deficiency is not replenished in time, there will be many hazards, which will not only cause shortage, but also osteoporosis, muscle and gonadal dysplasia, easy aging, high blood lipids, cardiovascular diseases and metabolic abnormalities.
3. In addition, I want to briefly explain a term to you: the so-called “genetic recombination technology” is to make the manufactured things the same as our body’s own. For example, the recombinant growth hormone is the same as our normal human growth hormone, both in structure and principle of action. Therefore, there will not be any major side effects.
4. Regarding the issue of tumor, as a hormone that stimulates the growth of tissues and organs, growth hormone does have a stimulating effect on tumor, but it should be clear that it does not cause tumor itself. If the child does not have other diseases (mainly tumors), the child will naturally grow taller with growth hormone and it will not cause tumors. But if the child has a tumor in his body, the tumor will grow while the child is on the medication. This is why we will give you so many tests before you use the medicine.
5. The following relevant factors should be understood before growth hormone application.
a. Whether the family has a family history of tumor tendency, especially gastrointestinal tumors.
b. Whether there is diabetes in the family, if so, then the child needs to do a glucose tolerance test.
c. Whether the child has chromosomal abnormalities, if so, the child needs to be careful with medication.
d. The child has no hematologic abnormalities and no history of cranial radiation exposure.
e. History of active hepatitis, if any, liver function, hepatitis C, hepatitis E, hepatitis B series should be checked.
f. Whether the child has a history of tumor.
g. Whether the child is using GH antagonists, such as glucocorticoids and cyclophosphamide.