Risks Associated With Growth Hormone Therapy

Growth hormone treatment is used in children who maintain a rate of growth that falls below 3 percentile and in adults who have significant growth hormone deficiency, which puts them at risk for certain disorders or conditions. For many years, growth hormone treatment involved the use of growth hormone from cadavers; however, in the 1980s a synthetic version was approved and is now used instead. Growth hormone treatment can work well in adding inches to an adult height and preventing certain disorders associated with growth hormone deficiency, but there are some risks involved with its use.

Function

The human body produces growth hormone in the pituitary gland. There are several disorders that can cause a child to grow at a significantly reduced rate or not at all, including tumors on the pituitary gland, thyroid disorder and certain genetic conditions. In addition, there are children who stop growing and no medical cause can be found. In all cases, if the medical tests indicate a deficiency of growth hormone, doctors may choose to offer the child synthetic growth hormone treatment.
Adults continue to produce growth hormone and the body uses it for various things, including the maintenance of healthy cholesterol levels and protection from certain arthritis conditions by enhancing bone density. When an adult has a significant growth hormone deficiency, doctors may also choose to treat the deficiency with growth hormone therapy.

Use

Growth hormone treatment is provided through injections. Most children have daily injections while most adults take injections two or three times a week. The injections are given just under the skin in the same way that an insulin injection is given. The injections can be given in the upper legs, upper arms, stomach or buttocks. It is recommended that the injection site be rotated to reduce the chance of bruising or infection from developing at the injection site. Parents of children entering treatment are given training on how to prepare the injection site, prepare the growth hormone that comes in powder form and must be mixed with distilled water, and provide the injection. Adults entering treatment are provided similar training. As children age, they are often instructed in how to prepare the growth hormone and give their own injections.
Injections are usually given every day for children, and some doctors recommend that they be given shortly before bedtime to simulate natural growth patterns, which are more active during sleep.
The patient will undergo regular checkups and lab work to be sure the growth hormone dose is appropriate and that there are no complications.
Children usually maintain treatment until they are through puberty, while adults on growth hormone therapy may be on it throughout their lifetime.

Risks

While the risks are small with growth hormone therapy, there have been some documented risks associated with its use.
Most of the risks associated with the therapy have been reported in patients over 10 years old.
In about 2 out of every 1,000 children being treated with growth hormone, a slipped capital femoral epiphysis occurs. SCFE makes the head of the femur tear away from the shaft. Treatment for SCFE is casting or surgery.
Another known risk in the use of growth hormone therapy is called pseudotumor cerebri, which is characterized by severe headaches, changes in vision and nausea. The incidence of pseudotumor cerebri is also about 1 in 1,000. Treatment of this condition is to reduce the dosage of human growth hormone for a short period and then gradually increase the dose until the desired dosage is attained.
Fluid retention is rarely seen in children who are on growth hormone therapy, but it is seen in adults who are being treated. Treatment for this condition is to stop the growth hormone treatment temporarily.
Children as well as adults who have undergone growth hormone therapy have reported join pain as well as developed carpal tunnel syndrome.
A more dangerous risk of growth hormone has been documented among critically ill elderly patients. These patients have shown a higher-than-average mortality rate. The reason for this occurrence is not known; however, it is significant enough that growth hormone treatment in severely ill elderly patients is now a rarity.
Growth hormone treatment also increases the patient's sensitivity to insulin, which in some cases can put them at a greater risk for developing diabetes.

Benefits

For many patients, the benefits of growth hormone therapy outweigh any possible risks. For children who undergo the therapy, it can add several inches to the final adult height, which can make a difference in self esteem, career choices and other quality of life standards. For adults, growth hormone therapy can add energy, bone density and muscle to their lives where they were significantly delayed or short in all of these areas.

Potential

The use of growth hormone has been controversial for many years. People without valid medical conditions have obtained it because of its muscle-building element. Critics of the therapy for children believe that a short child should not be considered a negative medical condition and take the "if it's not broken don't fix it approach. For each patient, the decision to undergo growth hormone therapy is a personal one in which the potential benefits must be weighed against potential side effects and risks.