Growth Hormone Deficiency

Growth hormone (GH) is a crucial substance that plays a key role in supporting the growth and development of children. It is naturally produced by the pituitary gland, situated at the base of the brain between its lobes. Growth hormone deficiency is a rare condition characterized by inadequate GH production, which hinders normal growth processes.

1.0Origin of growth Hormone

• During childhood, growth hormone plays a crucial role in promoting growth and supporting the maintenance of tissues and organs throughout life. It is synthesized by the pituitary gland, a small gland located at the base of the brain. As individuals enter middle age, the pituitary gland naturally decreases its production of growth hormone.
• This natural decline has led to interest in using synthetic human growth hormone (HGH) to potentially mitigate some of the aging-related changes, such as loss of muscle and bone mass.

2.0What is Growth Hormone Deficiency?

Growth hormone (GH) deficiency occurs when the body produces insufficient growth hormones for normal child development. There are two types of GH deficiency:

1. Congenital GH Deficiency: This type is present at birth. Babies with this condition may also have deficiencies in other pituitary hormones. Despite being born with GH deficiency, these babies may appear to grow normally until around 6 to 12 months of age.

2. Acquired GH Deficiency: This type develops when the body ceases to produce enough GH for normal growth. It can occur at any time during childhood.

3.0Sign and Symptoms of Growth Hormone Deficiency 

The symptoms of growth hormone deficiency vary based on the patient's age, underlying cause, and specific hormone deficiencies. Key symptoms include:

• Slow growth or lack of growth
• Short stature 
• Absent or delayed sexual development during puberty

Symptoms related to other pituitary hormone deficiencies that may accompany growth hormone deficiency, such as:

• Increased urination and urine volume
• Excessive thirst
• Facial abnormalities, which can be present in a small group of children with GHD, often resulting from pituitary defects
• Causes of Growth Hormone Deficiency

4.0Causes of Growth Hormone Deficiency

It can be caused by a variety of factors, many of which are present at birth (congenital). It can also develop later in life (acquired). 

• Congenital Causes: These include genetic mutations or structural abnormalities in the development of the pituitary gland and its surrounding structures.
• Acquired Causes: Although less common, these can include head trauma, infections, tumors, or radiation exposure.

5.0Diagnosis of Growth Hormone Deficiency

• Blood tests - Measuring GH levels directly is challenging because GH is produced in trace amounts, mostly at night, and can be undetectable at other times. Instead, doctors measure levels of other  stable proteins and indicate GH function: IGF-I (insulin-like growth factor I) and IGFBP-3 (insulin-like growth factor binding protein). 
• Bone age X-rays - These X-rays of a child's hands and wrists are compared to those of other children of the same age to determine the bone age. If a child's bone age is significantly younger than their actual age, it may indicate GH deficiency.
• GH stimulation test - This test is performed when other tests suggest a potential GH deficiency. The doctor administers a medicine that stimulates the body to produce a burst of GH, and a nurse takes multiple blood samples to measure GH levels and capture the peak. Low GH levels confirm the diagnosis of GH deficiency.
• Brain MRI-  This detailed image of the brain helps doctors identify if a problem with the pituitary gland or another area of the brain is causing GH deficiency.

6.0Growth Hormone Deficiency Treatment

• The treatment for growth hormone deficiency involves administering recombinant human growth hormone via subcutaneous injection (under the skin) once daily. 
• Parents are trained to administer the injections at home, rotating injection sites among the arms, legs, buttocks, and abdomen. The duration of growth hormone treatment depends on the child's growth response and the impact of puberty on growth,