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General Medical Questions
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Q: What are the current recommendations about human growth hormone for children with short stature? Are there any long-term studies on side effects?
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The Trusted Source
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Claire McCarthy, M.D.

Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".

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August 15, 2008
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A:

Using human growth hormone for children who have no medical reason for being short (called idiopathic short stature) is controversial.

It does appear to help, but:

  • It doesn't help much.
    The most children get from the treatment is 2 to 3 inches.
  • It doesn't help everyone.
    Everybody responds to growth hormone differently.
  • Some children would have grown more anyway.
    Most children with short stature have "catch-up" growth during puberty without any treatment at all.

At high doses, growth hormone can have serious side effects, including swelling, heart problems, diabetes and an increased risk of cancer. At the low doses generally used for treating short stature, growth hormone appears to have minimal side effects.

Before you start thinking "can't hurt, might help," consider that:

  • It's uncomfortable.
    Treatment involves daily injections for months on end.
  • It's expensive.
    On average, treatment costs about $50,000 per inch of gained adult height, something insurers are reluctant to pay for -- especially in the absence of any real medical problem.
  • Being short isn't bad.
    Many studies have shown that people who are short do just as well psychologically and in other areas of their lives as tall people.
  • Treatment can backfire psychologically.
    By treating a child with growth hormone, you are saying there is something wrong with his or her height. This can be damaging to a child's self-esteem, especially when the treatment may not increase height much at all.

Because of all this, specialists recommend that growth hormone treatment only be considered for children whose predicted adult height is more than 2.25 standard deviations below the mean -- for boys that's 63 inches; for girls 59 inches — and only for children for whom there is real evidence of current or future psychosocial problems from being short.

With support, love, and in some cases counseling, most psychosocial problems can be avoided, making treatment unnecessary.

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