GH deficiency
A deficiency in growth hormone (GH) is a condition in which the pituitary gland does not produce enough of the hormone responsible for appropriate growth in children. Lack of GH can occur at any age.
GH shortage can limit growth throughout puberty (which can also be delayed) and result in small stature in youngsters.
Adults require growth hormone to maintain healthy levels of body fat, muscle, and bone. Low or nonexistent levels of growth hormone can also result in low energy and a lack of enthusiasm.
What causes growth hormone deficit in adults?
The majority of cases of adult-onset growth hormone insufficiency are caused by pituitary gland damage induced by a pituitary tumor or its treatment via surgery and/or radiotherapy. Damage to the pituitary gland can also arise from:
- Brain radiotherapy for other tumors around the pituitary gland or for leukemia
- Due to serious head trauma
- Autoimmune disease
- From interference with the blood supply to the pituitary gland (such as in Sheehan’s syndrome, a loss of pituitary gland function caused by substantial blood loss after childbirth, or pituitary apoplexy, abrupt bleeding into the pituitary gland).
Most other types of growth hormone insufficiency result from genetic disorders (e.g., Prader-Willi syndrome or Turner syndrome) or improper pituitary gland development in the fetus (see the article on childhood growth hormone deficiency). However, because growth hormone insufficiency is a lifelong illness, medication may be required in adulthood as well (see the article on childhood-onset growth hormone deficiency).
In certain instances, there is no evident etiology for the deficiency, and the condition is referred to as idiopathic.
What causes growth hormone deficit in children?
Growth hormone insufficiency is estimated to affect between 1 in 4,000 and 1 in 10,000 children. It is typically idiopathic, however, approximately 25% of cases have an identifiable cause. Congenital causes include GH-releasing hormone receptor and GH1 gene anomalies as well as some central nervous system (CNS) defects. Therapeutic radiation of the central nervous system (high-dose radiation can cause global hypopituitarism), meningitis, histiocytosis, and brain damage are acquired causes. Prophylactic or therapeutic radiation of the spine may further damage the development potential of the vertebrae and imperil height gain.
Hypopituitarism may have genetic reasons, including hereditary or spontaneous mutations that disrupt pituitary cells. In such circumstances, anomalies of other organ systems, particularly midline deformities, such as cleft palate or septo-optic dysplasia, may also be present (which involves the absence of the septum pellucidum, optic nerve atrophy, and hypopituitarism). Generalized hypopituitarism can also be caused by a variety of illnesses that affect the hypothalamus (impairing hormone release) or pituitary, such as tumors (e.g., most frequently craniopharyngioma), infections (e.g., tuberculosis, toxoplasmosis, meningitis), and infiltrative disorders. Diabetes insipidus with lytic lesions of the bones or skull are suggestive of Langerhans cell histiocytosis.
Growth hormone deficiency symptoms
Common symptoms associated with a growth hormone insufficiency diagnosis include:
- Children with short stature and/or slower growth in height.
- Low amounts of glucose in the blood of newborns and toddlers.
- Children with GHD and related pituitary hormone deficits may exhibit additional symptoms, including a very tiny penis in newborn males and the absence of puberty during adolescence.
- Children with congenital GHD due to a syndrome may exhibit additional symptoms, including blindness.
- Babies with severe congenital GHD typically have just a minor reduction in birth length and may not exhibit signs of sluggish growth right away. In some youngsters, low blood sugar can be the most prominent indicator of GHD.
Additionally, adults with severe GHD may experience:
- An increase in the distribution of body fat with added weight around the waist
- A loss of muscle mass and strength
- Low energy levels
- Variations in cholesterol concentrations
- Increased likelihood of fractures
Treatment
Once a growth hormone shortage in adults has been confirmed, the doctor will prescribe daily growth hormone injections. The patient or a member of his or her family will inject the hormone into the patient’s body. Every four to eight weeks, the patient will return to the doctor for monitoring and a blood test to assist the physician in determining whether more or less hormone is required.
The individual will experience muscle or joint pain, swelling (fluid retention), and pain or numbness in the hands due to carpal tunnel syndrome if they receive too much growth hormone. If such symptoms manifest, the doctor will reduce the growth hormone dosage.
If the shortage in growth hormone is caused by a pituitary tumor, the doctor will perform annual MRIs to monitor the tumor. Currently, it is unknown whether the growth hormone will stimulate the growth of pituitary gland tumors.
Blood cholesterol and bone density will also be monitored. With treatment for adult growth hormone insufficiency, both of these indicators should demonstrate improvement.
Growth hormone therapy should not be administered to those with active cancer or tumors. People who are gravely unwell due to complications following open heart or stomach surgery, who have many injuries from a big accident, or who have breathing difficulties should also not receive this medication. Adults who take growth hormone will not begin to grow again.
Taking growth hormone might impact how the body utilizes insulin, therefore it is essential for diabetics to keep their doctors aware and monitor their blood sugar levels closely.
Until they reach puberty, children with congenital GHD are frequently treated with growth hormone. Often, children with insufficient levels of growth hormone during childhood will begin to manufacture sufficient levels as they mature.
Some patients, however, remain in treatment their entire lives. By measuring hormone levels in your blood, your physician can determine if you require recurring injections.
