Growth Hormone Deficiency (GHD)
By Dr. Maureen Dumba
We commonly associate hormones with emotions, and frequently use terms such as 'raging hormones' or 'being hormonal'. However, hormones actually do much more that just affecting how we feel, as they play a big and important role in our lives and our health.
Hormones are chemical messengers that interact with each other to regulate different functions within our bodies. One of these functions is growth.
The hormone for growth (called growth hormone!) is produced by a small gland at the base of your brain, called the pituitary gland. Growth hormone deficiency (GHD) occurs when not enough of this hormone is produced.
What happens in GHD?
Your pituitary does not work alone to stimulate growth. It first gets a message from a part of your brain called the hypothalamus. This sends another chemical messenger, called growth hormone releasing hormone (GHRH), to the pituitary gland, which then releases growth hormone.
Growth hormone travels around your body, working alongside other hormones to stimulate growth.
In GHD, circulating growth hormone levels are low or non-existent. This is either because the pituitary is not getting the message from the hypothalamus to release its stores, or it does get the message, but is unable to release growth hormone.
What are the symptoms of GHD?
In GHD, growth slows down. As a child, this often means that you are shorter than others your age. You may notice things like looking younger than your friends or carrying a little more fat than usual around your waist.
GHD in adults can lead to extra fat around the waist too, as well as tiredness and weakness. It can also affect your mood, making you feel anxious, irritated or sad.
How do you know if someone has GHD?
If you or your parents are worried about these symptoms, your doctor can arrange some tests. First, they may measure your height and monitor your growth rate for a little while to see if it is slower than it should be. They may also do blood tests to check your hormone levels. Imaging tests, like x-rays, CT or MRI scans can also help confirm a diagnosis of GHD.
What causes GHD?
Some people are born with problems with their hypothalamus or pituitary glands. This is called a congenital problem. Others develop problems as they grow up, and this is an acquired condition. Tests may help your doctors figure out the cause, but sometimes nobody knows for sure why you have GHD.
Can GHD be treated?
Yes! If your doctor confirms you have GHD, you can get growth hormone medicine, called somatropin, to top up your own levels. The medicine comes as a daily injection that goes under your skin. This means it can get into your bloodstream easily and go directly to where it is needed. You cannot take growth hormone as a tablet because the acid in your stomach destroys it.
Sometimes surgery is needed to remove anything that might be stopping growth hormone from being made. Your doctor will discuss this with you in more detail.
You will have regular follow up with a doctor who specialises in hormones, called an endocrinologist. They will see how you are progressing and look for signs that the treatment is working, like your growth rate.
- If you are worried about your height, make sure you speak to your family and your doctor.
- Slow growth should not stop you from doing all the things you enjoy!
- You are not alone - ask your doctor about local support groups.