Growth Hormone Therapy – Effects & Uses
Growth hormone therapy is a medical treatment using synthetic human growth hormone. It is used in children and adults with growth hormone deficiency or specific medical conditions.
Things worth knowing about "Growth Hormone Therapy"
Growth hormone therapy is a medical treatment using synthetic human growth hormone. It is used in children and adults with growth hormone deficiency or specific medical conditions.
What is Growth Hormone Therapy?
Growth hormone therapy is a medical treatment in which a synthetically produced form of human growth hormone, known as somatropin, is administered to patients. Growth hormone is a natural hormone produced by the pituitary gland at the base of the brain. It plays a vital role in body growth, metabolism, muscle development, and fat regulation. When the body fails to produce sufficient growth hormone, or when certain medical conditions are present, targeted hormone therapy may be necessary.
Indications – When is the Therapy Used?
Growth hormone therapy is prescribed for a range of conditions in both children and adults:
In Children
- Growth hormone deficiency: Insufficient production of growth hormone by the pituitary gland, leading to slowed growth and short stature.
- Turner syndrome: A genetic condition affecting girls that is associated with short stature.
- Prader-Willi syndrome: A rare genetic disorder characterized by low muscle tone, short stature, and obesity.
- Chronic kidney disease: Growth impairment due to long-term kidney dysfunction.
- SGA (Small for Gestational Age): Children born small for their gestational age who fail to show catch-up growth.
- Idiopathic short stature: Short stature without an identifiable underlying cause.
In Adults
- Adult-onset growth hormone deficiency: For example, following pituitary surgery, tumor, radiation therapy, or severe head trauma.
- Improvement of body composition, bone density, and quality of life in confirmed deficiency.
Mechanism of Action
Somatropin is a recombinant form of natural human growth hormone, produced through genetic engineering. It binds to specific receptors in various tissues and triggers a cascade of metabolic effects:
- Stimulation of the liver to produce IGF-1 (Insulin-like Growth Factor 1), the primary mediator of growth effects.
- Promotion of bone growth by stimulating the growth plates (epiphyseal plates) in children.
- Increase in muscle mass and reduction of body fat.
- Regulation of glucose metabolism and protein synthesis.
Administration and Dosage
Growth hormone therapy is typically administered as a subcutaneous injection (under the skin), usually once daily, often in the evening before bedtime. This mirrors the natural pattern of growth hormone secretion, which peaks during sleep. The dosage is individually determined and regularly adjusted by the treating physician based on laboratory values (particularly IGF-1 levels), growth rate, and clinical response. Modern injection devices (pens) make self-administration straightforward and convenient.
Duration of Treatment
In children, therapy is generally continued until growth is complete (closure of the epiphyseal plates). In adults with confirmed growth hormone deficiency, lifelong treatment may be indicated. The need for continued treatment is reassessed at regular intervals.
Side Effects
When used correctly, growth hormone therapy is generally well tolerated. Possible side effects include:
- Fluid retention (edema), particularly at the start of treatment
- Joint pain and muscle aches
- Reactions at the injection site (redness, swelling)
- Elevated blood sugar levels (especially relevant in patients with pre-existing diabetes)
- In rare cases: pseudotumor cerebri (increased intracranial pressure) – recognizable by headaches and visual disturbances
- In children with hip problems: slipped capital femoral epiphysis may occur
Contraindications
Growth hormone therapy must not be used in cases of:
- Active tumors or malignancies
- Severe illness following cardiac or abdominal surgery
- Diabetic retinopathy
- Known hypersensitivity to somatropin
Monitoring and Follow-Up
Regular monitoring is essential during therapy. This includes:
- Measurement of IGF-1 levels in the blood for dose adjustment
- Assessment of growth rate in children
- Monitoring of blood glucose, thyroid function, and bone density
- Ophthalmological examinations if increased intracranial pressure is suspected
References
- Grimberg A et al. - Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents. Hormone Research in Paediatrics, 2016.
- Molitch ME et al. - Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism, 2011.
- Ranke MB, Wit JM - Growth hormone - past, present and future. Nature Reviews Endocrinology, 2018.
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