Speaker: Dr. Anhalt, sometimes kids have tall father pro tall mothers it seems it kind of short and they send it to you and you do a big work up looking for growth hormone and things like that. Who are really the candidates for this and should I even consider things like growth or not?
Speaker: It was important to understand that most often children who are referred to the pediatric and endocrinologist are normal children, who have short genes or families that are short. In circumstances, where children are profoundly short and that is defined by the American Academy of Pediatrics as well as the Endocrine Society, and the Lawson Wilkins Pediatric Endocrine Society has being at we’re below the second percentile and your pediatrician or family care provider certainly guide you as to whether or not your is at that level that child would be considered to be short regardless of whether or not there is not family history of being that short.
The question of whether or not to treat a child like that is a discussion that needs to take place between the child’s primary care provider, the child, the family, and the pediatric endocrinologist. This is certainly not a condition where one size fits all. The food and drug administration of the United States as well as all the professional bodies that I mentioned earlier have recognized that in some children, can’t present at a disability. In those cases, it’s important to recognize that even in the absence of growth hormone deficiency those children are likely to benefit from growth promoting therapy.
In fact, over the last decade, the food and drug administration of United States has approved for use in children who are not growth hormone deficient in five separate conditions, the use of growth hormone to promote growth. Therefore, without making any generalizations, children who are below or at the second percentile who they are height is troubling to them, and would like to proceed with growth promoting therapy should be offered at that therapy regardless of whether or not they in fact have growth hormone deficiency.
Now, if growth hormone deficiency is established, it’s important to recognize that growth hormone treatment is not all about making a child taller that growth hormone has many important effects in the body and important for bone health, important for heart function, important for kidney function, important for cholesterol, and therefore in a child who has been shown to be deficient that treatment should be given and parent should be compelled to treat those children because of the many, many different defects that growth hormone has on the body.
Further more, when many of your growth is complete or when a child is done growing, it’s quite possible that, that child will require life long replacement of growth hormone because as we know, growth hormone is produced life long by people and therefore for all of the other reasons in addition to growth, growth hormone should continue life long in those that are truly deficient in growth hormone. Thank you.
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