If my child doesn’t grow taller, can I use growth hormone?

My child's height is not ideal. I want him to grow taller. Can I take growth hormone? Nowadays, many parents are always anxious about their children's height and want to improve their height by taking growth hormone. So, is it really necessary for your child to take growth hormone?

Human growth hormone (hGH) is a peptide hormone synthesized, stored and secreted by growth hormone cells in the anterior pituitary gland. Its main physiological function is to promote protein synthesis and fat decomposition in receptor cells in various tissues, organs and bones of the body, thereby regulating the body's metabolism and growth and development. It is the most important growth-promoting hormone in the human body [1].

Recombinant human growth hormone (rh GH) synthesized through genetic engineering technology has the same structure and mechanism of action as the growth hormone normally secreted by the human pituitary gland and is mainly used to treat growth hormone deficiency in children.

What are the reasons why children don’t grow tall?

The main reasons for not growing taller include genetic factors, malnutrition, lack of exercise, lack of sleep, psychological state, growth environment, low growth hormone levels, low thyroid hormone levels and many other reasons.

In what situations is growth hormone suitable?

1. Parents can refer to the child growth standard. A child's height between P3 and P97 is considered normal, P50 is the median value, and P25 to P75 is the medium level. Most children of this age are within this range. If a child's height is ≥ P97 or < P3, it indicates that the height is growing too fast or too slow [2].

2. If the child is found to have any abnormality, he or she should go to a regular hospital for treatment. In addition to routine examinations such as physical examination, blood routine, urine routine, liver and kidney function, blood calcium, phosphorus and alkaline phosphatase, the following should also be done:

① Thyroxine measurement

② Determination of growth hormone and insulin-like growth factor (IGF-1)

③Bone age examination

④ MRI of the sella turcica region of the skull

⑤Chromosome karyotype examination, etc.

Note: Relevant examinations may vary in different medical institutions. Please refer to the clinical physician's advice and arrangements for specific procedures.

3. Based on the examination results, it is necessary to clarify under the guidance of a doctor whether growth hormone injections are needed, as well as the treatment plan and course of treatment. At the same time, pay attention to diet, sleep, balanced nutrition, etc., and have regular check-ups.

What types of growth hormone are there?

There are currently three main types of injection formulations on the market: powder, short-acting aqueous solution, and long-acting aqueous solution.

In terms of injection frequency, powder = short-acting liquid > long-acting liquid. Powder and short-acting liquid are injected once a day, and long-acting liquid is injected once a week.

In terms of efficacy, short-acting aqueous solution = long-acting aqueous solution > powder. There is a qualitative difference between powder and aqueous solution. Aqueous solution is safer, while powder needs to be dissolved and is easily contaminated.

In terms of price, powders are cheaper than short-acting liquids and longer-acting liquids. Powders are the cheapest; longer-acting liquids are more expensive.

From the perspective of patient compliance, short-acting liquid preparation = long-acting liquid preparation > powder preparation. Short-acting liquid preparations are equipped with a pre-filled mechanical pen, which is convenient to carry and less painful; long-acting liquid preparations are only injected once a week; powder preparations are relatively troublesome and more painful. Overall, liquid preparations are more child-friendly and have higher patient compliance.

Are there any side effects of growth hormone?

Because growth hormone is injected subcutaneously , usually in the abdomen, thigh or arm, some children will experience redness, pain or swelling. Generally, no special treatment is required and the condition returns to normal after 3-5 days of medication. Although the safety of recombinant human growth hormone is generally good, there are also a few adverse reactions, such as water and sodium retention, benign intracranial hypertension, decreased insulin sensitivity, increased risk of secondary tumors, scoliosis, and femoral head slippage, so it needs to be used with caution [3].

What other methods can help children grow taller?

In addition to genetic factors, children's growth and development are also affected by many factors, which can be improved in the following ways.

1. Eat a balanced diet, paying special attention to the supplementation of calcium and high-quality protein, such as milk, soy products, nuts, beef and mutton, etc.

2. Do appropriate exercise, especially stretching outdoor exercises such as high jump, basketball shooting, and rope skipping, and get more sun exposure.

3. Get enough sleep. Growth hormone is mainly secreted at night, so let your child develop the habit of going to bed early and getting up early.

4. Disease factors: Pay attention to your child’s physical health, seek medical treatment in a timely manner, and intervene actively.

5. Healthy environment: Parents should be patient with their children, not always blame them, and create a relaxed atmosphere.

Pharmacist reminds you

Don't worry too much about your child's height. It is not recommended to use drugs for children of normal height. Instead of worrying about whether to take drugs, you might as well pay more attention to your child's physical and mental health from now on, start with small things, and let your child have a happy childhood.

References:

[1] Yang Yunxia, ​​Ren Yali. Research overview of long-acting growth hormone preparations[J]. Chinese Journal of Pharmaceutical Biotechnology,

2021,16(05):459-464.

[2] WS/T 423—2022, Growth standards for children under 7 years old[S].

[3] Shu Chang, Pan Hui. Safety of recombinant human growth hormone in the treatment of growth hormone deficiency and idiopathic short stature in children[J]. Journal of the Chinese Academy of Medical Sciences, 2011, 33(02): 123-126.

Department of Pharmacy, Tianjin Children's Hospital

Author: Liu Yue Pharmacist

Reviewer: Sun Yanyan, Chief Pharmacist

Yu He, Chief Pharmacist