Growth hormone is not a magic weapon for growing taller, and its abuse has many harmful effects

Every parent hopes that their child can grow taller. Once they find that their child is slightly shorter than their peers, they will try various methods to increase their height quickly. Therefore, the legendary growth hormone, the magic weapon for growing taller, has become a hot commodity in the eyes of parents. So, what exactly is growth hormone? Can it really make all children grow taller? Now, let pharmacist Xiao Shan answer your questions.

1. What is growth hormone?

Growth hormone is a protein hormone secreted by the anterior pituitary gland in the human body. It plays a key role in human growth and development. It can stimulate the growth and differentiation of bone and cartilage cells, and regulate the metabolism of protein, sugar and fat, thereby promoting the growth and development of bones, muscles and organs, and increasing children's height [1]. Once the growth hormone level is lower than the normal range, it will lead to consequences such as growth retardation, sexual organ dysplasia, thyroid dysfunction, and hypoglycemia.

The "height-increasing injection" that people often talk about actually refers to recombinant human growth hormone (rhGH), which has the same structure as the growth hormone secreted by the anterior pituitary gland and has the same effect. The growth hormones available in China are mainly divided into short-acting and long-acting types. The short-acting ones can be divided into injections and freeze-dried powder injections (Table 1). The only long-acting polyethylene glycol recombinant human growth hormone in China is human growth hormone coupled with hydrophilic polymer polyethylene glycol to improve the stability of growth hormone, reduce renal clearance, and prolong the half-life of the drug, thereby achieving a long-term therapeutic effect. Short-acting growth hormone is injected subcutaneously 30 minutes before bedtime every night, and long-acting growth hormone is injected once a week at a fixed time.

Growth hormone drugs must be injected under the guidance of an experienced specialist. The specific dosage should be determined according to the patient's condition and treatment effect. The patient needs to follow the doctor's advice and go to the hospital for regular follow-up visits. The patient should also have relevant indicators such as height, weight, sexual development, bone age, thyroid function, and fasting blood sugar measured [2].

2. Can people who are short use growth hormone to grow taller?

Some parents heard that growth hormone injections can increase height, so they can't wait to inject growth hormone to make their children grow taller. "A 15-month injection costs half a Tesla" and "Spending 480,000 yuan for a child to grow 1 cm taller" are common news. Growth hormone can indeed treat certain diseases that cause short stature, so can all short children be injected with growth hormone to grow taller?

In fact, not every child is suitable for increasing height by taking growth hormone. Growth hormone is not a magic drug for children to grow taller. Very few children really need growth hormone treatment. The vast majority of children only need a balanced diet, more high-quality protein, scientific and effective exercise, good sleep and an optimistic attitude to grow taller, and do not need to use growth hormone.

Generally speaking, only children who meet the following four points at the same time may need growth hormone injections:

1. Growth retardation. ① The height is lower than the 3rd percentile of normal healthy children of the same age and gender (or lower than 2 standard deviations of the average height) [3]. ② The annual growth rate of children under 3 years old is less than 7 cm/year, 3 years old to pre-puberty is less than 5 cm/year, and puberty is less than 6 cm/year [2]. The standard percentile values ​​of the height of healthy children aged 0-18 years are shown in Table 2.

2. Bone age is more than 2 years younger than actual age[3]. Normally, the difference between bone age and actual age should be within ±1 year.

3. Growth hormone deficiency. Growth hormone deficiency can only be diagnosed when the peak values ​​of the two growth hormone stimulation tests are both less than 10μg/L. Any stimulation test has a false positive rate, so it is necessary to select two drugs with different modes of action for testing. Commonly used stimulation drugs include insulin, arginine, clonidine, levodopa, pyridostigmine, etc.

4. Serum insulin-like growth factor 1 level is lower than normal.

In addition, the use of growth hormone must meet many indications, such as a well-proportioned body to exclude genetic dwarfism, normal intellectual development to exclude cretinism, and imaging examinations of the hypothalamus and pituitary gland to exclude congenital developmental abnormalities or tumors.

Note: ① Source of the table: “Height and weight percentile values ​​for children and adolescents aged 0-18 years”, Growth and Development Research Office, Capital Institute of Pediatrics; ② Developed based on data from a 2005 survey of children’s physical development in nine provinces and cities [4]; ③ Before the age of 3, height is used.

3. Abuse of growth hormone has many harmful effects

Common endocrine genetic diseases that can be treated with growth hormone in pediatrics in China include growth hormone deficiency, idiopathic short stature, small for gestational age, Turner syndrome, Prader-Willi syndrome, and Noonan syndrome, a total of six types [2]. Randomly expanding the scope of growth hormone application and over-treatment will not only fail to make children grow taller, but will also bring many health risks. Abuse of growth hormone will cause children to have premature skeletal maturation and premature closure of the epiphyseal line, and they will not be able to reach the height level they should have. In addition, abuse of growth hormone may also lead to adverse reactions such as benign intracranial hypertension, hypothyroidism, abnormal glucose metabolism, femoral head slippage, scoliosis, enlargement of hands and feet, pigmented nevi, redness and swelling at the injection site, and rash [2].

In summary, parents must have a correct understanding of their children's height and understand that growth hormone is not a panacea for growing taller. Even for children who need it, they must undergo rigorous examination and evaluation and use the medication under the guidance of a specialist. During the treatment with growth hormone, parents should also go to the pediatric endocrinology clinic for regular follow-up to evaluate the treatment effect and pay attention to whether there are any adverse reactions.

References

[1] Sun Xun, Zhu Shangquan. Structure and function of growth hormone[J]. Foreign Medicine (Physiology, Pathology and Clinical Science), 1999(01):6-9.

[2] Endocrine Genetics and Metabolism Group, Pediatrics Branch, Chinese Medical Association. Recommendations for the standardized clinical application of recombinant human growth hormone in pediatrics[J]. Chinese Journal of Pediatrics, 2013(06):426-432.

[3] Endocrine Genetics and Metabolism Group, Pediatrics Branch, Chinese Medical Association. Guidelines for the diagnosis and treatment of short stature children[J]. Chinese Journal of Pediatrics, 2008(06):428-430.

[4] Li Hui, Ji Chengye, Zong Xinnan, Zhang Yaqin. Standardized growth curves of height and weight of Chinese children and adolescents aged 0 to 18 years[J]. Chinese Journal of Pediatrics, 2009(07):487-492.