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Growth hormones give short children stature
But some doctors may overuse them
August 20, 1996
Web posted at: 11:30 p.m. EDTFrom Correspondent Dan Rutz
ATLANTA (CNN) -- Growth hormone therapy is helpful to children with medical deficiencies, but some doctors are too quick to prescribe the drug to short children, a study says.
A survey of 434 pediatric endocrinologists found that about four out of 10 children who underwent the controversial and expensive therapy did not have the conditions to warrant it, according to a team from Case Western University in Ohio.
The U.S. Food and Drug Administration has approved the therapy, which costs between $13,000 and $16,000 per year, for children with growth hormone deficiency and chronic renal failure.
But there are no generally accepted guidelines for the therapy, and it may be applied for non-medical reasons such as pressure from the family or the physician's beliefs, wrote pediatrician Leona Cuttler and her colleagues in this week's Journal of the American Medical Association.
The therapy is successful, however, in many medically required cases -- increasing the rate of growth for as many as 90 percent of children treated. But, its effect on adult height and its adverse effects are uncertain.
Brent Carney has benefited. He grew 1 foot the first two years he was on synthetic growth hormone.
"I'm very grateful. I mean now I can be normal height and just reach things and be normal," Carney said.
Carney is among 14,000 U.S. youngsters with a clear deficiency in growth hormone.
"The alternative would have been that his projected height was 4 foot 8 as an adult male, which is obviously very, very short and would have been a handicap for him, really," the boy's mother, Mary Ann Carney, said.
A dose of patience
The potential long-term effects of growth hormone therapy are still unknown, and that makes some doctors think twice before using a potent drug to force nature into a growth spurt.
In Atlanta, Dr. Robert Schultz of Scottish Rite Children's Hospital says he's willing to try growth hormone for children who, for whatever reason, lag far behind the norm. But he won't prescribe it for kids who may just be late bloomers.
"It's amazing how many calls we get from parents who want us to give growth hormone in situations where we don't feel it's appropriate," Schultz said.
"Out of every 100 children we evaluate per year for growth problems and concerns, we only put 5 to 10 percent (on the treatment). Many of them just have hereditary short stature," the doctor said.
Schultz sees many patients who, like 13-year-old Dustin Moore, say they want to find out if they are going to grow.
"I wasn't growing and I felt like I needed to be a little bit taller because my Dad's 6 feet tall," Moore said.
Schultz suspects that Moore is just a late bloomer, and that the only medicine he needs is a dose of patience.
Child psychologist Laura Mee of Egleston Children's Hospital in Atlanta agrees that neither peer nor parental pressure warrants a quick fix unless there are clear medical reasons.
"I think there's an extraordinary amount of pressure on boys in that age group to hit puberty, and the ones who are later in hitting puberty get a lot of teasing for that," Mee said.
Reuters contributed to this report.
Related sites:
- Growth Hormone: Not for All Short Children from the Medical Sciences Bulletin
- Recombinant Human Growth Hormone from United Health Care
- Human Growth Hormone from American Medical Informatics
- Endocrinology and Short Stature from the Endocrine Society
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