Little is known about the long-term effects of human growth hormone. Research is scant — and while some doctors feel confident there will be few long-term issues, others fear we could be putting kids at risk for health complications. Is the worry warranted, or are fears more reflective of anti-hormone hype?
Before 2003, parents needed proof of a growth hormone deficiency or related medical condition to get human growth hormone (HGH) treatments for their children, but now, doctors can prescribe them to kids who are simply really, really short, even if it it’s unclear why. Researchers suspect there could be some negative psychological effects as well.
Just over a decade has passed since the U.S. Food and Drug Administration expanded the pool of children eligible to receive human growth hormone treatments by approving the new indication “idiopathic short stature,” which means that a child isn’t growing as expected, but doctors can’t find any clear cause for the stunted growth.
In 2003, studies suggested these kids could add an extra 2 to 3 inches beyond their otherwise projected height with little risk of side effects. Now that one generation of children has had access to the treatment, more data exist to investigate side effects and outcomes. Although researchers have learned a little bit more since 2003, long-term outcomes are still the least understood. One thing hasn’t changed at all: Starting human growth hormone treatments is never a decision doctors or families take lightly.
“You have to be pretty dedicated to maximize the child’s height potential to go through the growth hormone pathway,” says Stephen Lauer, MD, PhD, an associate professor of pediatrics at The University of Kansas Medical Center in Kansas City. “You’re trying to convince an elementary school-aged child that it’s in their best interest to get a shot every day.”
Children undergoing growth hormone treatments receive 6 or 7 shots a week, every week, as long as they remain on the treatment — typically several years. Most children receive treatment for 2 to 3 years, though some may stay on it for 5 to 10 years, according to Bradley Miller, MD, PhD, a pediatric endocrinologist at the University of Minnesota Masonic Children’s Hospital in Minneapolis. How long they undergo treatment generally depends on when they start. “It can start from birth, and you can be treated until you’re done growing,” he says. Many kids are referred to endocrinologists at around 11 years old, and the end of puberty generally marks the end of a person’s growth, about 17 for boys and age 15 for girls. Studies are underway to explore treatment regimens of once-weekly or once-monthly injections, Dr. Miller says, but those preparations are at least 5 years away.
Tara Haelle is a freelance science and health writer and photojournalist whose work has appeared in NPR, Scientific American, Forbes, Politico, HealthDay and elsewhere. She blogs at Red Wine & Applesauce. She is the co-author with Emily Willingham of The Informed Parent.