Patient's question:
.9 My child is a girl, 3.9 years old, with a height of 95 cm. The bone age test showed 2 years. The growth hormone stimulation test result was 3.3, with a normal value of 10. The MRI results for the pituitary gland were normal. Do I need to have another stimulation test at a different hospital? Is this considered growth hormone deficiency? Do I need to inject growth hormone? What are the side effects?Doctor's answer:
Growth hormone in higher animals and humans is a protein. In plants, the growth hormone is indoleacetic acid, a hormone secreted by the anterior lobe of the pituitary gland that promotes body growth. Growth hormone indirectly promotes the formation of epiphyseal cartilage during the growth period by stimulating the liver to produce growth hormone mediators, thereby promoting the growth of bones and cartilage and increasing body height. Growth hormone also affects intermediary metabolism and energy metabolism, promoting protein synthesis, enhancing the absorption and utilization of important elements such as sodium, potassium, calcium, phosphorus, and sulfur, while inhibiting glucose consumption and accelerating fat breakdown, shifting energy sources from glucose metabolism to fat metabolism.If growth hormone secretion is insufficient during childhood, it can lead to delayed growth and development, resulting in unusually short stature, known as "dwarfism." Conversely, excessive growth hormone secretion can cause excessive growth throughout the body, with particularly significant bone growth, leading to abnormal height, known as "gigantism." After adulthood, when epiphyses have fused, long bones no longer grow. If growth hormone secretion remains excessive at this stage, it will stimulate the proliferation of extremity bones, facial bones, and soft tissues, resulting in disproportionate enlargement of hands, feet, nose, jaw, ears, tongue, and internal organs such as the liver and kidneys, known as "acromegaly."
If gigantism and acromegaly are caused by pituitary tumors, local radiation therapy or surgical removal may be performed. High doses of estrogen can inhibit the pituitary's secretion of growth hormone. For dwarfism, early hormone treatment should be administered, as human growth hormone has a significant therapeutic effect on dwarfism. Due to the difficulty in obtaining growth hormone, its clinical application has not yet been widely adopted. Currently, scientists have used genetic engineering methods to isolate the human growth hormone gene from chromosomal DNA and recombine it into plasmids, using E. coli for transformation, with the aim of producing human growth hormone through fermentation. Thus, clinical application is expected to be expanded.
Additionally, in some dwarfism cases, the pituitary gland does not reduce the number of cells secreting growth hormone; instead, the problem may lie in degenerative changes in hypothalamic neurosecretory cells, leading to a deficiency in growth hormone-releasing hormone. Currently, synthetic human pancreatic growth hormone-releasing factor is being used to treat such patients, with some therapeutic effects.
Growth hormone promotes human growth and regulates material metabolism in the body. It primarily raises blood sugar levels by inhibiting the utilization of glucose in muscle and fat tissues while promoting gluconeogenesis in the liver and glycogen breakdown. Growth hormone also promotes fat breakdown, increasing plasma free fatty acid levels. During fasting, insulin secretion decreases while growth hormone secretion increases, reducing glucose utilization and increasing fat utilization, leading to higher levels of glucose and free fatty acids in the blood.
Advice: Human growth hormone (HGH) and human chorionic gonadotropin (HCG) can be used, but it is recommended to undergo regular medical examinations and treatment at formal hospitals. Hormone treatment is generally ineffective after the age of 18. HGH can increase height, while HCG enhances male characteristics, but action must be taken quickly, as bone growth is nearly complete by age 17.
Additional Suggestions:
1) Ensure sufficient sleep time, at least 9 hours, preferably before 11 PM (the golden time for growth during sleep).
2) Maintain a balanced diet to ensure adequate nutrition.
3) Engage in regular, moderate physical exercise, such as basketball, running, or swimming.
Human growth hormone is extracted from animal tissues (including humans), posing risks of transmitting infectious diseases (e.g., HIV). Additionally, growth hormone may increase the risk of diabetes, so weigh the pros and cons carefully.
Lifestyle Care: Growth hormone, also known as human growth hormone (hGH), is a peptide hormone banned in sports. It is typically used to treat dwarfism and has anabolic effects, increasing muscle mass, promoting bone growth during childhood and adolescence, and strengthening tendons and enlarging internal organs. Athletes illegally use growth hormone to build muscle and increase strength for competitive advantages. The use of human growth hormone carries a high risk of contracting fatal diseases (e.g., HIV), with documented cases of death from encephalitis caused by growth hormone use. Excessive use of growth hormone can reduce insulin sensitivity, leading to glucose intolerance. According to foreign reports, 80% of growth hormone users develop diabetes, requiring insulin treatment. Other side effects include menstrual disorders, reduced libido, and impotence.
The abuse of growth hormone in sports is unethical and dangerous. In children during development, excessive exogenous growth hormone can cause gigantism. In adults, excessive use may lead to coronary heart disease and peripheral nervous system disorders, with cardiovascular and musculoskeletal conditions potentially irreversible. Excessive use of exogenous growth hormone can also cause the body to produce antibodies against growth hormone, affecting endogenous growth hormone activity and disrupting hormone secretion. Its potential long-term side effects are irreversible and even fatal.
Answerer: Liu Xiao