Growth Hormone Deficiency

As the name implies, growth hormone deficiency results when the pituitary gland doesn't produce enough growth hormone to stimulate the body to grow. This can result in noticeably short stature in children.

  • Growth hormone deficiency may be partial (the pituitary gland produces insufficient amounts of growth hormone) or total (the pituitary gland produces no growth hormone).
  • Growth hormone deficiency may occur during infancy or later in childhood.
  • About one in 4,000 to 10,000 children have growth hormone deficiency.
  • With early detection and treatment, many of these children can reach a normal height.

What are the symptoms of growth hormone deficiency?

Since growth takes place over many years, and since children grow at different rates, symptoms of growth hormone deficiency may be hard to identify. In addition to noticeably slow growth with normal body proportions, signs may include:

  • immature appearance, compared to peers
  • a chubby body build
  • a prominent forehead
  • an underdeveloped bridge of the nose

Growth hormone deficiency has no effect on a child’s intelligence.

These symptoms may resemble other conditions, so be sure to always consult your child's physician for a diagnosis.

How do you define ‘normal’ growth?

Growth rates vary considerably from child to child. But measured in height, average "normal" growth is often described as:

  • 0-12 months: about 10 inches a year
  • 1-2 years: about 5 inches a year
  • 2-3 years: about 3½ inches a year
  • 3 years to puberty: about 2 to 2½ inches a year

If your child is less than the third percentile in height for a child of his age, that can be a red flag for growth hormone deficiency.

What causes growth hormone deficiency?

Damage to the pituitary gland or hypothalamus may be the result of an abnormal formation that occurred before your child was born (congenital) or something that occurred during or after birth (acquired).

Congenital growth hormone deficiency can occur if there are mutations in genes for factors that are important in pituitary gland development, or in receptors and factors (including growth hormone) along the growth hormone pathway; to date, however, the cause of most of these cases is unknown.

Acquired causes of growth hormone deficiency include:

  • a brain tumor in the hypothalamus or pituitary
  • head trauma
  • radiation therapy for cancers, if the treatment field includes the hypothalamus and pituitary
  • diseases that infiltrate the hypothalamus or its connection to the pituitary gland, such as histiocytosis
  • an autoimmune condition (lymphocytic hypophysitis)

It's also important to remember that growth hormone deficiency is only one of many conditions that may affect your child’s growth. Your child’s short stature may be caused by other syndromes, and growth failure may be due to decreased nutritional intake, gastrointestinal disorders, diseases that have increased metabolic demand or hypothyroidism.

What are complications of growth hormone deficiency?

Some research suggests that there are additional complications from growth hormone deficiency, including:

  • decreased bone mineral density
  • increased cardiovascular risk factors
  • decreased energy level

Questions to ask your doctor

You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider and that you understand your provider’s recommendations.

If your child is experiencing symptoms of growth hormone deficiency and you’ve set up an appointment, you probably already have some ideas and questions on your mind. But at the appointment, it can be easy to forget the questions you wanted to ask. It’s often helpful to jot them down ahead of time so that you can leave the appointment feeling like you have the information you need.

If your child is old enough, you may want to suggest that she write down what she wants to ask her health care provider, too.

Some of the questions you may want to ask include:

  • What’s causing my child’s growth hormone deficiency?
  • Will you be prescribing growth hormone replacement therapy?
  • Are there any side effects or potentially dangerous risks to treatment?
  • How long will my child have to remain on medication?
  • How much can I expect my child to grow?

How Boston Children’s Hospital approaches growth hormone deficiency

We view the diagnosis of growth hormone deficiency as an important first step to treatment — and, ultimately, to your child’s long-term health and continued growth. You can rest assured knowing your child is in capable hands.

Our compassionate staff includes physician specialists who are experienced in the evaluation, diagnosis, and treatment of growth hormone deficiency. And we are uniquely qualified to determine the best course of care for your child. Our child-centric approach ensures that we care for your child as a child, not just another patient.

Because the chain of events involved in growth hormone deficiency is so complex, our researchers are investigating the different events that can cause a child to have short stature. Not all of these individual defects are well understood or easy to detect with a test, making this research vital to treatment strategies.

Our Division of Endocrinology is one of the world's leading centers dedicated to caring for children and adolescents with acute and chronic endocrine and metabolic disorders. For children who suffer from growth problems, our dedicated team of doctors, nurses, and other caregivers offer hope for a healthier future.