Childhood Growth Hormone Deficiency
Learning that your child has growth failure due to Growth Hormone Deficiency (GHD)
may be upsetting. The good news is that this is a treatable condition and you and
your child are not alone. GHD affects about 22,350 children in the United States*,
although the disease can occur at any age and for different reasons.
In children, the most obvious symptom of GHD is short stature due to slower than
normal growth. In addition to helping them grow taller, as they continue to develop,
growth hormone (GH) is needed in the body for other reasons.
You probably have a lot of questions regarding the treatment of GHD. The information
on this web site is to help you better understand what to expect and what sort of
therapy may be best for your child.
*Lindsay R, et al. Utah Growth Study: Growth standards and the prevalence of growth
hormone deficiency. J Pediatr. 1994;125:31-32 and US Census Bureau Current Population
Reports (2009).
Causes of GHD
To better understand GHD, you have to start by understanding growth hormone. Growth
hormone is made inside the pituitary gland, a very small gland at the base of the
brain. When growth hormone is released inside the body, it acts as a "messenger"
telling the child's body to grow. When a child has GHD, for some reason the pituitary
gland is not making enough growth hormone.
Children are sometimes born with GHD because their pituitary gland or hypothalamus
gland may not be fully developed. GHD may also develop after birth because of damage
to the brain from head trauma, a serious brain infection or even a brain tumor.
The most common tumor involving the pituitary gland is called a craniopharyngioma.
This type of tumor is benign (not cancerous) and can be successfully treated with
surgery and radiation. However, the treatment itself can sometimes affect the pituitary
gland, resulting in GHD. In these rare cases, and some others, the child may need
growth hormone therapy for life. While this is the most common form of tumor, it
is not the only kind. Talk to your child's doctor for further information.
Diagnosing GHD
You might be the first to notice that your child is not growing. You may see they
are not keeping up in height with other children their age or they are not outgrowing
their shoes and clothes. In other cases, your child's primary healthcare provider
is the first to notice the problem. By tracking their growth on a growth chart,
they may see that your child's growth rate is slowing down. Just another reason
to have regular measurements taken—a good rule of thumb is to have your child's
height measured at every doctor visit.
In either case, you will need your primary doctor to refer your child to a pediatric
endocrinologist (a doctor who specializes in diseases related to hormones) for the
actual diagnosis. This doctor will take a family and medical history, along with
an X-ray of the hand and wrist (to learn the child's bone age), and blood tests to help determine
if there is a growth problem and if that problem is related to GHD.
Since the pituitary gland produces growth hormone in different amounts at different
times of the day, a single blood test to measure the amount of growth hormone may
not be accurate. Instead, endocrinologists perform what is called a stimulation
test or "stim" test, during which the child is given a substance that causes the
pituitary to release growth hormone all at once. The doctor then measures
the amount of growth hormone present in several blood samples taken over a period
of time.
If a child with GHD does not receive treatment, it could result in them being significantly
shorter than their peers when they reach adulthood. Even before they reach adulthood,
simple tasks often taken for granted like reaching a high shelf or hangers in a
closet can present a challenge.
Getting Help With Norditropin®
We understand that you may have many questions about therapy. Fortunately, Norditropin®
comes with a range of support services to help both you and your child make the
most of growth hormone therapy.
Norditropin® is a type of growth hormone made in the lab and is identical to
the growth hormone naturally made inside your body. Because it is the same as natural
growth hormone, Norditropin® can help children with GHD grow taller.
With its long-term studies and well-known safety profile, Norditropin® is a
brand that pediatric endocrinologists rely on to treat children with GHD during
critical growing years
Norditropin® comes in a delivery device called the FlexPro® pen. This pen
has many features to make it easy to use, like:
- It's pre-filled with medication, so you will never have to mix or load cartridges.
- There's no refrigeration required after first use for the 5 and 10 mg pens, so you
can take them almost anywhere—unlike most other growth hormone products.*
- NovoFine® needles are some of the smallest needles available.** The NovoFine® Autocover®
30G has a protective outer shield that hides the needle before, during and after
the injection. This shield also locks into place after the injection to help reduce
needlestick injuries. And it uses the 8-mm NovoFine® 30G needle, which 90% of patients
surveyed found practically pain-free.
- It's easy to learn how to use—in fact, 100% of patients in a study of 70 children
and teenagers said the pens were easy to learn to use.
If you are considering treatment with Norditropin® for your child, make sure
to write down any questions you have to discuss with their doctor. He or she will
be able to provide you with a plan that's right for your child. You can also check
out the Frequently Asked Questions section of our site
for even more information.
*All Norditropin® products must be refrigerated prior to first use. Do not freeze.
After initial use, FlexPro® 5 mg/1.5 mL and 10 mg/1.5 mL delivery pens can either
be stored outside of the refrigerator (at up to 77°F) for use within 3 weeks, or
in the refrigerator (between 36°F and 46°F) for use within 4 weeks. The FlexPro®
15 mg/1.5 mL and NordiFlex® 30 mg/3 mL delivery pens must always be refrigerated
(between 36°F and 46°F)—both prior to and after the initial injection—for use within
4 weeks.
**Needles are sold separately and may require a prescription in some states.
Support for Patients on Norditropin®
In addition to actual growth hormone therapy, Novo Nordisk also offers NordiCare®,
a free support service for Norditropin® patients. NordiCare® is there
throughout treatment to help with issues that could prevent a patient from receiving
treatment such as:
- Insurance problems or paying for Norditropin®
- Getting started on therapy
- Staying on treatment through unforeseen events, such as moving or changing doctors
or insurance providers
With NordiCare®, each patient receives their own personal case manager, dedicated
to handling their needs. You can call your case manager at any time during your
treatment for answers and assistance. To learn more about NordiCare®,
click here.
Questions for Your Child's Doctor
When growth hormone deficiency (GHD) is first diagnosed, you're sure to have a lot
of questions, and you may be able to find information from various sources, including
the Internet. But remember, your child's treatment will be specifically tailored
to them and their medical history, so the best source of information will be their
doctor.
Click here to print this list
To help you and your child begin talking with their doctor about growth hormone
therapy, we've provided a list of questions you or your child might want to ask
during the first visits.
- What is growth hormone?
- Is growth hormone therapy safe?
- How do I know if my child needs growth hormone?
- How does growth hormone work?
- Are there any side effects involved with growth hormone therapy?
- How is growth hormone taken? How often? Does the injection hurt?
- What if my child is afraid of needles?
- Why does growth hormone have to be given by injection?
- What if we miss a dose? What if we inject too much?
- Where do we inject?
- How long before growth hormone therapy starts to make a difference?
- How tall will it make my child?
- How do I store my growth hormone medicine?
- Can I travel with my growth hormone medicine?
