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About growth hormone (GH) and growth hormone deficiency (GHD)

When the body does not produce or release enough growth hormone it is called growth hormone deficiency or GHD. There's a lot to know about GHD, and at first it can seem quite overwhelming. Here is some information that may help you understand GHD better.

What are hormones?

Hormones are chemical messengers that are produced in one part of the body and travel through the bloodstream to other parts of the body, where they deliver a message to cause some kind of change.

What is growth hormone?

Growth hormone is a hormone made by the pituitary (pi-TOO-i-tair-ee) gland, a pea-size organ located just under the brain and behind the bridge of the nose. In children, growth hormone primarily regulates their growth. However, growth hormone is important for adults, too. It helps regulate your metabolism, and helps keep your bones and muscles healthy.

What is GHD?

GHD is when the pituitary gland does not produce or release enough growth hormone into the bloodstream. This can be because of a genetic defect, pituitary tumor, traumatic brain injury, or some unknown cause. When the pituitary doesn't produce or release enough growth hormone, it is called growth hormone deficiency or GHD.

In children, some signs of GHD are:
•  Growth of less than 2 inches per year between the ages of 2 and 11 years in girls or the ages of 2 and 13 years in boys
•  Leveling off and slowing of the growth progress
•  Growth that is below the 5th percentile on standardized growth charts
In adults, some signs of GHD are:
•  Changes in body composition
•  Changes in metabolism

How do I know if my child or I have GHD?

A doctor who specializes in endocrine care (an endocrinologist) can determine if you or your child have GHD. The doctor will first ask questions about your health and growth history, as well as about your family history. You will also undergo a complete physical examination. When necessary, the doctor will order blood tests to track the level of growth hormone in your blood.

If you or your physician recognizes any of the signs of GHD, you may be referred to an endocrinologist—a highly specialized doctor with years of extra training in diagnosing and treating endocrine (hormone) issues. The endocrinologist will still continue to track you or your child's growth progress.

You might also be given a Stim Test (short for Stimulation Test) to help diagnose GHD. This is an important test, which can often help your doctor be sure of GHD. At this point, your doctor wants to be sure of this diagnosis, which is why you or your child may be undergoing a Stim Test.

What happens if my child or I have GHD?

Growth hormone therapy, in the form of daily growth hormone injections administered 6 or 7 times a week, may help kids with GHD to reach their growth potential. Growth hormone treatment may help adults with GHD deal with their weight, body fat distribution, and body composition.

Learn more about GHD:
•  Stimulation testing
•  Questions for your doctor


Norditropin® Indications and Usage

Norditropin® (somatropin [rDNA origin] injection) is used to treat children with growth failure caused by very low or no production of growth hormone. It is also used to treat children who have short stature associated with Noonan syndrome and Turner syndrome, for treatment of children with short stature born small for gestational age with no catch-up growth by age 2-4 years, and to treat adults who do not make enough growth hormone.

Important Safety Information

Remember, your doctor is the main source of information about you and your health. Please consult your doctor if you have any questions about your health or your medication.

Do not use Norditropin® if you have any of the following conditions: an allergy to phenol or any other ingredients in the medicine; active cancer or other forms of tumor; severe diabetic eye disease; acute critical illness due to certain types of heart or abdomen surgery, trauma, or acute respiratory failure.

Children should not use somatropin if they have any of the following conditions: closed epiphyses (closed bone growth plates), Prader-Willi syndrome with severe obesity, upper airway obstruction or sleep apnea, or Prader-Willi syndrome with significant respiratory impairment.

Be sure to tell your doctor if you have diabetes mellitus; have had cancer or other forms of tumor; are pregnant, planning to be pregnant or are breastfeeding.

Be sure to tell your doctor about all medications you are taking especially if they are: a glucocorticoid medication such as hydrocortisone or cortisone acetate, thyroid hormone, insulin and/or oral diabetes medicines, drugs metabolized by the liver (for example, corticosteroids, sex steroids, anticonvulsants, cyclosporine), or oral estrogen replacement.

Adult height can be influenced if you are on Norditropin® for growth failure and at the same time using glucocorticoids or thyroid hormone.

If you are treated with insulin and/or oral diabetes medicines, the dose of your insulin/oral diabetes medicines may need to be adjusted.

Side effects are usually mild and temporary. Side effects may include headaches, muscle pain, joint stiffness, weakness, high blood sugar (hyperglycemia), sugar in your urine (glucosuria), swollen hands and feet due to fluid retention, and redness and itching in the area you inject.

If you have any of these symptoms, discuss them with your doctor.

If you have headaches, eyesight problems, nausea and/or vomiting, these may be symptoms of raised pressure in the brain. Contact your doctor right away.

In very rare cases children treated with somatropin have experienced pain in the hip or knee or a limp. These symptoms may be caused by a slippage of the growth plate in the hip (slipped capital femoral epiphysis).

Scoliosis (curvature of the spine) can occur in children who experience rapid growth. Because growth hormone increases growth rate, children should be monitored for progression of scoliosis.

Thyroid function tests should be performed periodically.

Skin lesions should be checked carefully for any unusual changes.

Somatropin treatment can increase the chances of developing middle ear infections in patients with Turner syndrome.

Congenital heart disease is a common finding in Noonan syndrome and patients should be closely monitored.

Talk to your doctor if you think you have any of these conditions.
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