Growth hormone has been used for more than 30 years with varying degrees of success to treat children of short stature. Surprisingly little research has been done on the long term success of this treatment.

A recent French study looked at the final height achieved by children taking growth hormone and reports disappointing results. Of the 3233 children whose treatment started between 1973 and 1989 (with the last follow up in December 1993), 35 per cent stopped taking the drug prematurely because of lack of response or tiredness. Those treated before puberty achieved the greatest growth, but overall the drug failed to restore normal growth for most who used it.

Those who fare best on the drug are also those who are genuinely low in growth hormone to begin with. But it can be difficult to say what is “low” and equally impossible to prescribe treatment (both in frequency and dose) accurately since “normal” levels of growth hormone in growing children are constantly changing.

The authors conclude that growth hormone therapy should not be universally relied upon to help growth restricted children achieve normal height or given as a “panacea” for children of short stature. In the end, what may be of greatest benefit is to help children who are normal, but of short stature, to come to terms with this fact (BMJ, 1997; 315: 708-13).

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Written by What Doctors Don't Tell You

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