Growth hormone deficiency (GHD) is a rare condition. It can be congenital (present from birth), or a person can acquire it during childhood or adulthood. The age at which GHD presents may determine the symptoms.

The signs and symptoms of GHD in children may include a slow growth rate and reduced facial bone development. Adults may notice unexplained decreases in muscle mass and experience low energy levels.

Most people tend to receive a GHD diagnosis as children. A doctor will treat GHD in both children and adults with growth hormone injections.

This article explains GHD in more detail, including its symptoms, diagnosis, and treatment.

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GHD arises when the anterior pituitary gland does not release enough growth hormone. The anterior pituitary gland is part of the pituitary gland, a crucial gland that produces many hormones.

In some cases, children are born with GHD, but others may acquire it during childhood. Adult-onset GHD is always acquired. In both children and adults, the cause is not always clear.

Congenital GHD

Irregularities in certain clusters of genes could predispose someone to GHD. The condition can sometimes run in families, but this is rare.

Some people born with GHD may have a smaller or missing pituitary gland.

Acquired GHD

Acquired GHD may result from:

  • tumors in the pituitary gland
  • radiation therapy or brain surgery
  • autoimmune disease
  • severe head injury
  • lack of blood supply to the pituitary gland

GHD can cause many symptoms, with some being more subtle than others.

In children

Congenital GHD presents at birth. A child with acquired GHD will develop symptoms as they get older.

Often, children born with GHD are a typical size at birth. The most telling sign of GHD is a slow growth rate. If a baby grows at an average rate from 6 to 12 months, it is unlikely they have GHD.

Other signs and symptoms in children include:

  • low blood sugar in newborns
  • a small penis in newborns
  • the fontanels of the skull not closing in newborns
  • fine hair
  • reduced nail growth
  • high voice
  • excessive abdominal fat
  • slow development of long bones
  • slow development of facial bones
  • delayed tooth eruption

In adults

People who acquire GHD later in life have different symptoms.

The symptoms of adult-onset GHD include:

  • an unexpected decrease in muscle mass
  • an unexpected increase in fat
  • lower energy levels
  • depression or anxiety
  • increased levels of low-density lipoprotein (LDL) cholesterol and triglycerides
  • a reduction in bone strength or osteoporosis

The diagnostic process for GHD in both adults and children will require the doctor to take a detailed medical history.

To confirm GHD, they will also conduct a growth hormone stimulation test. This involves drawing blood to analyze growth hormone levels.

Other blood tests that may aid diagnosis include:

  • prolactin
  • free T4 or total T4
  • TSH
  • FSH
  • LH
  • cortisol
  • testosterone

The recommended treatment plan for GHD is similar in both children and adults.

Treatment in children

The treatment of GHD in children involves daily injections of recombinant human growth hormone (rhGH). It is important that children receive a diagnosis quickly so that treatment begins as soon as possible.

The earlier a child receives treatment, the more likely they are to grow at the typical rate. After retesting and assessment, treatment may continue into adulthood.

In 2023, the Food and Drug Administration (FDA) approved somapacitan (Sogroya), the first weekly — rather than daily — injection for use in children ages 2.5 years and up.

Treatment in adults

Adults also receive rhGH injections as part of their treatment plan.

As GHD may continue to cause problems when a person’s growth is complete, those who receive treatment as children may continue to do so as they get older. This continued treatment can prevent the loss of muscle mass and other effects of the condition.

In 2020, before it received approval for use in children, the FDA approved the weekly injection for adults with GHD.

If doctors diagnose GHD early in children and treatment starts promptly, most children will reach a typical height and develop as usual.

For adults with GHD, regular treatment can alleviate or reduce the symptoms, such as low energy and a decrease in muscle mass.

Endocrinologists are doctors who specialize in hormone conditions and treat GHD in both adults and children. People may receive a referral to an endocrinologist through primary care.

If a person wants to find an endocrinologist directly, they can try the Endocrine Society and the Pediatric Endocrine Society.

GHD is rare, but most people tend to receive a diagnosis as children. The sooner treatment with growth hormone injections starts, the more likely a child will grow at the typical rate.

Treatment for adults living with GHD also includes growth hormone injections. These injections help alleviate the symptoms, which may include a loss of muscle mass and low energy levels.