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 injections of growth hormone.
This article will explain GHD in more detail, including its symptoms, diagnosis, and treatment.
GHD arises when the anterior pituitary gland does not release enough growth hormone. The anterior pituitary gland is part of the pituitary gland, which is a crucial gland because it 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 known.
Abnormalities 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 may result from:
GHD can cause many symptoms, with some being more subtle than others.
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 6–12 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 and teeth
People who acquire GHD later in life have different symptoms.
The symptoms of adult-onset GHD include:
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 test involves drawing blood to analyze growth hormone levels.
Other blood tests that may aid diagnosis include:
- free T4
The recommended treatment plan for GHD is similar in both children and adults.
Treatment in children
The treatment of GHD in children involves injections of recombinant human growth hormone (rhGH). It is important that children receive a diagnosis quickly so that treatment commences as soon as possible.
The earlier a child receives treatment, the more likely they are to grow at the typical rate. Treatment may continue into adulthood, after retesting and assessment.
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, the Food and Drug Administration (FDA) approved the first weekly — rather than daily — injection for adults with GHD.
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.
GHD is rare, and doctors often diagnose it in children. The sooner treatment starts, the more likely it is that 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.