Growth hormone, also known as somatotropin, is a hormone produced by the pituitary gland (a small gland located at the base of the brain). This hormone is essential for healthy development and growth in children, and it also helps regulate energy production in both children and adults.

Growth hormone deficiency (GHD) is a growth disorder produced by damage to the pituitary gland. It can be total, when no growth hormone is produced, or partial, when it’s produced but in insufficient quantities

GHD can be congenital, which means the child borns with it; or it can be acquired, which means that it can develop at any point in a person’s life.

Acquired GHD is often the result of damage to the pituitary gland, either due to illness, severe brain injury, exposure to radiation therapy, or tumors.

Children born with congenital disabilities of the skull and face (such as cleft lip or palate) can also have decreased levels of growth hormone. However, most of the time, the cause of GHD is unknown

Signs of GHD in children include:

• Slow growth
• Severe short stature
• Delayed puberty
• Chubbiness
• Young-looking face

Children with GHD have a slow or flat rate of growth. Therefore, initially, a pediatrician will look at a child’s birth height and weight and draw his or her growth curve on a growth chart. If no other symptoms are present, the doctor may continue monitoring the child’s growth.

When a problem is suspected, some laboratory and imaging tests may be indicated, including:

• CBC count
• Serum electrolytes
• Thyroxine (T4)
• Thyroid-stimulating hormone (TSH)
• Insulin-like growth factor 1 (IGF-1)
• Insulin-like growth factor binding protein 3 (IGFBP3)
• Growth Hormone
• Growth hormone stimulation test
• Hand x-ray, to determine bone age
• Head MRI
• Karyotype
• Celiac panel

There are other factors besides GHD that can impair a child’s growth, especially malnutrition and malabsorption problems.

Treatment of growth hormone deficiency involves the administration of daily growth hormone injections at home. This is long-term and must be often done for several years.

During this period, continuous medical monitoring is required. Common side effects of the treatment include:

• Headache
• Muscle and joint aches
• Water retention
• Allergic reactions
• Fracture in the ball of the hip joints

Children who are diagnosed early have a better chance to grow to near-normal adult height. Nevertheless, if left untreated, GHD can result in short stature and delayed puberty.

You should take your child for a pediatric consult if he or she seems abnormally short for his or her age.

Usually, GHD is not preventable. You can keep an eye on your child’s growth chart at each checkup with the pediatrician.

If your pediatrician finds a problem with your child's growth rate, you will most likely get a reference to see a specialist.