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The Most Frequently Asked Questions when Beginning Growth Hormone Therapy FAQ Part I
Growth Hormone therapy for both children and adults... is often confusing. To help you we have put together a list of questions which we are often asked by parents. Remember these are questions specific to children who are either newly diagnosed or just starting growth hormone treatments. If you don't see an answer to your question, or just need to talk with a more "experienced" parent who has gone through this- Please call! That is why we are here. We have faced this and know how challenging it can be!
 1) What is Growth Hormone?
Growth hormone is a protein hormone secreted by the pituitary which promotes linear growth.
2) Is Growth Hormone a Steroid?
No. It is a protein hormone made up of amino acids.
3) Are there any side effects when using Growth Hormone?
Growth hormone does not have any significant side effects when used as a replacement therapy for growth hormone inadequacy or deficiency. Children with hypopituitarism (multiple pituitary hormone deficiencies) sometimes experience fasting hypoglycemia that improves with treatment. Growth hormone results in reduction in body fat with increased muscle growth development.
The recommended doses of growth hormone do not lead to problems, but long-term over-dosage, could result in signs and symptoms of acromegaly consistent with the known effects of excessive human growth hormone. This is not to be expected with properly prescribed growth hormone replacement therapy. Consult your physician or pharmaceutical company for further detail.
4) Why is growth hormone necessary?
Growth hormone is a natural hormone which necessary for normal linear growth. Growth hormone is indicated for the long-term therapy of children who have growth failure due to inadequate growth hormone secretion.
5) How do you determine the dosage and will the dosage remain the same throughout therapy?
Growth Hormone is generally prescribed in a dosage of 0.3mg/kg/week. Higher doses may benefit some teenage growth hormone deficient patients, especially those who are most growth retarded during puberty.
6) What changes, if any, should I expect to see in my child during therapy? (moodiness/hyperactivity etc.)
There should be no specific changes in your child's mood or activity on growth hormone therapy. However, children generally will have an improvement in self-esteem which may lead to other improved psychological aspects.
7) What are the different types of growth hormone and how often are the injections given?
Growth hormone is available as a powder, or as a premixed liquid. It is also available in devices which use a vial that you will mix or that will mix itself when readied for use. Growth Hormone is usually administered 6-7 days per week.
 8) Should I worry when bubbles appear in the syringe that has been prepared for my child's injection?
A few bubbles may be of no consequence. One needs to practice to improve technique. Mixing and drawing require training and practice.
9) How long will my child be on growth hormone?
Growth Hormone is utilized for until full growth has been attained with a bone maturation of 16 years or more for males and 14 years or more in females or the growth rate is less than 2cm/year.
Consult your physician for continuing growth hormone therapy under the guidelines for adult growth hormone deficiency. Growth Hormone Therapy may be indicated in adults with Growth Hormone Deficiency and teenagers after full growth has been attained. Growth Hormone stimulation tests are necessary. Peak Growth Hormone values of less than 5mg/ml qualify for continued replacement therapy. Adult Growth Hormone Deficiency patients have impaired quality of life, reduced exercise capacity, high cholesterol, increased body fat, reduced muscle mass and reduced bone density.
10) Should my child give his own injections?
Children can share in the administration of their injections with supervision. Children 8 years of age and older may decide to give their own injections. Sharing part of theinjection technique may be important to self-esteem.
11) What kind of growth should I expect to see in my child?
Generally, growth prior to therapy is less than 5 cm (2.5 inches) per year. Growth may be 8 to 12 cm during the initial year of growth hormone therapy. The second and third year may be closer to 7 cm per year. Growth is approximately 1½ inches or less prior to therapy and 3-4 inches per year after initiation of therapy.
12) I left the growth hormone at room temperature for several hours. What shall I do?
Growth hormone is a protein which can be destroyed by extreme temperatures. Prior to mixing growth hormone, a vial can be left out for 72 hours and then reconstituted with full effectiveness. Once a vial is reconstituted it could be left out at normal temperatures up to 24 hours. Manufactures have devices which protect medicine for a short time. Always refer to the information provided by them regarding the safety of your medications.owth hormone is a protein hormone, which can be destroyed by heat or extreme temperatures, but there are some general recommendations to follow. Prior to reconstitution (mixing) of your growth hormone, a vial can be left out for 72 hours and then reconstituted with full effectiveness. Once a vial is reconstituted it could be left out inadvertently at normal temperatures up to 24 hours.
13) If my child prefers injections in the legs instead of the arms, is it okay in the legs only?
Rotation of injection site is encouraged in the arms and legs; other areas may also be utilized. Avoidance of the same location is important to avoid local bumps in the skin called lipohypertrophy.
14) Is it advisable to give the injection when my child is sleeping?
This is a asked question only parents can decide. Injections are generally preferred at bedtime. Each child has an individual response or fear of injections.
15) I don't feel I can give the injections to my child. Is this a normal reaction?
This is a normal reaction of conscientious parents who have concern of hurting their children. Children may express discomfort following an injection. Utilizing smaller needles and quicker subcutaneous injections are recommended. The child needs reassurance that the discomfort will diminish when they become used to the injections. The parent can reinforce the benefit of the injection by maintaining a positive attitude. Ask your child’s physician about your options.
16) What if I forget an injection?
One can make up for missed injections by adding extra doses on other days. Remember the total weekly dose remains the same.
 17) What if my child wants to discontinue the injections, but there is a potential for more growth?
Children need to be encouraged to continue their therapy for full effectiveness. Only an individual family can make a final decision regarding what is best for their child. One needs to examine the child's motive for wanting to discontinue injections when they are obtaining a definite benefit. MAGIC has a free DVD available "Just Say YES To Growth Hormone". (Call to request copy.)
18) What should I do if I run out of growth hormone?
It is recommended that you be aware of your growth hormone supply and contact the source of supply prior to running out. Make sure the prescription is refillable and the insurance company has continued the approval. It is advisable to restart the injections as promptly as possible.
19) How often will my child need to visit the endocrinologist and what additional tests need to be taken during the course of therapy?
The number of visits to the endocrinologist depend upon the age of the child and if there are other conditions or hormone deficiencies. The general recommendation is for visits every three months. Periodically, blood testing is necessary such as thyroid function studies and a bone age assessment is recommended yearly. There is an increased incidence for the need of thyroid replacement as well, and indeed other deficiencies may be co-existing.
To Continue to Frequently Asked Questions Part II- click here.
Contributed By:
Louie G. Linarelli, M.D.
San Diego, CA
Updated 2006 by
David R. Brown, M.D., F.A.C.E.
Minneapolis, MN
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