Growth hormone deficiency (GHD) is a condition caused by insufficient amounts of growth hormone in the body.
This is also called dwarfism or pituitary dwarfism. Children with GHD have abnormally short stature with normal body proportions. Adults with growth hormone deficiency experience the early signs of aging. GHD can be present at birth (congenital) or develop later (acquired).
The condition occurs if the pituitary gland makes too little growth hormone. It can be also the result of genetic defects, severe brain injury, or being born without a pituitary gland. In some cases, there is no clear cause identified.
Sometimes, GHD can be associated with lower levels of other hormones, such as vasopressin (which controls water production in the body), gonadotropins (which controls the production of male and female sex hormones), thyrotropins (which control the production of thyroid hormones) or adrenocorticotrophic hormone (which controls the adrenal gland and related hormones).
Symptoms
Many teens with GHD experience low self-esteem due to developmental delays, such as short stature or a slow rate of maturing. For example, young women may not develop breasts and young men’s voices may not change at the same rate as their peers.
Reduced bone strength is another symptom of AGHD. This may lead to more frequent fractures, especially in older adults.
People with low growth hormone levels may feel tired and lack stamina. They may experience sensitivity to hot or cold temperatures.
| Clinical features of adult GH deficiency | Improved by GH replacement |
| Increased abdominal fat | Yes |
| Reduced muscle mass and strength | Yes |
| Reduced cardiac capacity | Yes |
| Reduced blood volume | Yes |
| Cold intolerance | Probably |
| Impaired exercise capacity | Yes |
| Thin, dry skin | Yes |
| Reduced sweating | Yes |
| Reduced bone mineral density | Yes (delayed effect in a year) |
| Psychosocial dysfunction | Yes |
| Artherogenic lipid profile | Probabnly |
| Increased atherosclerosis | Not known |
| Reduced life expectancy | Not known |
Those with GHD may experience certain psychological effects, including:
- depression;
- lack of concentration;
- poor memory;
- bouts of anxiety or emotional distress.
Adults with AGHD typically have high levels of fat in the blood and high cholesterol. This isn’t due to poor diet, but rather to changes in the body’s metabolism caused by low levels of growth hormone. Adults with AGHD are at greater risk for diabetes and heart disease.
Diagnosis
A physical exam and measurement of height, weight, arms, and leg lengths are the first steps to diagnosis, in addition to thorough medical history. Blood tests to measure the levels of growth hormone in the body as well as the levels of other hormones.
Imaging tests including X-rays and MRI of the head may be helpful in narrowing down the underlying disorder causing GHD by revealing abnormalities of the hypothalamus or the pituitary glands.
Your levels of growth hormone fluctuate widely throughout the day and night (diurnal variation). A blood test with a lower-than-normal result isn’t enough evidence in itself to make a diagnosis.
One blood test can measure levels of proteins which are markers of growth hormone function but are much more stable. These are IGF-1 (insulin-like growth factor 1) and IGFPB-3 (insulin-like growth factor binding protein 3).
Your doctor may then go on to a GH stimulation test if screening tests suggest that you have a GH deficiency.
Treatment
Some cases of GHD can be treated with the use of synthetic growth hormone under the supervision of a pediatric endocrinologist. If other hormone deficiencies exist, other hormones can be given in addition to synthetic growth hormone.
Growth hormone is given by injection, typically into the body’s fatty tissues, such as the back of the arms, thighs, or buttocks. It’s most effective as a daily treatment. A doctor can also offer to take Ipamorelin or Sermorelin therapy instead, learn more about Ipamorelin here and find out more about Sermorelin therapy here.
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