FINDING OUT MORE ABOUT GROWTH HORMONE DEFICIENCY GLOBAL MASTER COPY - FOR INTERNAL USE ONLY

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1 FINDING OUT MORE ABOUT GROWTH HORMONE DEFICIENCY GLOBAL MASTER COPY - FOR INTERNAL USE ONLY

2 Doctors have measured the height and weight of lots of children of the same age. They have used this information to create charts like those shown below. CHILDREN COME IN ALL SHAPES AND SIZES If your growth curve is lower than the lowest curve on the chart for girls or boys of your age, you may benefit from help to grow. Doctors plot your growth on charts like this. It helps them to see how you are developing compared with other boys or girls of your age. These charts show the average growth curves for boys and the average growth curves for girls. The top line shows the average for tall/heavy children. The bottom line shows the average for small/light children. Most children s growth rates fall somewhere between the top and the bottom lines.

3 WHY MIGHT YOU BE SMALLER THAN OTHER CHILDREN? Your growth mostly depends on the genes you inherit from your parents. Tall adults tend to have tall children and short adults usually have short children. Doctors can use a mathematical formula based on your parents heights to work out how tall they expect you to be once you ve finished growing. This is called your target size. If you are smaller than would be expected after looking at your parents and if you are much smaller than other children of your own age, there may be a reason why you are not growing as quickly as you should. WHAT ELSE CAN AFFECT MY GROWTH? Growth can be affected by things that happen in children s lives. Some things happen outside The reasons why some children don t grow properly can be very sad: There may be a war or a famine in their countries which makes it hard to find good food to eat. Children s lives may be very stressful if, for instance, their families are living in difficult circumstances. A long-term disease may be affecting their health. Fortunately, the problems are not always difficult to solve. There are often ways to help. Some things happen inside Some children s bodies don t produce enough of a particular hormone that they need. It is called growth hormone. These children can have medicine to help them.

4 WHAT IS GROWTH HORMONE? Your body produces a hormone that plays a central role in the modulation of growth, called growth hormone. Growth hormone is needed to help your bones, teeth and muscles to develop as they should. It also affects the way your body uses the protein, fat and sugar that comes from your food. 1 When your body does not make enough growth hormone naturally, you can get the extra growth hormone you need by taking medicine. WHERE IS GROWTH HORMONE MADE? Growth hormone is made in the anterior part of the pituitary gland, along with other hormones that your body needs. 1 This gland is only the size of a pea and it is positioned underneath your brain. 3 The pituitary gland releases several hormones (chemical messengers) into your bloodstream. These hormones travel through your body to target organs where they deliver their instructions. Growth hormone makes your bones, tissues and organs grow. 1 Doctors can do certain tests to find out if your body is not making enough growth hormone. Hormones are your body s chemical messengers. They travel in your bloodstream telling your bones, tissues or organs what to do. 2 Your condition can be treated with growth hormone injections, which increase the amount of growth hormone in your body, helping bones to grow and muscles to develop. 4-7

5 WHAT HAPPENS IF I HAVE GROWTH HORMONE DEFICIENCY? Children who don t produce enough growth hormone are small for their age. Apart from that, children with growth hormone deficiency usually have normal body proportions, facial appearance and intelligence, but sometimes they may look younger in comparison with their friends. 8 If you have growth hormone deficiency, doctors would like you to take extra growth hormone in medicine to help your bones, teeth and muscles to grow strong. Your doctors know that improving your growth and development now may help to avoid certain health problems in the future. This is why it is very important to have regular check-ups with your doctor. They can check that you are developing and growing well. WHAT MIGHT HAVE CAUSED GROWTH HORMONE DEFICIENCY? Scientists are still learning more about the causes of growth hormone deficiency. Some children can be born with growth hormone deficiency, while others may develop it after birth due to a brain injury, a tumour, or radiation treatment to the head. 9,10 In quite a few children, doctors are unable to find the cause. There are certain signs and symptoms that might make your doctor suspect you have growth hormone deficiency. However, they will carry out tests to confirm this before they reach a diagnosis. Doctors take an x-ray of your left hand to look at your bones. They can measure your bones to see if they have developed more slowly than they would expect at your age. Some tests can stimulate your body to produce growth hormone so that doctors can measure how much is released. They can also measure other factors and proteins in your body that are closely connected with growth hormone. 9

6 YOUR DOCTORS BELIEVE THAT YOU NEED MEDICINE TO HELP YOU TO HOW DO I TAKE MY MEDICINE? GROW Getting a diagnosis of growth hormone deficiency is very important. It means that the doctors can treat you with growth hormone injections which increase the levels of growth hormone in your body 11 and support your natural growth and development. 1 Artificial growth hormone is made using special, biotechnical processes. It is made to be as close as possible to naturally occurring, human growth hormone. It works by increasing the amount of growth hormone in your body, helping your bones to grow and your muscles to develop. 12 You need to inject your medicine every day. The human body naturally makes more growth hormone at night than it does during the day, so take your injections at bedtime. This will help copy the natural rhythm of your body. 13 You will need to take your injections every day until you reach the end of puberty because that is when bones stop growing naturally. 9 Treatment with growth hormone is long-term, often lasting for several years. 9 Your doctor will check your progress regularly and take blood tests to make sure you are staying healthy in every respect. Rotate your injection site You need to inject your medicine every day under the skin. You should change the place where you inject your medicine each day.

7 Exercise regularly Run, walk, dance, play sports. Just have fun! But do remember that it is important to rest if you get tired 14,15 WHAT ELSE CAN I DO TO LOOK AFTER MYSELF? Eat a healthy balanced diet Ensure you have the important vitamins and nutrients needed for healthy growth and development: 16 Eat small, nutritious snacks and meals throughout the day Eat a variety of foods which include fruit and vegetables, grains, dairy (milk, yogurt, cheese, and/or fortified soya beverages), protein foods (seafood, lean meats and poultry, eggs, beans and peas), and oils Take a look at [include link to local guidelines] Always make sure to follow the advice you ve been given by your doctor, nurse or dietitian. Have a routine Make your injections part of your normal routine. Let it become one of the things you always do before going to bed, like cleaning your teeth. Be patient Remember: growth is a slow process. Even though your growth hormone injections can help you to grow, it may take several months before you notice that you have grown taller. References: 1. Kato Y et al. Intern Med 2002; 41: Medline Plus Hormones. Available at: Accessed October Medline Plus Pituitary and Pineal glands. Available at: pituitary.html. Accessed October Salas PY et al. Int J Endocrinol 2013, Article ID Accessed May Johnston LB, Savage MO. Arch Dis Child 2004; 89: Southern Reh C, Geffner ME. J Clin Pharmacol 2010; 2: Takeda A et al. Health Technol Assess 2010; 14:1-209, iii iv. 8. Growth Hormone Deficiency. A Guide for Parents and Patients. Available at: FILES/02_Growth_Hormone_Deficiency.pdf. Accessed July Medline Plus Growth Hormone Deficiency Children. Available at: medlineplus.gov/ency/article/ htm. Accessed October Sathyapalan T, Dixit S. Expert Rev Anticancer Ther. 2012; 12: Sandoz. Omnitrope Summary of Product Characteristics. February US FDA Somatropin Information. Available at: Drugs/DrugSafety/ucm htm. Accessed July Morris CJ et al. Mol Cell Endocrinol 2012; 349: Healthy Children (from the American Academy of Pediatrics). How to get fit. Available at: How-to-Get-Fit.aspx. Accessed October Healthy Children (from the American Academy of Pediatrics). Making fitness a way of life. Available at: Accessed October Healthy Children (from the American Academy of Pediatrics). Making healthy food choices. Available at: English/ages-stages/gradeschool/nutrition/Pages/Making-Healthy-Food-Choices.aspx. Accessed October Job code: HQ/OMN/ Date of preparation: December 2016