Symptoms of Human Growth Hormone (HGH) Deficiency

Growth hormone deficiency (GHD) can result from gene mutations, injury to the pituitary gland through trauma or disease, or sometimes without a known cause. Depending on when GHD manifests and in whom, different symptoms may present.

Without the growth hormone (GH), children can’t grow correctly. Several accompanying problems can be present as a result. These include:

• Looking much younger than other children their age
• A chubby body build with extra thickness around the middle and torso
• Very fine or thin hair growth
• Delayed puberty
• Growth retardation
• Short stature
• Maturation delays
• Delayed development of facial bones
• Slow tooth eruption
• Delayed lengthening of the bones
• Poor nail growth
• High-pitched voice
• Delayed closure of the sutures of the skull
• Episodes of low blood sugar
• Reduced bone strength
• Depression or anxiety over short stature
• Measurement of height in the lowest third percentile as compared to other children the same age
• Increased cardiovascular risks
• Decreased energy levels
• Prominent forehead
• Underdeveloped bridge of the nose
• Increased risk of having frequent infections if the gene bruton tyrosine kinase (BTK) is mutated

Each of these factors must be considered when the endocrinologist prepares treatment plans. Depending on the severity of the condition or which genes might be affected, customizing recombinant human growth hormone (rHGH) from DNA or a synthetic growth hormone-releasing hormone (GHRH) may be advisable as well as other supporting therapies.

Adult Symptoms of Growth Hormone Deficiency

While many of the symptoms of GHD in children relate to decreased growth and growth potential, if the onset of GHD occurs in a full-grown adult, symptoms take on different forms. Most forms of GHD in adults result either from injury or disease to the pituitary gland so dealing with accompanying side effects of treatment regarding these issues presents additional concerns. Symptoms include:

• Reduced energy
• Altered body composition
• Osteoporosis due to reduced bone mass with a tendency to have more bone fractures with increased age
• Reduced muscle strength
• Lipid abnormalities such as increased LDL cholesterol and triglyceride levels
• Insulin resistance
• Cardiac function impairment
• Anxiety and depression
• Increased fat throughout the body but especially in the trunk
• Increased risk of heart disease and stroke
• Weakened heart
• Tiredness
• Reduced ability to concentrate
• Memory issues
• Decreased sexual function and interest
• Feelings of being isolated from other people
• Greater sensitivity to heat and cold
• Baldness in men
• Dry, thin skin
• Decreased tolerance of exercise
• Extracellular fluid volume
• Lack of motivation
• Lethargy
• Atherosclerosis or clogging of the arteries
• Metabolic syndrome
• Diminished lung respiratory muscle capacity

Again, diagnosis of the true cause behind perceived or possible GHD is imperative.

Diagnosis Tests for GHD

Genetic testing, blood levels, and pituitary stimulating tests work well for diagnosing GHD in children. These along with the obvious growth concerns tend to make the more obvious and sometimes severe symptoms easier to interpret. There also exists the concept of partial GHD in children, meaning the symptoms are less severe, but are often still treated with rHGH.

Adult GHD however, is a multifactorial disorder usually resulting from pituitary adenomas or some other pituitary gland treatment. Some discussion has arisen regarding partial GHD in adults, but it is harder to diagnosis when in combination with obesity, increasing age, and without other additional pituitary hormone deficits. Also, since the adult is already at full height and maturity, the obvious growth-impairment symptoms are lacking. Some tests to help with diagnosis include:

• Comprehensive biochemical testing to check for lipid imbalance, increased LDL cholesterol, atherosclerosis, reduced insulin sensitivity, and metabolic syndrome
• MRI scans to reveal any structural abnormalities or tumor in the brain
• Pulmonary function tests to check lung muscle capacity
• DEXA dual-energy X-ray absorptiometry scan to reveal possible osteoporosis or fractures
• Medical history to determine any history of head trauma
• Insulin tolerance test

It is important to complete all the necessary blood tests etc. due to the fact that signs and symptoms of growth hormone deficiency can be masked by testosterone or thyroxin or result from deficiencies in these hormones, other hormone dysfunction, or metabolic disorders. Excess GH or rHGH can result in other hormone deficiencies, that could lead to serious conditions. These include stroke, paralysis, liver damage, cardiac infarction, increased risk of cancer, and diabetes.