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