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What is growth hormone deficiency (GHD)?

Growth hormone deficiency (GHD) occurs when the pituitary gland doesn't produce enough growth hormone to stimulate the body to grow. It can be congenital (present at birth) or acquired as a result of pituitary damage from trauma, radiation, infection, or tumors. Most cases are identified in children. Although it is uncommon, growth hormone deficiency may also be diagnosed in adults. Too little growth hormone can cause short stature in children, and changes in muscle mass, cholesterol levels, and bone strength in adults.

GHD in Children

Symptoms of GHD may include a younger appearance (compared to peers of the same age), a chubby body build, increased fat around the face and stomach, sluggish hair growth, and slow tooth development. GHD may also delay puberty and sexual development.

GHD in Adults

Symptoms of GHD may include anxiety and/or depression, decreased muscle mass and strength, difficulty in concentrating/memory issues, heart disease, and dry, thin skin. Adults with GHD are at increased risk for developing osteoporosis due to reduced bone density.

What causes GHD?

Damage to the pituitary gland or hypothalamus may be the result of an abnormal formation that occurred before your child was born (congenital) or something that occurred during or after birth (acquired).

Congenital growth hormone deficiency can occur if there are mutations in genes for factors that are important in pituitary gland development or in receptors and factors (including growth hormone) along the growth hormone pathway; to date, however, the cause of most of these cases is unknown.

Acquired causes of growth hormone deficiency include:
  • A brain tumor in the hypothalamus or pituitary
  • Head trauma
  • Radiation therapy for cancers if the treatment field includes the hypothalamus and pituitary
  • Diseases that infiltrate the hypothalamus or its connection to the pituitary gland, such as histiocytosis
  • An autoimmune condition (lymphocytic hypophysitis)

How is GHD diagnosed?

Diagnosis is confirmed by a stimulation test, where a patient is given a substance that causes or stimulates an increase in GH production. Blood samples will be collected at regular intervals over several hours and analyzed to determine if the pituitary gland produced the expected amount of GH in response to the stimulant. Hand X-rays, brain MRI, and other blood tests checking organ function may also be performed as part of the diagnosis work-up.

How is GHD treated?

Typically, treatment of growth hormone deficiency involves receiving regular injections of synthetic human growth hormone, and children receive daily injections. Children receive treatment until they have reached their full adult height, reached full bone maturity, or have grown less than 2 cm in the last year. Adult-onset GHD may require life-long treatment.

How can a specialty pharmacy help?

Kroger Specialty Pharmacy's total life care programs set a clear path to caring, compassionate therapy management and support.

We are here to provide patients, providers, and partners with the necessary coordination of care vital to achieving successful treatment outcomes. Our team of patient care experts comprised of pharmacists, nurses, reimbursement specialists, and dedicated Patient Care Coordinators (PCCs) work together to offer our patients and partners with individualized care. During treatment, KSP offers ongoing patient evaluation and clinical support including frequent patient follow-up and continual education.

What are some support resources?

Please also refer to the manufacturer’s website for your prescribed medication(s).