Principles for the use of growth hormone

Growth hormone can promote growth, affecting glycolipid metabolism

Good doctor online: What types of short stature can be treated with growth hormone?
Professor Fan: According to the drug description, the most common and most important indication for growth hormone is the treatment for patients with growth hormone deficiency, which is also the best disease. This is followed by non-growth hormone deficiency, including idiopathic shortness, Turner syndrome due to lack of growth hormone or lack of growth hormone.

Good doctor online: What kind of therapeutic effect does growth hormone have?
Professor Fan: Growth hormone has two main functions. The first is to promote growth. For children, it is mainly to help them grow taller. Second, growth hormone can affect sugar and lipid metabolism. For example, patients with severe growth hormone deficiency will have elevated blood lipids, and a large amount of fat will accumulate in the abdomen and chest, affecting the appearance. After the medication, the blood lipids will return to normal, the abdominal fat accumulation will gradually disappear, and the person will become more slender and the muscles will be more developed.
Therefore, patients with growth hormone deficiency, even if they do not have high growth requirements in adulthood, it is recommended to use growth hormone in small doses under the guidance of a doctor. This is beneficial for improving metabolism and lifelong health.
For children with non-growth hormone deficiency, the purpose of medication is to promote their growth. Generally, the height is within the height range of a normal person, and the drug is stopped. For those whose height is in the normal and short range, but the increase is required, medical treatment is not recommended.

Common 4 types of adverse reactions
Good doctor online: What side effects or adverse reactions can occur with growth hormone?
Professor Fan: In general, if the drug is used strictly in accordance with the drug instructions and indications, growth hormone is a safer drug with fewer side effects or adverse reactions.

If side effects or adverse reactions occur after administration, it is mainly related to the dose of the drug. In normal people, growth hormone is the natural secretion of the body, enough for the growth of physical fitness. In the treatment of growth hormone deficiency, we use a small dose of replacement therapy, that is, how much to make up, and replace the normal physiological needs of the human body with drugs. This dose is basically safe. If used in the treatment of non-growth hormone deficiency, such as idiopathic short stature, Turner syndrome, etc., the dose is relatively large, or the medication is longer, the side effects will appear.

The most common side effect of growth hormone is elevated blood sugar. There are some diseases that cause excessive growth hormone in the body, such as giant disease and acromegaly, and there is a problem of abnormal glucose metabolism, which leads to an increase in blood sugar. When using growth hormone replacement therapy, if the drug dose is too large, it may cause abnormal glucose metabolism, and severe type 2 diabetes may occur. But there are individual differences that may be related to family history.

In the past, the second common side effect was local skin reactions, such as local itching, redness, and more common in some early drugs. But now, with the increasing purity of growth hormone preparations, the quality of domestic preparations is getting better and better. These local reactions are almost gone. Some children develop local pain after injection, which is mainly related to psychological factors and can be tolerated.

The third common side effect is pseudo-brain tumors. The child will have a headache, and the intracranial pressure will increase after the injection. These symptoms disappear after stopping the drug. For this situation, parents should be reminded to take the child to review regularly, and to go to the hospital in time for discomfort.

The fourth side effect is joint slippage. This is a very rare situation, mainly related to the acceleration of the child’s growth after medication. Parents are more concerned about and valued. It also includes growth hormone that promotes cell proliferation and division, and may induce tumor or relapse. However, from the situation in our hospital and a large number of international statistics, the incidence of cancer is not significantly increased by the use of growth hormone.

In addition, some children may experience physical pain due to accelerated growth, especially in the afternoon. We call it growth pain, which is normal. We have also encountered some children in the clinic and found some curvature of the spine. Our analysis found that these children had less obvious congenital malformations and scoliosis before the injection of growth hormone. However, the doctor did not check carefully before treatment. As the height increased, this problem was highlighted, and parents noticed it as a side effect of the drug. In fact, the two have nothing to do with it.

Good doctor online: Adverse reactions and side effects of growth hormone, are there individual differences?
Professor Fan: Yes. All drug reactions are first related to the drug itself, and then to individual differences. We ask doctors to make a record before using angtropin growth hormone, carefully check whether the child has scoliosis, etc., and do a basic routine biochemical examination. And considering the difference between the group and the individual, everyone has the risk of having a tumor, and the child should be properly examined to understand the family history of the disease.

Professor Fan: The examination includes preventive testing and etiological testing. Prophylactic tests include basic hematuria, liver and kidney function, blood sugar, lack of pituitary hormones, and detection of tumor markers (can remind tumors). Some children develop hematuria or proteinuria when they use growth hormone. If the basic examination is not done in advance, the doctor can’t tell whether the patient already has the underlying disease or the adverse reaction caused by the medication.
Etiological testing involves performing a magnetic resonance of the pituitary when necessary. Some growth hormone deficiency is caused by pituitary dysplasia or pituitary growth hormone deficiency caused by tumor compression in rare cases. This can be found by magnetic resonance.

Good doctor online: How long does it take to review the process of injecting growth hormone, including which items?
Professor Fan: Most of the diseases treated with growth hormone are not temporary diseases. In other words, it does not have the same stage as a cold, and it can be cured in a few days or weeks, often requiring long-term treatment. This also requires regular review and follow-up.
In general, we require a routine examination in the first month after growth hormone, and then review it every three months. The examination has two purposes. The first one is to see the curative effect. After the medication, the child’s physical development and long-term changes are monitored. The second is to monitor whether the test results show adverse reactions or side effects.

Good doctor online: If the child has a pseudo-headache or other brain symptoms, or in the daily review, but also check the magnetic resonance?
Professor Fan: Generally not needed. This diagnosis is mostly one-time, mainly used to observe the development of the pituitary gland to determine whether there are intracranial congenital malformations and pituitary development, or to exclude pituitary abnormalities caused by secondary tumor compression and intracranial hemorrhage. And the child has already had magnetic resonance before taking the drug, and it is not necessary to repeat it after the diagnosis.

Moreover, pseudo-headaches or pseudo-brain tumors are known side effects of drugs. We will give the child a week of withdrawal, and if the symptoms are fully recovered, it is a drug problem. Most children stop taking the drug for a while, and most of them can continue treatment without a second headache.
Have adverse reactions with growth hormone

Good doctor online: Is it because the child has an adverse reaction after taking the drug? First, it is recommended to stop the drug for a period of time. If the symptoms disappear, it means that it is related to the drug?
Professor Fan: Right. Parents should read the drug instructions carefully before giving them medication. If there is an adverse reaction after administration, check the drug instructions, and there are tips.

For some small, common adverse reactions, you can stop taking the drug. If the blood sugar rises, you can stop taking the medicine to see the recovery of blood sugar. Before using the drug, special emphasis is placed on understanding whether there is a family history of diabetes or oncology. We must tell parents that if there are these situations in the family, we must be cautious in the course of medication and insist on regular review. Can not be used in the process of growth hormone, half a year or a year is not reviewed, this is irresponsible for children.

Good doctor online: How long is it appropriate to stop taking medicine?
Professor Fan: This varies from person to person and varies from symptom to symptom. It is recommended that all withdrawals and recovery medications should be carried out under the supervision of a doctor. Parents should not make assertions.