Growth Hormone Deficiency in kids?

[Alison's Mom]

Now I'm 4'11 and DH is 5'6, so we weren't expecting any tall kids, but both kids are VERY short, DD particularly, who at age 5 is quite a bit shorter than even I was at her age. She is a good 3 inches shorter than the next shortest kid in her class, and also 3 inches below 3% on the charts; she is shorter than an average 3yr old: http://www.magicfoundation.org/www/docs/7/growth-charts

DS is 3.5 and is 1/2 inch below 3% on the boys' chart for his age, and I am concerned that they are not growing much, and maybe there is a bigger problem. My dad likes to measure DD's height when we go to their house, so it seems she is growing, but very slowly. DS doesn't like to be measured, so we don't have much of a chart for him. They both do outgrow clothing and shoes, but very slowly.

Both kids are healthy, active and 'normal' developmentally, and were average size at birth, just tapered off significantly at around 12 months.

We were referred to a ped for DD at around 18 months who did a round of tests and checked her ht/wt for a couple of years and declared her healthy and just short. We also saw a nutritionist who said she eats more than most kids who come through the office and her diet was not the reason she was short.

Because of this, I put it on the back burner and didn't even get DS tested as I assumed we would get the same results, until today - I was reading about a kid who was slightly younger than my DD and a bit shorter who was going to be tested for Growth Hormone Deficiency.

I checked out this page: http://www.hgfound.org/pub_growth.html and got some info on it, and it appears if they find GH deficiency, they give daily injections to remedy the problem.

Any experience with this, and does anyone know of side effects that come with growth hormone therapy? Thanks.

[vancouverlori]

Originally Posted by Alison's Mom

I was reading about a kid who was slightly younger than my DD and a bit shorter who was going to be tested for Growth Hormone Deficiency.

I checked out this page: http://www.hgfound.org/pub_growth.html and got some info on it, and it appears if they find GH deficiency, they give daily injections to remedy the problem.

Any experience with this, and does anyone know of side effects that come with growth hormone therapy? Thanks.

I'd say it's worth looking into. Growth Hormone has other health effects besides just growth. I don't have any personal experience with it, but I know it's now being touted as the "elixir of youth" with all kinds of health claims. I personally and professionally (I'm a pharmacist) disagree with *that* sort of use, but I know it's generally very well tolerated - few side effects in therapeutic doses. Injections are inconvenient, but kids who need them usually get used to them, and it is subcutaneous, which isn't too bad. (A friend of mine has a transgendered son and she has to give him weekly hormone shots intramuscularly.) The worst side effect with growth hormone is the one on the family budget. I believe they're a provincial benefit for children - so make sure you have your BC Fair Pharmacare status all updated with your most recent income info. (Less of an issue if you have extended medical, but still should be done.) The doctor may have to send in a "special authority" form, but any doctor dealing with this should know all about that.

This is all very general, but I thought it would be helpful to give you the big picture. I like to use Drugs.com for drug info when I'm not at work. Their patient info for somatostatin (generic drug name for growth hormone) is pretty standard. Don't be alarmed by the "call a doctor immediately if..." section. It's meant to tell you what the extremely rare but very serious side effects are, so you can get medical attention right away. Most of the side effects are related to the injections themselves, and others don't apply to therapeutic use in children.

I would also consider grandparents heights, assuming they didn't go through famines or major illnesses as children. My inlaws lived through famine in China, and they're 5' and 4'10". My BIL's are both decent height for asian guys - 5'10" ish. But DH had leukemia as a kid and was on steroids for many years, so that's why he's only 5'4". So I'm expecting Calvin to be a bit taller than both of us - my dad is also 6'. And he seems to be headed that way.

Short's ok, though. I like to tell my husband that he's "travel-sized for convenience" as Mushu from Mulan put it.

[sbgrace]

My son has always been tiny and I don't know how genetically. No one has ever wanted to test his hormone levels because he is proportional (3 to 5% weight, height, head). I plan to ask again soon.

[kjbrown92]

How is their sleep? growth hormone is released when sleeping so if they don't sleep well, then they may not grow well.

[Alison's Mom]

Thanks everyone.

Lori - thanks for all the info. I feel a bit better about potentially using GH therapy now that you, as a crunchy pharmacist says it's not bad in terms of side effects.

Grandparents - hmmm, my parents are short: 5'0 and 5'4, and DH's parents were 5'0 and about 5'9. There are reasonably average height people on both sides of the family - 5'10 for uncles and 5'5 for aunts, etc, just not my parents, who are both the shortest in their families.

Sleep - there were definitely times when both kids didn't get enough sleep, most recently because DS would nap, and then not be tired until 11pm. Because of that, we have cut the nap, and now they both sleep from 8.30-7.30-ish, so at least 10 hours and generally closer to 11 hours. Their previous lack of sleep may have had something to do with it as well. DD now sleeps through the night, and DS wakes up once to call me into his bed, or crawl into ours. I doubt that could be disrupting his sleep too badly?

I've read there are also thyroid issues that could cause lack of height, and also just heard that some celiacs don't show any symptoms except short stature/thin, so I guess there are those factors to look into further.

I know someone whose DD is seeing a ped endocrinologist for another reason and said it was next to impossible to get the referral.

Both kids are thin but also proportional - the first thing the ped said was that he didn't suspect dwarfism or anything like that, because you can usually tell just by looking at a kid.

[Jamie1989]

Children's Growth

The key to normal growth and health for a child is how much they grow in 12 months. For details go to a parent support group called the MAGIC Foundation. Excellent info and details. www.magicfoundation.org

[JaneS]

Deficiencies in fat soluble vitamins can also be a cause.

Since you are in Canada the first suspect is vitamin D deficiency. You cannot make vitamin D from the sun most of the year. I would get a blood test and start supplementing see this website for info www.vitamindcouncil.org

Vitamin D is actually not a vitamin but a hormone!

Growth is not just genetically driven. See "WAPF fed" link in my sig. for more on fat soluble vitamins, tons of info at that site.

Every single one of my IRL Weston Price foundation friends noticed a huge jump in their child's growth the year they started supplementing high vitamin cod liver oil and high vitamin butter oil for the fat soluble vitamins and bone broths and/or raw milk for the minerals.

You need vitamin A to help vitamin D work so you can do what we do (live in Massachusetts so similar vitamin D issues) and do high vitamin CLO plus extra vitamin D and the butter oil.

Does she eat soy? Very bad news for growth b/c it has enzyme inhibitors which binds to minerals and prevents body from utilizing them, and also estrogen hormones.

Do your dairy products have artificial growth hormones added?

[Alison's Mom]

Thanks Jamie - yes I'll check out the magic site more later.

JaneS - very interesting stuff - thank you!

No dairy for us as DS is allergic, although DD could have some of the WAPF stuff I guess. We do have a lot of soy (due to dairy allergy) which does have vit D added to it just like regular milk does.

What's the best way to get Vit D in a northern climate? What do you do in the summer - do you use sunscreen or expose them without sunscreen in the morning and evening?

Which CLO do you use, and how to you get your DS to take it? There was talk on the Vancouver thread on CLO and I'll look back to see what type people were using, but was it Blue Ice or something like that?

It would be hard for us to avoid soy completely, as the kids have multiple food allergies between them - anaphylactic risk for peanuts/tree nuts, plus allergies to egg and dairy, so if we cut out all soy (we currently use soy milk, plus eat a reasonable amount of tofu), we'd be hard pressed to find meat alternatives. I guess there is rice milk, although the last time I tried, they didn't like the taste, and I couldn't say I really blamed them

I like the bone broth idea - I could definitely do that. Just get organic marrow bones and boil to make soup?

Thanks - I had thought fleetingly about a Vit deficiency, but thought the blood test done by the ped would have picked up on that.

[Siennaflower]

I am having dd tested soon. She just turned 7 and is 43", which is an inch below the 3rd percentile. She eats great and sleeps well, she's just short. I'm 5'2" myself, but I was actually taller than my peers until puberty. And dh is 6'1". I'm also having her tested for Celiacs and thyroid issues. I feel bad for her because she's being teased about her size at school

[out#edbyJs]

My dd will be 7 in a month and is also 43".
Last June at her yearly check-up we did a bone age scan and found out that her bones were that of 3 year old.
So we were referred to an endo and had an appointment in Nov. He found that she took after my dh (5'4") and myself (5'7" and a very late bloomer) and that those two things together were causing her to be so small at this age.
He assured us that because of her delayed bone age she would grow longer than other kids and eventually catch up. But we shouldn't expect anything much over 5'.

He ran some blood tests just to verify what he said and we found out that her thyroid levels are abnormal and suggest possible hypothyroidism. Unfortunately her numbers are so close to borderline he is unsure whether or not to treat her for it. We are still waiting to hear back from him as to our next move.

I would suggest doing a bone age x-ray first, it's the simplest way to see if what is going on, on the inside matches the outside.

[chlobo]

Once again joining a club no one wants to join.

But thanks for the information ladies. Hoping it can help my small fry.

[JaneS]

Originally Posted by Alison's Mom

Thanks Jamie - yes I'll check out the magic site more later.

JaneS - very interesting stuff - thank you!

No dairy for us as DS is allergic, although DD could have some of the WAPF stuff I guess. We do have a lot of soy (due to dairy allergy) which does have vit D added to it just like regular milk does.

What's the best way to get Vit D in a northern climate? What do you do in the summer - do you use sunscreen or expose them without sunscreen in the morning and evening?

Which CLO do you use, and how to you get your DS to take it? There was talk on the Vancouver thread on CLO and I'll look back to see what type people were using, but was it Blue Ice or something like that?

It would be hard for us to avoid soy completely, as the kids have multiple food allergies between them - anaphylactic risk for peanuts/tree nuts, plus allergies to egg and dairy, so if we cut out all soy (we currently use soy milk, plus eat a reasonable amount of tofu), we'd be hard pressed to find meat alternatives. I guess there is rice milk, although the last time I tried, they didn't like the taste, and I couldn't say I really blamed them

I like the bone broth idea - I could definitely do that. Just get organic marrow bones and boil to make soup?

Thanks - I had thought fleetingly about a Vit deficiency, but thought the blood test done by the ped would have picked up on that.

We do cod liver oil from Radiant Life b/c it doesn't have any flavors or rosemary extract but Blue Ice is the other recommended brand as well. DS has been taking CLO since he was 8 mos old so he just slurps it easily but maybe you could try putting in a shot of orange juice or getting a flavored one. There are also Blue Ice Gummies for kids but see recs for amounts, you might have to do several of them.

Although personally in your situation I would be following the Weston Price protocol of 1/4-1/2 tsp. of high vitamin cod liver oil and a form of K2 three times per day (depending on type whether it is short acting MK-4 or long acting MK-7) with every meal to correct mineral deficiencies.

And we also do extra vitamin D capsules either from Carlson's, NOW or Vital Choice. I use sunscreen only if we are going to spend the day at the beach, not if we are outside on a day to day basis. And both DS and I tested low in the beginning of the fall. Most people need to supplement. The amount in regular milk is paltry. If you are in Canada and not giving supplements way over the standard rec daily amount (which is ridiculous according to vitamin D researchers), you are deficient.

The type of vitamin D added to soy milk is D2 which is not utilized in the body as well as the natural form D3 from cod liver oil or lanolin pills. D2 also has harmful side effects. The amount is also ridculously low. I would check any tests done against the advice of the Vitamin D Council on testing. It also depends on when you get the test done. Vitamin D is used up very quickly when there is no sun.

I sincerely recommend reading this Mothering article about soy and switching to rice milk (not a good source of nutrients tho) and coconut milk and frequent bone broths for minerals:

Whole Soy Story: The Dark Side of America's Favorite Health Food
http://www.mothering.com/food/whole-soy-story

See article on 24 hr. bone broths:
www.westonaprice.org/Broth-is-Beautiful.html

I would treat bone broths like milk and make it a staple of your diet several times a day. Chicken is certainly the most versatile. Use it to make grains, stew, soups, potatoes, chilis, etc. Healthy diets do not have to include milk, but healthy traditional diets which were dairy free always included bone broth several times a day like the Japanese their miso soup broths for example.

I think based on the diet you told me, your kids are indeed deficient in minerals b/c they are not consuming enough minerals in fortified imitation milk products and its also coming in products like soy with anti nutrients which inhibit mineral absorption.

Standard blood testing is not effective to determine deficiencies, as the blood will keep its standard ranges at all costs... meaning if it will take minerals from the bones and teeth to keep the levels consistent to prevent seizures. It frustrates me to no end that mainstream doctors do not know this!

It is much much harder with allergy kids. I know b/c we were dairy and egg free for a while too, and DS has nut and seed and wheat allergies. But those are the kids that need the fat soluble vitamins the most. If I were you, I would get into other natural sources of vitamin K2 in your situation and pronto. Fish eggs like salmon roe are the best source of K2 but I know hard for kids to take! My DS loves salmon roe with cream cheese on mini pancakes but he is weird.

There are K2 pills from Jarrow made from natto I think? It is a fermented soy in small amounts, so natto is okay. There is also a Thorne K2 product that are drops which is likely allergy free. Unlike butter oil , these might not be dosed 3x day.

Vitamins A and D without K2 as well are at best not effective, and at worst, dangerous to the body.

While vitamins A and D contribute to growth by stimulating growth factors and promoting the absorption of minerals, vitamin K2 makes its own essential contribution to growth by preventing the premature calcification of the cartilaginous growth zones of bones.38

Vitamin K2 may also be required for the safety of vitamin D. The anorexia, lethargy, growth retardation, bone resorption, and soft tissue calcification that animals fed toxic doses of vitamin D exhibit bear a striking resemblance to the symptoms of deficiencies in vitamin K or vitamin K-dependent proteins.
http://www.westonaprice.org/On-the-T...ly-Solved.html

[JaneS]

And just to be clear, once you start reading about Weston Price's findings, you will better understand where I'm coming from. Standard medical and dietary advice ignores the fact that without sufficient amounts of the fat soluble vitamin trio of vitamin A, D and K, any minerals in your diet simply will not get to where they are supposed to go: the bones.

And also retinyl palmitate chemical form of vitamin A is useless at best and toxic at worst. Beta carotene in carrots, sweet potatoes, etc, is not converted 1:1 to vitamin A, retinol. So a carrot, if you are converting optimally, which people with damaged guts, older people AND children will not even give an adult 1/5th of the standard 5000 IU RDA of vitamin A. Which is about 4x less than was in traditional healthy diets too, so again, a paltry low number and typical modern diets don't even meet that.

And that concludes my fat soluble vitamin soapbox for the day!

[JaneS]

Originally Posted by out#edbyJs

Unfortunately her numbers are so close to borderline he is unsure whether or not to treat her for it.

what are they using for normal values b/c TSH normal values have changed in recent years.

[JaneS]

Originally Posted by Alison's Mom

What's the best way to get Vit D in a northern climate? What do you do in the summer - do you use sunscreen or expose them without sunscreen in the morning and evening?

I can't resist, one more thing... no you need in the middle of the day to make D especially so far from equator. Otherwise the sun's rays are not at right angle to even make any D, and only a few months out of the year when sun is close to you as I said before. Probably only 4 months in summer for you. There is a calculator online to show this that vitamin D researchers have come up with but I have to run so I cannot search around for it forgive me...

[tanyalynn]

If you're going to do bloodwork, I'd ask about zinc. I think you need RBC zinc, some measures of zinc, like using whole blood, aren't a good measure, they tend to be actively controlled (so you need to be severely deficient to see a dip). Zinc deficiency commonly causes low growth--not that most kids who are short/small have low zinc, but in areas with very low zinc intake, short stature is a common result and when zinc is supplemented, growth increases.

[chlobo]

This is all great advice. Do you have any thoughts on what to do about a toddler (2.5) who doesn't eat a lot? I mean a miniscule amount. Won't drink bone broth. Has stopped "slurping clo from the spoon". We tried the radiant life gummies (did the fclo ones) and they were soundly rejected. I can't even get him to take probiotics now, which he also used to eat off the spoon.

The only thing I'm able to get him to take is a sublingual b & his cell salts.

Originally Posted by JaneS

We do cod liver oil from Radiant Life b/c it doesn't have any flavors or rosemary extract but Blue Ice is the other recommended brand as well. DS has been taking CLO since he was 8 mos old so he just slurps it easily but maybe you could try putting in a shot of orange juice or getting a flavored one. There are also Blue Ice Gummies for kids but see recs for amounts, you might have to do several of them.

Although personally in your situation I would be following the Weston Price protocol of 1/4-1/2 tsp. of high vitamin cod liver oil and a form of K2 three times per day (depending on type whether it is short acting MK-4 or long acting MK-7) with every meal to correct mineral deficiencies.

And we also do extra vitamin D capsules either from Carlson's, NOW or Vital Choice. I use sunscreen only if we are going to spend the day at the beach, not if we are outside on a day to day basis. And both DS and I tested low in the beginning of the fall. Most people need to supplement. The amount in regular milk is paltry. If you are in Canada and not giving supplements way over the standard rec daily amount (which is ridiculous according to vitamin D researchers), you are deficient.

The type of vitamin D added to soy milk is D2 which is not utilized in the body as well as the natural form D3 from cod liver oil or lanolin pills. D2 also has harmful side effects. The amount is also ridculously low. I would check any tests done against the advice of the Vitamin D Council on testing. It also depends on when you get the test done. Vitamin D is used up very quickly when there is no sun.

I sincerely recommend reading this Mothering article about soy and switching to rice milk (not a good source of nutrients tho) and coconut milk and frequent bone broths for minerals:

Whole Soy Story: The Dark Side of America's Favorite Health Food
http://www.mothering.com/food/whole-soy-story

See article on 24 hr. bone broths:
www.westonaprice.org/Broth-is-Beautiful.html

I would treat bone broths like milk and make it a staple of your diet several times a day. Chicken is certainly the most versatile. Use it to make grains, stew, soups, potatoes, chilis, etc. Healthy diets do not have to include milk, but healthy traditional diets which were dairy free always included bone broth several times a day like the Japanese their miso soup broths for example.

I think based on the diet you told me, your kids are indeed deficient in minerals b/c they are not consuming enough minerals in fortified imitation milk products and its also coming in products like soy with anti nutrients which inhibit mineral absorption.

Standard blood testing is not effective to determine deficiencies, as the blood will keep its standard ranges at all costs... meaning if it will take minerals from the bones and teeth to keep the levels consistent to prevent seizures. It frustrates me to no end that mainstream doctors do not know this!

It is much much harder with allergy kids. I know b/c we were dairy and egg free for a while too, and DS has nut and seed and wheat allergies. But those are the kids that need the fat soluble vitamins the most. If I were you, I would get into other natural sources of vitamin K2 in your situation and pronto. Fish eggs like salmon roe are the best source of K2 but I know hard for kids to take! My DS loves salmon roe with cream cheese on mini pancakes but he is weird.

There are K2 pills from Jarrow made from natto I think? It is a fermented soy in small amounts, so natto is okay. There is also a Thorne K2 product that are drops which is likely allergy free. Unlike butter oil , these might not be dosed 3x day.

Vitamins A and D without K2 as well are at best not effective, and at worst, dangerous to the body.

[chlobo]

Originally Posted by JaneS

And just to be clear, once you start reading about Weston Price's findings, you will better understand where I'm coming from. Standard medical and dietary advice ignores the fact that without sufficient amounts of the fat soluble vitamin trio of vitamin A, D and K, any minerals in your diet simply will not get to where they are supposed to go: the bones.

And also retinyl palmitate chemical form of vitamin A is useless at best and toxic at worst. Beta carotene in carrots, sweet potatoes, etc, is not converted 1:1 to vitamin A, retinol. So a carrot, if you are converting optimally, which people with damaged guts, older people AND children will not even give an adult 1/5th of the standard 5000 IU RDA of vitamin A. Which is about 4x less than was in traditional healthy diets too, so again, a paltry low number and typical modern diets don't even meet that.

And that concludes my fat soluble vitamin soapbox for the day!

Just to followup on this, so you are saying that unless you are supplementig k2 you shouldn't be supplementing A & D b/c they are all co-factors?

[out#edbyJs]

Originally Posted by JaneS

what are they using for normal values b/c TSH normal values have changed in recent years.

The lab has the limit for tsh at 4.3

Her numbers:
In Nov. 4.8
In Jan. 3.8
In Feb. 4.5

I told the doc I was aware of the suggested lowered rate and I was wondering his thoughts on it. He said it was responsible to take that into account but that those numbers are based on adults and the only way to tell if it would help her is to do a 6 month trial of the meds to see if her growth improved.

[chlobo]

Originally Posted by JaneS

And just to be clear, once you start reading about Weston Price's findings, you will better understand where I'm coming from. Standard medical and dietary advice ignores the fact that without sufficient amounts of the fat soluble vitamin trio of vitamin A, D and K, any minerals in your diet simply will not get to where they are supposed to go: the bones.

And also retinyl palmitate chemical form of vitamin A is useless at best and toxic at worst. Beta carotene in carrots, sweet potatoes, etc, is not converted 1:1 to vitamin A, retinol. So a carrot, if you are converting optimally, which people with damaged guts, older people AND children will not even give an adult 1/5th of the standard 5000 IU RDA of vitamin A. Which is about 4x less than was in traditional healthy diets too, so again, a paltry low number and typical modern diets don't even meet that.

And that concludes my fat soluble vitamin soapbox for the day!

So is there an A supplement that is good to use other than high vitamin clo?