Sam Nicholson was a small child. His mother, Erica, did not find this surprising. Erica is only about five feet tall. She weighs about 100 pounds. She describes all of her children as small. It’s just seems to be natural for her babies to be born that way. Sam is now two years into a growth hormone treatment. He’s grown significantly. Questions remain, however, about the risks of this form of treatment. Keep reading to learn more, or follow the original story here for further information.
A Series of Diagnoses
Initially, a pediatric endocrinologist diagnosed Sam with celiac disease. This autoimmune condition inhibits the absorption of nutrients by the body. After switching to a gluten-free diet, Sam grew an inch in one month. Despite this improvement, doctors noted his growth rate was slow. They predicted he would grow to be about 4’7” as an adult.
Erica and her son began a quest for answers. Through this process they encountered a variety of frightening possibilities. Tests eventually rules out conditions such as Russell-Silver syndrome, dwarfism, and growth hormone deficiency. The final diagnosis doctors agreed upon was idiopathic short stature (ISS). In other words, no reason has been discovered for Sam’s lack of growth.
What Goes Up
Laurie Cohen is the clinical chief of endocrinology at Boston Children’s Hospital. As a specialist, Cohen points out that short stature on its own is not a disease. When children chart further and further outside the standard norms, however, Cohen says it could be a sign of another underlying problem.
There is also some suspicion that parents of short male children are more likely to consider treatment than parents of short female children. Socially, it is common for shorter women to be accepted. Often times, short stature in girls and women is considered cute. Short boys and men, however, appear to face disadvantages and ridicule. Some parents, as was the case with Erica Nicholson, simply worry that some unknown danger may be around the corner for their child.
Use of growth hormone in cases of ISS is often debated. Concern exists that it could result in dangerous risks for a child who’s only medical condition is lower than average stature.
Growth Hormone
One complication, specifically for insurers, is the difficulty in determining which children are living with disease and determining the urgency of growth hormone versus other medical expenses.
One study conducted in France connected the use of growth hormone to a greater risk of death. The US FDA determined this study to be inconclusive. Specialists, however, still believe parents should know about the uncertainties associated with growth hormone.
Short term risks of growth hormone are better understood. Intracranial hypertension, worsening scoliosis, and diabetes are all potential risks. Its the potential long term side effects which are not yet fully understood. Despite this, Erica believes it is worth it for her son. Since treatment, Sam began to look more like other kids his age. His muscle strength improved enough that he could ride a bike.
