Should Children Take a Growth Hormone?

The use of growth hormone (GH) therapy in children has been a topic of intense debate in recent years. With the advancement of medical technology and the increasing pressure on children to conform to societal standards of height and appearance, more and more parents are considering the option of GH therapy for their children. However, this decision is not without its ethical and medical implications. This paper aims to explore the complexities surrounding the question: should children take a growth hormone?

Medical Implications

Growth hormone therapy involves the administration of synthetic human growth hormone (somatotropin) to stimulate linear growth in children with growth disorders. These disorders may include growth hormone deficiency, Turner syndrome, Prader-Willi syndrome, chronic kidney disease, and small for gestational age (SGA) infants. According to the Hormone Health Network, “GH therapy can be safe and effective when used as directed by a knowledgeable medical professional.”

However, it is essential to consider the potential risks and side effects associated with GH therapy. Some of these risks include:

Injection Site Reactions:

One of the most common side effects of GH therapy is injection site reactions. These reactions may include redness, pain, or swelling at the site of injection. While these symptoms are usually mild and temporary, they can cause discomfort and distress to the patient. Proper administration technique, rotation of injection sites, and use of appropriate needles can help reduce the risk and severity of injection site reactions.

Fluid Retention:

Another potential risk of GH therapy is fluid retention, which can lead to weight gain, joint pain, and carpal tunnel syndrome. Fluid retention occurs when the body holds onto excess fluid, leading to swelling in various parts of the body. This side effect can be uncomfortable and affect the patient’s quality of life. It is essential to monitor fluid retention regularly and adjust the GH dosage accordingly to minimize this risk.

Increased Risk of Diabetes and Insulin Resistance:

GH therapy has been associated with an increased risk of diabetes and insulin resistance. GH therapy can affect the body’s insulin sensitivity, leading to high blood sugar levels. Patients with a family history of diabetes or other risk factors for diabetes should be monitored closely for signs of developing diabetes or insulin resistance. Adjusting the GH dosage and implementing lifestyle changes, such as a healthy diet and regular exercise, can help reduce this risk.

Scoliosis:

Scoliosis, or abnormal curvature of the spine, is a potential risk of GH therapy. While scoliosis is not a common side effect, it can occur in some patients, particularly those with preexisting spinal abnormalities. Regular monitoring of the patient’s spine is essential to detect any signs of scoliosis early and take appropriate measures to prevent its progression.

Slipped Capital Femoral Epiphysis:

Slipped capital femoral epiphysis (SCFE) is a hip disorder that can lead to arthritis. It is a potential risk of GH therapy, particularly in children and adolescents. SCFE occurs when the growth plate at the top of the femur slips, leading to hip pain and decreased range of motion. Regular monitoring of the patient’s hip joint is essential to detect any signs of SCFE early and take appropriate measures to prevent its progression.

Intracranial Hypertension:

Intracranial hypertension, or elevated pressure within the skull, is a potential risk of GH therapy. This side effect can cause headaches, vision changes, and other neurological symptoms. Regular monitoring of the patient’s intracranial pressure is essential to detect any signs of intracranial hypertension early and take appropriate measures to prevent its progression.

Progression of Preexisting Scars:

GH therapy can affect the body’s wound healing process, leading to the progression of preexisting scars. Patients with a history of significant scars or wounds should be monitored closely for any signs of scar progression. Adjusting the GH dosage and implementing appropriate wound care measures can help reduce this risk.

Additionally, long-term effects of GH therapy are not yet fully understood, and further research is needed to better establish the safety and efficacy of this treatment over an extended period (National Institute of Diabetes and Digestive and Kidney Diseases).

Ethical Implications

The decision to administer growth hormone therapy to a child goes beyond medical concerns and delves into the realm of ethics. Some of the ethical issues surrounding GH therapy include:

1. The pressure to conform to societal norms: The desire for children to be taller and more physically attractive has led to the increased demand for GH therapy. This pressure can lead to harmful psychological consequences, such as low self-esteem and poor body image, and may inadvertently place the blame on the child for not meeting these unrealistic expectations.
2. Parental autonomy versus the child’s best interests: While parents have the right to make decisions regarding their child’s medical treatment, they must also consider whether GH therapy aligns with their child’s best interests. In some cases, parents may prioritize their own desires for their child’s appearance over the child’s overall well-being and happiness.
3. The commodification of growth hormone: The growing market for GH therapy has resulted in the treatment becoming a commodity. This commodification can lead to the exploitation of vulnerable families who may feel pressured into purchasing GH therapy for their children due to societal or personal pressures.
4. Distributive justice: The high cost of GH therapy raises concerns about distributive justice. Access to this treatment may be limited to those who can afford it, exacerbating health disparities and creating an unequal distribution of resources (National Center for Biotechnology Information).
5. Slippery slope argument: The use of GH therapy for growth disorders raises questions about its potential use for non-medical purposes, such as enhancing athletic performance or cosmetic reasons. This could lead to a slippery slope in which the line between therapeutic and enhancement uses of GH therapy becomes increasingly blurred.

Conclusion

The question of whether children should take a growth hormone is a complex one, fraught with both medical and ethical implications. While GH therapy can be a safe and effective treatment for children with growth disorders, it is essential to consider the potential risks and side effects associated with this treatment. Furthermore, the decision to administer GH therapy should involve a comprehensive evaluation of the child’s best interests and a discussion of the ethical implications surrounding this treatment.

Ultimately, the decision to pursue GH therapy should be made with careful consideration, thoughtful deliberation, and the input of a multidisciplinary team of healthcare professionals. By taking a balanced and informed approach, parents and healthcare providers can ensure that the best interests of the child are at the forefront of this important decision.

References

1. Hormone Health Network. (n.d.). Growth hormone therapy in children. Retrieved from https://www.hormone.org/diseases-and-conditions/growth-hormone-disorders/related-conditions/growth-hormone-therapy-in-children
2. National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Growth hormone therapy. Retrieved from https://www.niddk.nih.gov/health-information/endocrine-diseases/growth-hormone-therapy
3. National Center for Biotechnology Information. (2020). Ethical issues raised by the use of growth hormone. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK221585/
4. Veale, D., &