Height | Treating Short Stature Before Puberty: Restoring Normal Height

Beyond giving their children a head start, parents are more concerned about whether their children can "grow taller and faster." If their child is slightly shorter than their peers, worries emerge. But what if it's a case of "short stature"? Fortunately, timely identification of the underlying causes of short stature allows many patients to restore their normal height through appropriate treatment.

According to Dr. Tsui Tsz Kwan, a pediatrician, assessing a child's growth involves a key objective indicator known as the "Growth Chart." This chart encompasses gender-specific percentile curves for age, weight, and height. Generally, when a baby's growth indicators fall between the 3rd and 97th percentiles, it is considered within the normal range. However, if a child's height falls below the 3rd percentile on the growth chart, it may indicate short stature, also known as "stunted growth."


Pathological vs Non-pathological

The causes of short stature are diverse and can be categorized as either pathological or non-pathological. Dr. Tsui Tsz Kwan further explains that non-pathological causes include genetic factors, delayed individual maturation, delayed development, and idiopathic short stature. Pathological causes encompass low birth weight, malnutrition, chronic illnesses such as chronic kidney disease, genetic or chromosomal variations, endocrine disorders like hypothyroidism and growth hormone deficiency. Lionel Messi, the triumphant hero who led Argentina to World Cup glory, has also battled with a condition called growth hormone deficiency.

Unraveling the Underlying Causes

When diagnosing short stature, doctors conduct preliminary examinations to understand the child's medical history and family background. Additional tests such as blood work, X-rays, and even brain imaging may be arranged to determine the underlying causes behind their short stature. Dr. Tsui Tsz Kwan suggests that if the cause is related to poor lifestyle habits or nutritional deficiencies, addressing these issues through balanced diet, sufficient rest, and moderate exercise may be sufficient. If medication is the culprit, adjusting the relevant drugs may be necessary. In cases of hypothyroidism, supplementing with thyroid hormones can restore normal growth. As for individuals with growth hormone deficiency, receiving growth hormone injections generally leads to noticeable height improvement.

The Role of Growth Hormone in Height Development

The human body produces its own growth hormone, secreted by the anterior pituitary gland. It travels through the bloodstream to the liver and various organs, including bone and muscle cells, stimulating growth. Growth hormone also plays a role in regulating sugar and fat metabolism. When it comes to growth hormone medication, it has been approved by the U.S. Food and Drug Administration for treating growth hormone deficiency, Turner syndrome, Prader-Willi syndrome, SHOX gene deletion, chronic kidney failure, idiopathic short stature, and children who are "small for gestational age." Dr. Tsui Tsz Kwan also notes, "Starting growth hormone therapy early yields the best results, ideally before puberty, and it is generally administered until the growth plates close, which marks the end of puberty. However, a small percentage of children may experience side effects such as headaches, joint pain, swelling, and high blood sugar.

Monitoring Growth Progress

Dr. Tsui Tsz Kwan shares a recent case involving a 15-year-old boy who measured 157 centimeters in height, falling between the 3rd and 10th percentile on the growth chart. While he did not meet the criteria for short stature, he still fell short of his family's median genetic height of 166 centimeters. Upon reviewing his records, it was discovered that he was born small for gestational age. The boy and his parents hoped to undergo growth hormone therapy, but his growth plates were nearing closure, making the treatment less effective. They had to abandon the idea. Dr. Tsui Tsz Kwan advises, "Parents should regularly measure their child's height every 4 to 6 months. Children between the ages of 4 and 10, before puberty, typically grow 4 to 6 centimeters per year. If parents notice any height issues or if their child is significantly shorter than peers, seeking medical advice early is crucial to avoid missing the golden treatment opportunity.