Growth Hormone Deficiency & Multiple Pituitary Hormone Deficiency
What are GHD & MPHD
Growth Hormone Deficiency (GHD) is a condition caused by a severe shortage of growth hormone, sometimes even a complete absence of growth hormone. It affects between 1 in 3,000 and 1 in 10,000 people and the lack of the growth hormone will restrict the child’s growth resulting in a much lower than average height.
Multiple Pituitary Hormone Deficiency (MPHD) is a condition caused by a shortage of several hormones produced by the pituitary gland. It has similar characteristics to GHD but has additional complications caused by the absence of other hormones including:
- Thyroid-simulating hormone (TSH) and cortisol, the hormone associated with the body’s fright and flight response.
- The gonadotrophins – follicle stimulating hormone (FSH) and lutenising hormone (LH)
- Adrenal-stimulating hormone (ACTH) is much less frequently involved, but the deficiency of this hormone is extremely important to detect.
If they pituitary gland is failing to produce sufficient qunatities of all the hormones it produces the condition is known as Panhypopituitarism.
Why does it occur?
The exact reason for most occurances of GHD/MPHD is not known, therefore they are known as an idiopathic conditions. It is not inherited and can either be present at birth or develop later in childhood.
The pituitary gland is located in the base of the brain and is responsible for producing various hormones including the one for growth. It may not have developed properly during birth which could explain the low hormone levels being produced, or it may have been affected after birth through head injury, tumours or some treatments for other conditions such as radiotherpay and surgery.
How is GHD/MPHD diagnosed?
The diagnosis is confirmed by measuring the level of growth hormone production in response to a stimulation test, which generally requires a morning in hospital.
MPHD can also be diagnosed through a blood test to check various hormone levels and it can be identified through MRI scan to check any damage to the pituitary gland.
Signs & Symptoms
GHD does not affect intrauterine growth, at least not to an extent measurable by birth weight or length, but usually from around the age of two or occasionally from birth, growth is slower than normal.
A child with GHD will have short stature and look young for their age, however the body will be in proportion and they will have normal facial features and intelligence. However, prior to treatment children with GHD may be overweight as the growth hormone also controls the level of fat under the skin.
The symptoms of MHD include the short stature associated with the reduction in growth hormone, hypothyroidism which can produce lethargy and weight gain. The Cortisol deficiency can increase the susceptibility to infections and cause a delay to, and even absence of, puberty.
Treatment & Support
GHD is treated with a daily injection of growth hormone that replaces the hormone the body is failing to produce. During treatment it is important that height is monitored regularly and sometimes a bone scan and brain scan might be done. There are usually no side-effects but it is important to report any should they occur. For most children this treatment will result in the child reaching expected height.
MPHD is treated through replacing the elements the body is failing to produce. This can mean a combination regular injections of growth hormone, thyroxine (to replace the absent thyroid-stimulating hormone) and cortisone to replace the absence of adrenal-stimulating hormone). And if gonadotrophin deficiency becomes apparent at the time of puberty (which is usually late in growth hormone deficient children), then sex hormones have to be given to initiate sexual maturation.
Please consider calling our helpline for support and advice, we can also help put you in touch with other families with the same condition. We also have members of our Facebook Group who may be able to help you.
We hope to add personal experiences and stories from people affected by GHD/MPHD soon.
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