Puberty blockers to allow growth hormones to work?

[Norabuzz]

Hello. Has anyone used (/considered using) puberty blockers to delay puberty in order give time for growth hormones to work? Our son (11) has growth hormone deficiency (moderate to severe). He has just started on GH injections to hopefully increase his growth rate. He's below the 5th percentile in height. While puberty hormones will help our son to grow, they also act to close the growth plates, limiting the time he has to allow the GH to work. Doctor suggested we could consider delaying puberty for 1-2 years to give our son a little more time.

It's such a big decision. My biggest worry is any possible impacts on future fertility. Would be grateful to hear from anyone who has gone down this path or looked into it.

Thanks

We're moving this thread to our Chat topic at the OP's request.

Bumping this along. Please let me know if you've been through this!

Sorry Nora, I don't have any experience or advice but I'm interested in your post because I have a very small 6 year old ds and I've never been sure at what point I should have him looked at by a doctor. I also don't want to make him paranoid about his height (any more paranoid than he already is because people frequently tell him how tiny he is 🙄). If you don't mind me asking, when did explorations first begin with your ds?

Has his bone age been measured? It might be that his growth plates are nowhere near shutting off. What does the endocrinologist say about future fertility?

Nora, are you a member of the FB group for families of children with growth issues? Can’t remember off the top of my head what it’s called but if you’re not, I’ll find out and repost. I found the group very helpful a few years ago when ds was being evaluated.

Rogue the key metric is growth trajectory - is there an expected level of growth each six months / year. If your ds is following a height centile line then his trajectory is likely to be ok.

TheRogue, we didn't start until now unfortunately. Our paediatrician was tracking his height and weight and noticed a real slowdown. There was a year he didn't grow at all. I would really suggest you checking it out with the doctor if you're concerned. This is definitely one of those the sooner the better things.

Titchy, thanks. Yes growth plates have been measured. Endocrinologist confirms he has started puberty and has about 3-4 years of growing left.

Pseud, no I'm not on any FB group. If you could let me know the name, I'd be so grateful, thank you!

Thanks Nora. I suppose my issue is that I haven't tracked his growth so don't know if it when it has slowed down. He was a "normal" sized baby and followed the 25th percentile during baby years. I just measured him recently and according to the charts it looks like he's fallen off them completely. Anyway, I won't hijack your thread. I'll make some enquiries with our doctor.

Please do TheRogue and best of luck. Really wish we had spotted our son's deficiency much earlier!

Thanks Nora. Best of luck to you, too. Hopefully Pseud will come back with the details of that FB group for you.

For what reason? Is it a health thing or you just don’t want a short song

Hi kneecapper. It's a health reason, he has a hormone deficiency.

how does/will the hormone deficiency affect him?

I’m sure your concern about fertility is a common one to your endocrinologist. Just ask him to call you to discuss the side effects of the treatment plan.
What are the effects of his current hormonal insufficiencies to his fertility?

I think the group is called the child growth foundation. Its a great group with lots of families who will be able to help you with knowledge and experience.

What is his projected height with and without treatment?

Thanks Turanga, yes have found my way to that group.

Thanks fallfallfall. Yes we have an appointment in a month. Just keen to hear others' experiences in the meantime. We have since sought a second opinion and that endo didn't think we had anything to worry about fertility wise and recommended we proceed with the puberty blockers. His potential genetic height is 179cms but he won't reach that without the GH. Absolute best case he will reach 170cms with the GH.

inchplant he has a growth hormone deficiency. The impact is on his height - he won't reach his expected height without the growth hormones.

@Norabuzz

inchplant he has a growth hormone deficiency. The impact is on his height - he won't reach his expected height without the growth hormones.

So it is just about not wanting him to be short?

@Norabuzz sorry I didn’t return sooner, glad you’ve found the FB group, the Child Growth Foundation was the one I meant. They have a website too, I actually had a phone call with one of the people who set it up who was brilliant at helping me put together a plan of action when I felt ignored by my GP. Good luck with it all.

Thanks Pseud, much appreciated

So it is just about not wanting him to be short?
The OP said best case is 170cm with GH. 170cm is still short for a man. This is something that could affect him his whole life so I don't think the OP is unreasonable at all.

My ds has growth hormone deficiency and was on GH injections for a while. At one point I was told he may have to have a puberty boost if he didn’t start ‘changing’ by 15. He is 18 now and has probably reached his full height which is about 5’6” so yes small for a man, but he doesn’t seem to concerned about it.

Oh just seen that 170 is 5’6