Delayed puberty in 14yo DS

[OneLittleHopper]

DS will be 15 in a couple of months - he has basically stopped growing over the last year and still no signs of puberty. Bloods came back showing low iron and v low testosterone but otherwise he is healthy. Coeliac test was negative. He has been on iron supplements so hoping that will help a bit.

We saw a paediatric consultant this week who said we can either keep on waiting for puberty to start naturally, or that ds can have a 3 month course of testosterone injections to kickstart things. He will be reassessed in a few months. Sounds like we basically have around a year before the puberty ‘window’ closes.

DS is obviously anxious and upset about everything and has point blank refused to consider the injections. I think this is primarily because he doesn’t want to have an injection. Obviously it’s his decision and I don’t want to pressure him but I’m not sure we should wait much longer. I’m worried we are just running out of time and that he will regret it when he goes into year 10 and he’s obviously much smaller than all his friends. Has anyone been in a similar situation and what did you decide to do?

@Iamfree I've had a look at some facebook pages, but they seem very USA focussed. Is there one you would recommend for UK?

»growth hormone treatment in children in UK ». But also join the US ones. The protocols are the same

The protocols are not the same. In the UK the standard protocol is that boys are given testosterone. In the US they are given HCG most often, which is a better treatment. If you're in London I can recommend an NHS endocrinologist who does prescribe HCG.

@BlackSwani know for a fact that prof Dattani, Dr albanese and Helen Spoudeas (all paediatric endos) prescribe growth hormone. Testosterone is only for constitutional delay of growth and puberty. There are regular stim tests for GH deficiency done at guy’s, kings, and great ormond street. As I said this is first hand experience and I have seen those three endos personally

To clarify I'm talking about delayed puberty as the original post is about delayed puberty. My son saw Dr Spoudeas for years when she was still practicing in the NHS and she prescribed him GH at GOSH. When it came time for puberty - the endos there wanted to prescribe testosterone. With some research we found that the endos at Barts will prescribe HCG instead of testosterone: this has the advantage of stimulating the testes (which testosterone will not do) and he was then able to bank sperm.

@BlackSwanthanks so much for clarifying and indeed OP mentioned “delayed puberty” but also short stature. As I said I have personal experience too going from a non growing 5’ boy to a 6’2’ (MPH was 5’10). So GH is magic but many people are not aware and GPs tend to fob off and have no sense of urgency. Thats why OP needs to be super quick and advocate for her son

Agree 100% - if the growth plates close it's too late. Fantastic result for your son. When was his final growth achieved? My son will soon be 16, I'm not sure how much more height we will get - but he's done super well on it.

@Chesticles I am glad you have an appointment now.

My DS has delayed puberty. I initially took him for an appointment at age 15 as I was concerned. My DH said ‘he’ll catch up’ 🙄 and thought I was worrying too much. However the fact that the GP and then the endocrinology team at the hospital took it seriously showed that it was worth investigating.

It’s not just about testosterone, they also checked his pituitary gland / growth hormones, x-ray of his hand, testicle measurements, urine - they were extremely thorough. There can be underlying conditions that can cause delayed puberty that need to be ruled out.

In DSs case puberty has thankfully started naturally so he does not need hormones, and he is beginning to have a growth spurt at last, but the tests have identified a medical condition (not serious but significant) that is likely to have caused his delayed development. I am glad we have some answers and the hospital has been fantastic.

Child was 5’ at 13 (step child), 5’ at 14 - 0 growth. Then GH started at 14, was 5’6 at 15, 5’10 at 16 when we thought he would stop growing. Now 18 and 6’2 and might not even be fully done but GH stopped at 17.5. Hand xray age is still 16.7 so he might end up growing even more. he’s super happy about it and I pushed and pushed the doctors and endo so thankfully it got done, not easy as we know

That's terrific. My son is just shy of 16, I hope we will see some more growth - but he's done really well on GH (since the age of 4).

@BlackSwanhow tall is he now and what’s MPH?

He's 177cm and the MPH is 178.5. I don't remember what his last bone age scan was.

@BlackSwanso 5’10 exactly as my same was at 16! Already a great height although my ss prefers to be 6’2 of course! Best of luck and I so wish we had more switches on GPs in this country. The “he’s a late bloomer” refrain drives me mad!

Please think long and hard before considering testosterone.

It’s very nuanced, but there’s a real risk of it affecting height potential due to closing bone plates and it may cause fertility issues in adulthood.

DS's appt wait is 15 weeks. . I'm so stressed and worried about him now. I am kicking myself for not taking him to the doctors earlier. And this appt is just with a paediatrician not even an paediatric encrinologist. He'll almost be 16 by then, it may be too late for intervention by that point. Hes not even 5 feet.

Do you have the means to take him to an endocrinologist privately? Private health insurance or paying out of pocket?

@chesticlesyou must find the money to take him to see a paediatric endo privately - time is really not on your side. Firstly go to a place like oryon and get a left hand and wrist xray. Also do some basic blood tests (randox or if you’re in London medical Diagnosys in Victoria/north London is happy to do under 18). So usual full blood count, thyroid including antibodies, all hormones (testosterone, igf1, prolactin, etc), celiac, vitamin D, iron studies

then make an appointment today with a paediatric endo (where are you ? We can give some names). Sorry but cancel Christmas or whatever but you MUST do this. When my step son needed I had even found a place in Turkey selling growth hormone and I would have gone and bought it there (they ship to the UK loads but I planned to go in person). Any questions, just ask and we will help you

@Chesticles do you have an update? Hoping for a positive update after the comment above mine is so daunting. Going through the same with my ds he was referred to paediatrician yesterday he is just 14

@TheJadeNewt He was referred to a pediatrician back in Oct 2025, and the appt is for the 1st April 2026. A long wait unfortunately. I really hope that its just he is a late bloomer, but if its anything else that we are not too late to intervene. Partly I am just sticking my head in the sand about it all, as he doesn't want any intervention as it involves blood tests. Just over 2 weeks til the initial appt and hopefully not long after that until he gets some bone xrays.

@Chesticles thank you for your reply. What area are you in?