Should Short Boys Take Growth Hormone?
If they're healthy, probably not, experts say
If both parents are short, that limits what growth hormone therapy can do. "We can't modify your genetic potential," Vuguin said.
The fictional family in Allen's report fit that scenario. The mother was 5 feet tall, while the dad stood at 5 feet 6 inches. Their son's predicted height, with no intervention, was 5 feet 5 inches -- the lower end of "normal."
"You have to think, how important is an inch or two of extra height in the big picture?" Vuguin said. "Is the difference between 5 feet 5 inches and 5 feet 6 inches that important?"
Allen said there are instances where healthy children are extremely short, and "it's appropriate to help them grow." But for most kids, it's "reasonable" to just keep watching their growth rate and reassure the parents.
Often, parents worry about their child (again, usually a son) being teased, or -- as an adult -- feeling unhappy or even being at a disadvantage career-wise.
But studies have not borne out those worries, Allen said. Short children and adults do not seem less happy than their taller peers, and there's no proof that treating idiopathic short stature improves quality of life.
"The more we look into this 'assumed morbidity' associated with short stature, the less we find," Allen said. "And it's been very difficult to show that treating (idiopathic short stature) improves kids' well-being as adults."
As far as safety, growth hormone "has an excellent track record while kids are on it," Allen said. But no one knows yet if there are risks later in life. In theory, growth hormone might raise the odds of diabetes or certain cancers down the road. But for now, those are theoretical risks, Allen said.
The other big issue is cost. A conservative estimate is that each inch of height gained with growth hormone treatment would ring up at $35,000 to $50,000, Allen said.
Growth hormone is not the only option for idiopathic short stature. Boys can be given low doses of androgens, or "male" hormones. This therapy boosts boys' growth rate in the short term, but there's no evidence it increases their adult height, Allen said.
"It's always reasonable to say, 'Let's just watch this,'" Allen said. At first, the gap might worsen if a short child's peers hit puberty earlier and their growth takes off, he noted. But once a "late bloomer" starts puberty himself, his growth will accelerate, too.