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Growth Hormone Deficiency

What is growth hormone deficiency?

Nurse taking height of a child female patient.

Children who don’t have enough growth hormone often grow more slowly and may be shorter than their peers.

Growth hormone deficiency (GHD) is a condition where the body does not make enough growth hormone. Growth hormone, also called somatotropin, is a hormone made by the pituitary gland, a small gland in the brain.

The body needs growth hormone to build bones, muscles, and tissues. Growth hormone also helps the body use food for energy.

Symptoms of growth hormone deficiency

In children, growth hormone deficiency signs and symptoms may include:

  • Growing more slowly than expected for their age, usually fewer than 2 inches per year
  • Shorter height
  • Younger appearance
  • Changes in facial features, such as rounder face or smaller jaw
  • Delayed puberty

In adults, growth hormone deficiency may cause:

  • Thinning or weak bones (osteoporosis)
  • Loss of muscle and decreased muscle strength
  • Increased body fat, especially around the belly
  • Higher “bad” LDL cholesterol levels
  • Greater risk of heart or blood vessel problems, such as heart attack or stroke
  • Feeling tired, anxious, irritable, sad, or not motivated

Symptoms of GHD usually improve with treatment. GHD does not affect learning or memory.

Causes of growth hormone deficiency

There are 3 main types of GHD based on the cause:

  • Congenital GHD: A child is born with this type. It can happen because of gene changes passed down from parents to children.
  • Acquired GHD: This type develops later in life. It can happen because of:
    • A severe head injury
    • Damage to the pituitary gland, which makes growth hormone
    • Damage to the hypothalamus gland, which controls the release of growth hormone
    • Infection that affects the brain
  • Idiopathic GHD: In some cases, the cause of GHD is not known.

Diagnosis of growth hormone deficiency

If your child has signs of poor growth, your care team may suggest that they see a pediatric endocrinologist. This doctor has special training to diagnose and treat hormone problems.

Tests to diagnose growth hormone deficiency may include:

  • Physical exam and growth checks: Your child’s height and weight will be measured over time and compared to typical growth patterns.
  • Bone age x-ray: An x-ray may be taken of your child’s hand and wrist to see if the bones are forming as expected for their age.
  • Blood tests: Blood samples can show levels of growth hormone (GH) and other substances released into the blood from the pituitary, like IGF-1 (insulin-like growth factor 1) and IGFBP-3 (insulin-like growth factor binding protein 3). Providers may also use blood tests to check for other conditions, like hypothyroidism, celiac disease, or delayed puberty.
  • Genetic tests: Tests may look for gene changes that cause GHD or other conditions that affect growth.
  • Imaging scans: An MRI or CT scan of the brain can show if there are problems with the pituitary gland or hypothalamus.
  • Growth hormone (GH) stimulation test: This test uses medicines to stimulate the pituitary gland to see how much growth hormone is released over time.

Treatment of growth hormone deficiency

GHD is treated with growth hormone replacement therapy using a man-made growth hormone. It is given as a daily or weekly injection (shot) in the fatty part of the skin of the arm, stomach, thigh, or buttocks.

After your child starts treatment, they may:

  • Grow taller and need new clothes and shoes
  • Have a better appetite and look leaner
  • Feel better overall

Your child may take the growth hormone therapy for several years until bone growth slows or stops. The dose will change as they grow.

In some cases, growth hormone therapy may continue into adulthood. This can help support:

  • Bone health
  • Lean muscle mass
  • Energy levels
  • Quality of life

Growth hormone deficiency in cancer survivors

Some survivors of childhood cancer may develop GHD after:

If your child is a cancer survivor, know their risk and watch for signs of growth problems. You can:

  • Ask your child’s oncologist about their risk of late effects
  • Tell your child’s primary health care provider about their risks.
  • Share a copy of your child’s Survivorship Care Plan. This plan includes a summary of their treatment and possible long-term health problems.

Your child should have regular exams every 6 months until they finish growing. These visits should include a physical exam to check their:

  • Height, weight, and growth
  • Stage of puberty
  • Nutrition
  • Energy level and general well-being

Prognosis for growth hormone deficiency

With early diagnosis and treatment, your child has a better chance to reach a normal or near-normal adult height. Early treatment improves outcomes.

Be sure to follow your care team’s recommendations for follow-up care. This may include:

  • Visiting the endocrinologist every 6 months
  • Getting blood tests every 4–6 months so that the hormone dose can be adjusted, if needed
  • Checking height and weight regularly
  • Getting bone age x-rays yearly
  • Reporting any side effects from treatment

Tips for families

  • Closely watch your child's growth and make sure they get all needed checkups as suggested by your health care provider.
  • Follow the treatment plan carefully, including growth hormone replacement therapy.
  • Some children may have body image or social concerns if their growth is different from their peers. Let your care team know if your child has emotional changes or problems coping.
  • Get support from patient groups to connect with others going through similar experiences.
  • Let your care team know about any problems you have with your child’s medical care, such as giving injections, getting medicines, or paying for growth hormone therapy.

Questions to ask the care team

  • How do you test for growth hormone deficiency?
  • What causes growth hormone deficiency?
  • What are the treatment options for GHD?
  • What are the possible side effects of growth hormone therapy?
  • How often does my child need checkups and tests?
  • How soon will we see growth changes with treatment?
  • How long will my child need growth hormone replacement therapy?
  • Will my child reach a normal adult height?
  • What treatment side effects or health problems should we watch for?

Key points about growth hormone deficiency

  • Growth hormone deficiency (GHD) is a condition where the pituitary gland does not produce enough growth hormone.
  • The main sign of GHD in children is a slower-than-normal rate of growth.
  • GHD can be caused by genetic factors, brain injuries, or medical treatments like radiation or brain surgery. Sometimes, the cause is unknown.
  • Treatment usually involves daily or weekly injections of a growth hormone replacement therapy.
  • Early treatment of growth hormone deficiency can help children reach their full height and support overall health and development.

Find more information

—
Reviewed: February 2026

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