Seeing a Pediatric Endocrinologist (specialist)
It is hard to say exactly whether or not a child has growth hormone deficiency (GHD)
A disorder where the body does not produce enough growth hormone. In some cases, no growth hormone is produced at all. When a child has GHD, the pituitary gland in his or her body does not make enough growth hormone for normal growth, and the child may not be able to reach his or her anticipated adult height
.
At first, your child’s pediatrician will compare the growth of your child with other
children at the same age using growth curves. Growth curves are charts that show
the country’s average height of children by age. If your child falls into the lowest
percentile, there may be a growth issue. At this time, your child’s pediatrician
may refer you to a specialist. This specialist is called a pediatric endocrinologist
A specialist doctor that treats conditions, such as growth disorders, that affect the gland system in children's bodies
(“endo”). He or she treats GHD in children.
Preparing for the Specialist’s Visit
Before seeing the specialist, there are a few things you can do to get ready. This
will make the first visit much more helpful. The specialist will need a lot of information
about your child. He or she will also want to you know about the pregnancy, labor,
and delivery of your child. The more you can share, the better. The specialist will
want to know about the child’s general health. He or she will also likely ask questions
about your child’s food and diet issues, past sicknesses, as well as stresses and
injuries.
Information about other members of the family is also vital. The specialist will
want to know about the heights of your relatives. The specialist may also ask if
there is any history of health problems in the family.
It is also a good idea to
bring all of your insurance information. The specialist’s office will be sure to
ask for it.
Once you are at the doctor’s office, he or she will plot a growth chart. The doctor
will use all of the measurements you can provide from your child’s birth until now.
But, there are extra steps that will be taken—such as different kinds of tests being performed—to
ensure a more accurate diagnosis.
Tests to Diagnose GHD
First, the specialist will give a thorough physical exam and do blood work.
This allows the specialist to rule out hormone issues other than GHD. The specialist
will also want to rule out conditions that affect the kidneys, bones, or digestive
system.
The specialist may take an X-ray of the child’s hand and wrist. Then, he or she
will compare the bone development to the child’s age and height. This is called
a Bone Age Test. It allows the specialist to predict the child’s adult height. However,
this is only a rough estimate. Many other factors may play a role in achieving normal
growth. Some of these factors include the child’s health and sexual development,
and family history. Rough estimates of the adult height will become more accurate
as your child grows older.
Since GH is released in bursts throughout the day, a blood test taken at random
is not accurate. For a better measure, the specialist draws blood several times over
a long period of time. Sometimes a child will go to the hospital. This is so blood
can be taken at regular times during the night. In some cases, blood is tested many
times over a whole day (24 hours).
Your specialist may choose to test GH levels by using a GH stimulation test. In
order to do this, the gland that makes growth hormone is forced to produce GH. The
specialist then tests the blood for the levels of GH. If none shows up in the results,
or if the levels are very low, there is a good chance that the child has GHD. Usually,
this test will last many hours.
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