The pituitary gland produces an essential hormone, which is known as human growth hormone (HGH) or simply growth hormone. This hormone stimulates the growth of the human body (1). Body composition, growth, repair of body cells, and metabolism require HGH (2,3).
HGH also boosts the development of muscles, muscle strength, and performance related to physical activity, and it also helps in recovering from diseases and injury (4–6). If there is a deficiency of HGH in the human body, quality of life decreases, and the chances of diseases increase too (7).
Deficiency of Human Growth Hormone In Children:
Deficiency of HGH occurs when the pituitary gland is not able to produce enough quantities of HGH in the body. This deficiency of HGH can occur at any age. One child out of 4,000 children to 1 child out of 10,000 children suffer from HGH deficiency (8).
Causes Of HGH Deficiency In Children And Adults
If the pituitary gland is damaged or any harm occurs to another gland known as the hypothalamus, it can result in the deficiency of HGH. The damage can occur before, during, or after the birth of the child.
The deficiency of HGH can also be due to a genetic syndrome in rare cases. However, the exact reason for HGH deficiency is not known in most cases. If a person has a brain tumor, brain injury, or had radiation therapy carried out on the head, the risk of developing HGH deficiency is more (8).
Treatment of Human Growth Hormone Deficiency In Children
The treatment of HGH deficiency is carried out with the help of synthetic growth hormone, which is supplied externally to assist in the growth of children or deficit of HGH in adults. One such product of Pfizer Pharmaceuticals is Genotropin. Here we will discuss what Genotropin is, its benefits and uses, precautions while using Genotropin, and its side effects.
What Is Genotropin?
Genotropin contains somatropin, a polypeptide growth hormone synthesized with the help of a modern technology known as recombinant DNA technology. A polypeptide consists of a chain of amino acids. The amino acids present in the Genotropin are similar to the HGH, produced by the pituitary gland of the human body (9).
In recombinant DNA technology, living organisms such as bacteria are used to synthesize medicines or hormones. DNA for a specific function from one organism is attached to the DNA of another organism (the bacteria), and then the bacteria produce the desired product (medicine or hormone) (10).
The bacteria Escherichia coli is used for the production of Genotropin by joining its DNA with HGH DNA (9).
How Does Genotropin Act?
Genotropin is similar to the HGH produced in the human body. Therefore, it interacts with the receptors present on the surface of the cells. It mimics the function of the naturally occurring HGH in the human body (9).
What Are the Uses of Genotropin?
Uses in Children:
In children, Genotropin is used for the following purpose:
- Deficiency of HGH in Children: When a child’s growth is affected due to the decreased secretion or an inadequate amount of naturally occurring HGH.
- Presence of a Genetic Syndrome: Prader-Willi syndrome is a genetic condition that causes failure of growth in children. However, caution is required while using Genotropin in such children.
- Small Born Children: Those children who are born small for gestational age and show a failure of growth. Such children are also unable to show much progress in development by the age of 2 years.
- Turner Syndrome: The children with Turner syndrome, a genetic condition, showing the failure of growth.
- Idiopathic short stature (ISS): Children suffering from ISS are shorter than the majority of children similar in gender and age (98.8%). Such children are growing because the growth plates have not been closed yet. However, they are unable to reach the height of other children of the same age because their rate of growth is not that much.
Uses in Adults:
In adults, Genotropin is used for overcoming the deficiency of naturally occurring HGH in the body. HGH deficiency in adults could be present from childhood or may develop later due to damage to the pituitary gland or hypothalamus gland, radiation therapy, or any surgery (9).
What Are the Benefits Of HGH?
Although Genetropoin is mainly used to overcome the HGH deficiency in adults and children and stimulate growth in children. Besides, with the use of growth hormone, bone density improves, the capacity to perform physical activity increases, body fat reduces, and muscle mass is built-up.
Many people also use growth hormones to increase their ability to perform in sports. It is also believed that anti-aging effects can also be achieved using growth hormone since it helps with the repair of cells (11).
How to Use Genotropin
The recommended doses of Genotropin for certain disorders are the following:
- Deficiency of HGH in Children: The recommended dose for HGH deficiency in children is 0.16 to 0.24 mg of Genotropin per kg of the body weight to be administered every week.
- Presence of a Genetic Syndrome: The recommended dose for HGH deficiency in Prader-Willi Syndrome in children is 0.24 mg of Genotropin per kg of the bodyweight to be administered every week.
- Small Born Children: The recommended dose for HGH deficiency in small born children of gestational age is 0.48 mg of Genotropin per kg of the body weight to be administered every week.
- Turner Syndrome: The recommended dose for HGH deficiency in children with Turner Syndrome is 0.33 mg of Genotropin per kg of the body weight to be administered every week.
- Idiopathic short stature (ISS): The recommended dose for HGH deficiency in children with Idiopathic short stature is 0.47 mg of Genotropin per kg of the body weight to be administered every week.
- Deficiency of HGH in Adults: Starting dose of 0.15 to 0.30 mg is recommended when body weight is not considered. This dose is then increased by 0.1 to 0.2 mg per day every 1 to 2 months.
The recommended dose is not more than 0.04 mg of Genotropin per kg when considering body weight to be administered every week. Based on the requirement, the dose can be increased by 0.08mg per kg of body weight every week at an interval of 4 to 8 weeks (9).
Precautions While Using Genotropin
- Closed Growth Plates: It should be kept in mind that when the growth plates in a child have been closed, growth hormones should not be used to increase height.
- Diabetic Retinopathy: If a diabetic patient is suffering from diabetic retinopathy, growth hormone should not be used.
- Patients with cancer: Patients who are suffering from cancer, diagnosed with cancer recently, or their cancer treatment is being carried out. Such patients should not be treated with a growth hormone. The chances of a brain tumor should be ruled out first because a brain tumor also decreases HGH levels.
- Critically ill patients: The use of HGH should be avoided in critically ill patients because of trauma, surgery, or respiratory failure.
- Checking thyroid levels: Thyroid function tests should be carried out when HGH is being used, and if required, thyroid hormone replacement therapy should be started.
- Checking of Cortisol levels: The levels of cortisol should be checked in patients treated with HGH. If required, the dose of corticosteroids should be increased in case they are already taking it.
- Precaution in children with Prader-Willi Syndrome: In obese children with Prader-Willi Syndrome or those with breathing problems, growth hormones should be avoided.
- Increase in Brain Pressure: Growth hormone may increase pressure in the brain in some patients, which can result in headaches and disturbed vision. In this case, immediately stop the treatment, and patients should be reassessed. There are more chances of developing this condition in children with Prader-Willi syndrome and Turner syndrome.
- Different sites of injection: The injection site should be changed every day to eliminate chances of skin problems such as soreness or lumpiness.
Side Effects of Genotropin
Common side effects include nausea, vomiting, headache, muscle pain, the feeling of tiredness, pain in arms and legs, sore throat, stuffy nose, sneezing, or weakness.
Serious side effects include severe headache, problems in vision, seizures, or breathing problems.
A doctor should be consulted immediately if fatigue is persistent, presence of a limp while walking, constant slow or fast heartbeat, swelling of hands, ankles, or feet, problems with hearing, or unusual weight gain.
Genotropin is prescribed by physicians to treat growth-related problems in children. Consideration and care should be the priority while using growth hormone for treatment. Only those growth hormones should be used that are prescribed by a practicing physician. Besides, any adverse reaction of the body towards the growth hormone should be noted carefully and conveyed to your doctor.
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- Clasey JL, Weltman A, Patrie J, Weltman JY, Pezzoli S, Bouchard C, et al. Abdominal visceral fat and fasting insulin are important predictors of 24-hour GH release independent of age, gender, and other physiological factors. J Clin Endocrinol Metab. 2001 Aug;86(8):3845–52.
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- Carroll PV, Christ ER, Bengtsson BA, Carlsson L, Christiansen JS, Clemmons D, et al. Growth hormone deficiency in adulthood and the effects of growth hormone replacement: a review. Growth Hormone Research Society Scientific Committee. J Clin Endocrinol Metab. 1998 Feb;83(2):382–95.
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- Pfizer Pharmaceuticals. GENOTROPIN- somatropin – Prescribing Information [Internet]. 2019 [cited 2021 Mar 5]. Available from: http://labeling.pfizer.com/ShowLabeling.aspx?id=577#section-10
- Khan S, Ullah MW, Siddique R, Nabi G, Manan S, Yousaf M, et al. Role of Recombinant DNA Technology to Improve Life. Int J Genomics [Internet]. 2016 [cited 2021 Mar 5];2016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178364/
- Cronkleton E. HGH: Side Effects in Men and Women [Internet]. Healthline. 2018 [cited 2021 Mar 5]. Available from: https://www.healthline.com/health/hgh-side-effects