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Dr. Andrew Rynne

Family Physician

Exp 50 years

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14 years old. Test showed delayed growth and puberty. Taking oxandrolone. Any suggestion?

Answered by
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Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Posted on Wed, 9 Jan 2013 in Growth and Development in Children
Question: I went to see growth specialist when 14.5 years old. after wrist xray test, blood test (for hormones?) and testis exam (No access to these records as destroyed in fire!), i was told that good news was there is no disease with me except for delayed growth/puberty. I was offered treatment but refused as we decided to 'wait' for 3 months to see if theres progress in my condition. 3 months later we went back and agreed to start oxandrolone. The physician referred to it as 'growth hormone' as it only fixes growth and DOESNT affect puberty which is partly why i agreed. Now im reading things like it's possible to mature the HPG axis and induce puberty etc.... My areas of concern are as follows:

From the data above, was there any ENDOGONOUS andro activity gonadal or otherwise?

Does a short course 2.5mg once daily oxandrolone induce central puberty or progress of central puberty?
doctor
Answered by Dr. Ganesh Sanap 4 hours later
Hi, thanks for writing in.

Oxandrolone belongs to group of anabolic steroid which can be used for induction of growth in late ages. But the age range is usually between 10-20 years , before fusion of epiphysis(growth plate). It will increase the growth, no effect on sexual puberty.

I think at age 30 , it will be quite difficult for action of drug. Also before starting any puberty increasing drug, it will necessary to evaluate the hormonal levels of growth hormone and androgen level.Endogenous activity can be stimulated on basis of hormonal level and receptor response.

I will suggest consult a endocrinologist again and get evaluated freshly. So that treatment can be started.

Hope your query is answered satisfactorily. Do let me know if you have more concerns.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ganesh Sanap 16 hours later
Thanks,

I HAD the treatment already, i dont need it now.....If i may say so, you mention ox increases growth without effect on puberty, then you mention 'puberty increasing' drug...So is Ox puberty increasing or not?

Best Regards


doctor
Answered by Dr. Ganesh Sanap 53 minutes later
Hi,

Oxandrolone is an anabolic steroid. It will affect nearly every cell of body, with bones also. Puberty increasing drugs usually belong to testosterone group. That is why I use different phrases.

Your problem has to be dealt as per need of which puberty is lacking. It cannot be treated as a general rule.

Hope your doubt is cleared now.

Thanking you.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ganesh Sanap 5 hours later
Thank you Dr XXXXXXX

I have a question,

I understand drugs affect HPG axis variably. Suppose a temporary androgen treatment in young boy causes HPG axis to 'mature' to certain degree, and then the axis continues to mature as boy goes through puberty and reaches adulthood.

Would it be medically correct to then say effects of the old androgen treatment are irreversible?

Or does cessation of the androgen treatment mean its initital effects also ceased?

With Best Regards,
XXXXXXX
doctor
Answered by Dr. Ganesh Sanap 42 minutes later
Hi, welcome back.

If it happens like HPG axis continues to mature after cessation of treatment then we can say that old androgen treatment is irreversible. It depends on which level defect is from hypothalamus-pitutory -gonadal level.

In most instances, cessation of androgen will cease its effect on HPG axis.

Hopefully, I have cleared your query.

Thanking you.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ganesh Sanap 26 hours later
Hello,


What about if it 'matures' the HPG axis, and this remains mature and matures even more as adulthood is reached. Can we say the drug's effect on HPG is therefore permanent? Or for example, after 10 years since stopping the drug, all our cells activities is indigenous?

With Kind Regards,
XXXXXXX
doctor
Answered by Dr. Ganesh Sanap 30 minutes later
Welcome back.

If it happens so then we can say that drug was effective and effect is permanent. However, there is no such effective treatment for permanent stimulation. It can happen only in conditions which are acquired like infection of gonadal organs. During that period, external therapy will be effective.

Hope you have cleared your query.

Thanking you.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ganesh Sanap 45 minutes later
Is the oxandorlone therapy i underwent long time ago still responsible for my testosterone secretion NOW in adulthood
doctor
Answered by Dr. Ganesh Sanap 22 minutes later
I think it is your endogenous secretion, not due to such old treatment.

We need all old reports to see what your androgen level was at that time. Then only we can make definitive conclusion.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ganesh Sanap 12 hours later
Thank you Dr XXXXXXX

Unfortunately there is no reports available, it was such a long time ago.

But i was told i have CDGP so presume my androgen level wouldve been low
doctor
Answered by Dr. Ganesh Sanap 25 minutes later
Welcome back dear friend.
It is not possible to comment on assumptions.
Regards.
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Ganesh Sanap 2 hours later
could you please forward this discussion to another doctor then. thanks
doctor
Answered by Dr. Ganesh Sanap 2 hours later
Hi,

Welcome back again.

CDGP means constitutional delay in growth and puberty. You never mentioned in previous discussion that your physician told you like that during first treatment.

I will explain what CDGP is. It is growth delay without any somatic, hormonal, congenital, acquired causes. It is an idiopathic delay. In that case, HPG axis is normal. Any drug will just induce the temporary pause in the process.

Your HPG was normal, if you were diagnosed as CDGP. I think Oxandrolone was given just as a precaution.

Please mention all relevant history so that we can come to conclusion.

Hope now you are satisfied with answer. Still, if you want to forward this discussion, then no problem. But for that, you have to close this query and have to start again with fresh one.

Regards

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Ganesh Sanap 19 hours later
thank you,

I'd like to ask about long term implication of medications on cells.

I understand in cells that its material composition changes....what are thses changes and how often do they take place?

with Best Regards,
XXXXXXX
doctor
Answered by Dr. Ganesh Sanap 52 minutes later
Welcome back again,

I am not sure what kind of material changes you are expecting/wanting to know about in the cells.

There are few changes such as dysplasia, metaplasia, anaplasia which are abnormal changes in the nature of cells. Other is ageing related changes. Please let me know what kind of changes are you looking for.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ganesh Sanap 3 hours later
Thanks,

I'm looking for material changes such as mineral renewal.

also ageing related changes.
doctor
Answered by Dr. Ganesh Sanap 1 hour later
Hi,
Thanks for writing back.
There is an entity known as dystrophic calcification. As cells get aged there is increase in calcium level in cells. After long time with age, gene APOPTOSIS get activated. It causes death of non functioning cells. It is an age related degenerative changes.
Regards.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Ganesh Sanap 2 hours later
Thank you Dr XXXXXXX

What about non age related changes.....changes of material composition that occur daily or weekly or yearly??

do material composition of ALL cells in our body renew every 7 years? iread somewhere

Regards
doctor
Answered by Dr. Ganesh Sanap 13 minutes later
Hello,
I have never read something like that. If possible please attach the link of thase documents. We will see the authenticity of that article.
Waiting for your reply.
Regards.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Ganesh Sanap 2 days later
Actually an endocronligist advised this but i no longer have the email.

Is there any daily processes or weekly or yearly that changes the mineral/chemical composition of cells?

Regards,

doctor
Answered by Dr. Ganesh Sanap 14 minutes later
Hello, welcome back ,

There is continued metabolism occuring in every cell of body. It has mineral and chemical composition changes both.

It will be very helpful if you elaborate which exact change you want to ask.
Looking forward for your response.

Regards.
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Ganesh Sanap 2 hours later
ANY change that would occur in GnrH releasing hypothalamus cells

Regards
doctor
Answered by Dr. Ganesh Sanap 8 hours later
Hi,

Apart from the physiological function changes - based on negative feedback mechanism (whenever the level of gonadal hormone decreases then in its response GNRH releasing cells become active and start secreting the stimulants for gonadal cells), I have not heard of any other microscopic / material composition changes in the hypothalamic cells.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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