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Bone age of seventeen, stunted growth, facial hair, on cortisone, X-ray done, growth chart flat. Treatment ?

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Posted on Fri, 8 Jun 2012
Question: Hello I have some important questions regarding my height. I am 15 and 3 months years old and 5 “6 1/4 and 135 lbs. My dad is 5 10-11” and my mom is 5”4-5 both didn’t stop growing until end of highschool, all of my relatives are around average size. I recently got an x-ray and my left wrist and my bone age is 17 and my plates are still open, but most likely not for much longer.I grew less than a half an inch this past year, my doctor said it looks like I might be done growing considering my growth chart is beginning to flatten. I also hit early puberty around 11-12 and I am nearing a 5 on the XXXXXXX scale now. I grow a bit of facial hair and shave every 3 or 4 days but don’t grow it thick its light and patchy.I have quite a bit of hair on my legs and arms and underarms. The only place I lack hair is the medial thighs. I have a XXXXXXX voice and decently wide shoulders and built body, but by no means am I short and stubby.I also was a premature child born at 29.5 weeks. I was 2 lbs. 4 ounces and was small throughout childhood. I also had bad asthma and took lots of cortisone which I heard can stunt growth. I also am a high stressed person i’d say, and never got great sleep. I obviously have lots of factors that could have stunted my growth. I also have small hands and a foot size of only 8

     I visited the Endocrinologist back when I was 11-12 and he told me I was gonna experience early puberty, but my bone age looked fine and he predicted my height to be 5”9. He claimed I was fine and didn’t need any treatment but to check back soon.Then I began to rapidly grow and didn’t think I needed another visit I was tall for once. Now i’m getting to be the short kid again being a freshman in HS.

     I am a very active kid with a good diet. I play sports every day and drink lots of milk , consume protein, take vitamins, and take melatonin (recently) for a better sleep. I also do some weights but nothing heavy just dumbbells and pushups, sit-ups, pull-ups, etc. I would say I’m in good shape.

     I just don’t seem to be growing right. Do you think I will grow anymore? How much? Do I qualify for any HGH therapies or treatments?
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Answered by Dr. V. Kumaravel (13 hours later)
Hello.

I would like to thank you for a clear and elaborate history of your problem that you had provided.

The height is determined by so many factors like your nutrition, hormones, illness, drugs and your parents height. your height of 5 “6 1/4 is more or less within your target height (That is determined by your parents height), probably your cortisone intake could have contributed to mild stunting in your growth.

I do understand that you are a 15 year old male with a bone age of 17 years, advanced bone age may be related to your early puberty. Bone age of 17 means that your height is mostly complete and you will be left with a growth of 1 to 2 inch more.

As for growth hormone therapy is concerned, I hope endocrinologist should have ruled out idiopathic short stature where no obvious reason for stunting is seen, But still as your bones are allready 17 years, there may not be real benefit with Growth hormone therapy.

I hope I have answered your query.

I will be available for follow up queries if any.

Regards.


Above answer was peer-reviewed by : Dr. Jyoti Patil
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Follow up: Dr. V. Kumaravel (8 hours later)
Considering my circumstances for an obvious mildy stunted growth, could I obtain growth hormones in hope it benefits me and helps me get an extra inch or two? My plates are still open and i want to get all the height i can.

I respect your answer, but I believe I would benefit from growth hormone as I have done lots and lots of research.Obviously it's not a prescription that is "easy" to get from a doctor, but from what i've told you would I qualify for it?
doctor
Answered by Dr. V. Kumaravel (9 hours later)
Hello again,

I can understand your concern. As of now your bone age is 17 years. Though your plates are still open, as per the most commonly used method for height prediction, based upon Greulich and Pyle's chart you have achieved 99% of the predicted height. I don't feel growth hormone will really add an extra inch.

Considering your concern 2 options might be possible, but it has its own pros and cons:

Option-1: what so ever worth, to try Growth hormone after basic work-up. But you have to remember the dose would be high in your case and hence increase in cost.

Option-2: we can suppress your puberty with drugs like GnRH agonist to keep your growth plates open up for some time and also add growth hormone.

I may not personally suggest any of these as you may not really qualify for it, given your current height and your bone age.

Regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. V. Kumaravel

Endocrinologist

Practicing since :2001

Answered : 297 Questions

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Bone age of seventeen, stunted growth, facial hair, on cortisone, X-ray done, growth chart flat. Treatment ?

Hello.

I would like to thank you for a clear and elaborate history of your problem that you had provided.

The height is determined by so many factors like your nutrition, hormones, illness, drugs and your parents height. your height of 5 “6 1/4 is more or less within your target height (That is determined by your parents height), probably your cortisone intake could have contributed to mild stunting in your growth.

I do understand that you are a 15 year old male with a bone age of 17 years, advanced bone age may be related to your early puberty. Bone age of 17 means that your height is mostly complete and you will be left with a growth of 1 to 2 inch more.

As for growth hormone therapy is concerned, I hope endocrinologist should have ruled out idiopathic short stature where no obvious reason for stunting is seen, But still as your bones are allready 17 years, there may not be real benefit with Growth hormone therapy.

I hope I have answered your query.

I will be available for follow up queries if any.

Regards.