Thursday, August 31, 2006

I just saw a CNN story called "High Price to Get Taller." It talked about the controversy of using human growth hormone in an attempt to make healthy short kids taller. Click here for the video clip: http://www.cnn.com/video/partners/clickability/index.html?url=/video/health/2006/08/31/cohen.paying.for.growth.hormone.affl

Bravo to bioethicist Lori Andrews who discussed the ethical problems of turning healthy short children into patients in need of a medical treatment. I agree with her belief that self-esteem doesn't come from buying inches. I understand, though, why parents would want to do what they can to help their short children grow taller. The fact that heightism is rampant in our culture influences many people to use growth hormone in an attempt to deal with the prejudice against short people. But in my opinion, the way to deal with heightism is to educate those who discriminate against short people, rather than trying to physically alter the victims of that prejudice.

Moreover, what the CNN story fails to mention, was that studies have shown that treatment with human growth hormone does not always translate into increased inches for the person undergoing the treatment, and that it looks like many recipients of growth hormone reach their adult height faster (so the rate of their growth is increased) but not taller. The young boy in the story who has gained 3 extra inches so far in treatment will not necessarily become 3 inches taller than his predicted adult height (and predicted height has a plus or minus 3 inch range). Also, the story reports that an extra inch costs about $50,000, which is true, and that if you want 4 extra inches, it will cost you $200,000. But studies show that for those children who do grow taller from the treatments, they add an average of one to one and a half extra inches...more money for treatment years does not translate into more inches. You can't just place an order for a particular height.

In addition, they CNN noted some potential side effects such as headaches and scoliosis but failed to mention the may potential adverse consequences of growth hormone therapy including: impaired glucose tolereance, diabetes, pseudotumor cerebri (a condition of the brain simulating the presence of an intracranial tumor), severe kidney damage, hypertension, and spontaneuos bone fractures. A small percentage of patients can be expected to form antibodies against growth hormone that can interfere with growth. Short-term acceleration of growth from human growth hormone therapy may hasten puberty and bone aging so that final adult height may actually be less than what it would have been without intervention. Similarly, stopping treatment before adult height is reached may render the child shorter than he/she would have been without treatment.
Finally, growth hormone causes the liver to manafacture chemicals that have effects on various parts of the body. One of the chemicals, insulin-like growth factor (IGF-1) is thought to play a role in breast cell growth and many doctors are concerned about a possible connection with the development of breast cancer. Human growth hormone (the synthetic version) has only been in use since 1985, and many children receiving this treatment do so for an average of 5-10 years. There has been insufficient time to determine potential long term consequences. Remember, the child is being subjected to these potentially serious effects when there is nothing physically wrong with him/her. They are healthy short children who live in a culture who is biased against short people.

Another point I want to make, is that the child they featured who had a predicted adult height of 5 feet 5 inches tall, and has grown 3 inches since he's been using human growth hormone. In 2003, the FDA approved the use of human growth hormone in healthy short children who had a predicted adult height of less that 5 feet 3 inches tall for men and 4 feet 11 inches for women. Therefore, the child did not meet the criteria set by the FDA, (a concern because more and more short people are being considered in need of treatment) and his treatment is even being covered by his insurance! (What about all the uninsured children in the U.S. who have no health care?)

CNN did a good job of showing some of the ehtical debate of using growth hormone with healthy short children, but with the above mentioned concerns about what they didn't highlight, I think people will come away with the idea that human growth hormone treatment is a safe and effective way of increasing height.

For me there is only one solution. We must confront heightism as a social issue, and not medicalize the victims of height prejudice.

2 Comments:

At 7:04 PM, Blogger diana said...

I back your standpoint on this scoliosis issue.

 
At 10:02 AM, Blogger vasudha said...

Hi, I am 25 year old from India. Standing at 4 feet 8 inches, i dont remember a day from my past 25years where i wasnt made to realise how short i was( as if there was any chance it would have escaped my notice). From the teacher's inconsiderate remark at school to friend's and peer's jokes and nasty comments, to constant advice from 'well-wishers' to losing leadership opportunities at school and further... i have faced it all. and yes, all of that has left a mark on me. i have a fragile ego and a raging temper (i realise, both of these have developed as a part of defence mechanism). my credibilty for everything has been questioned but i have been a fighter, constantly fighting my battles for survival everyday and winning them, proving my intellectal,creative capabilities. But of late i am losing my capability my energy to fight, slowly i am sinking into depresssion. I am sick and tired of proving myself. and i hate what other's perception has done to me, i have started hating my own body. I read you article on the forum for short people and loved it because i have raised the same points and concerns myself once. But right now i myself need help, some therapy that can take me out of this endless depression that i am falling into. I didn't know how else to contact you.

 

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