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Why is son's height is not growing as per the health chart?
My son is 8 years old and is the shortest boy in his class. Although both me and my husband are at a average height. His seems to be way below the normal height range that is mentioned in his health chart. Could it be associated with some hormones?
8 Answers
Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at his eight and height, plot them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages. Physical exam would also be done and likely consultation with a pediatric endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.
If your son is below the 3rd percentile of his peers or he has been falling of the growth chart or he is not growing close to his genetic back ground, he needs initial evaluation by his primary care. If there are concerns about his growth he needs to be referred to a specialist. He should have a proper evaluation to exclude hormone deficiencies, anemias, gastrointestinal problems and other medical problems. After excluding the above conditions if he continues to show suboptimum growth, helping him with growth hormone could considered. Thanks
Yes, absolutely. I would strongly encourage an evaluation by a pediatric endocrinologist.
LG
Several possibilities which range from benign to significant. The most common reason for this situation is constitutional growth delay, which is associated with a later onset of puberty. You already ruled out the most common reason: familial short stature. Less frequent, but serious problems include hormonal deficiencies, gastrointestinal disorders which can reduce
nutritional status, congenital heart disease and even some genetic syndromes. Assuming your child is overall healthy, CGD is a possibility based solely on how common it is. But the best action is to discuss with your son's doctor and decide if a referral to a pediatric endocrinologist would be in order.
The "short" answer is yes. But most height issues have a strong familial/genetic pattern so important to know about patterns of growth for the parents and grandparents to see if this is similar or dissimilar. Are there others in the family who were short or went into puberty later but then spontaneously caught up and could this be a similar benign pattern? A detailed history of pregnancy, birth weight and length, review of growth charts look for patterns. Same with a detailed history of other problems (celiac disease, underactive thyroid, for instance) and comparison between weight and height percentiles. Then detailed physical exam looking for conditions like Noonan Syndrome or others associated with short stature in boys. Then looking at a bone age xray to compare actual height and bone age plus some screening laboratory tests like IGF-1 and others that help sort out some subtleties. Finally, following height and weight every 3-6 months and plotting on the charts to see if there is any pattern or change that may require consultation with a pediatric endocrinologist for more specific evaluations. Special growth hormone stimulation testing is sometimes needed to help sort this out as well as brain MRI of the pituitary and hypothalamus regions where hormone are controlled.
See a board certified Pediatric Endocrinologist. We're experts in growth and puberty.
Yes, the most important condition to evaluate is growth hormone deficiency. You should take him to a pediatric endocrinologist to have him evaluated as soon as possible.
Your son may be a late bloomer which may result in him continuing to grow while his peers have stopped growing. He also could have a hormone problem or another medical condition. A medical provider should be able to look at your son's growth chart to see if there is a chance there is a hormone problem or not. If you are concerned, you should talk to your son's health care provider and ask if he/she thought your son needs screening tests or referral to a specialist.