The Most Frequently Asked Questions when Beginning Growth Hormone Therapy FAQ Part I

　　Growth Hormone therapy for both children and adults... is often confusing. To help you we have put together a list of questions which we are often asked by parents. Remember these are questions specific to children who are either newly diagnosed or just starting growth hormone treatments. If you don't see an answer to your question, or just need to talk with a more "experienced" parent who has gone through this- Please call! That is why we are here. We have faced this and know how challenging it can be!

http://www.magicfoundation.org/images/photos/00075188.jpg1) What is Growth Hormone?
　　Growth hormone is a protein hormone secreted by the pituitary which promotes linear growth.生长激素是由脑垂体分泌的、具有促进生长的蛋白类激素。

2) Is Growth Hormone a Steroid?
　　No. It is a protein hormone made up of amino acids.生长激素由氨基酸组成，故非固醇类激素。

3) Are there any side effects when using Growth Hormone?
　　Growth hormone does not have any significant side effects when used as a replacement therapy for growth hormone inadequacy or deficiency. Children with hypopituitarism (multiple pituitary hormone deficiencies) sometimes experience fasting hypoglycemia that improves with treatment. Growth hormone results in reduction in body fat with increased muscle growth development.生长激素替代治疗主要用于生长激素分泌不足，在治疗的过程中通常无明显的副作用，但可预防空腹血糖偏低、增加人体的肌肉和降低其脂肪含量。

　　The recommended doses of growth hormone do not lead to problems, but long-term over-dosage, could result in signs and symptoms of acromegaly consistent with the known effects of excessive human growth hormone. This is not to be expected with properly prescribed growth hormone replacement therapy. Consult your physician or pharmaceutical company for further detail.给予治疗剂量的生长激素通常不会产生副作用，但长期大量使用可能诱发肢端肥大。

4) Why is growth hormone necessary?
　　Growth hormone is a natural hormone which necessary for normal linear growth. Growth hormone is indicated for the long-term therapy of children who have growth failure due to inadequate growth hormone secretion.生长激素是原本存在的、维持人体正常生长所必需的激素。

5) How do you determine the dosage and will the dosage remain the same throughout therapy?
　　Growth Hormone is generally prescribed in a dosage of 0.3mg/kg/week. Higher doses may benefit some teenage growth hormone deficient patients, especially those who are most growth retarded during puberty.生长激素每周的常用剂量是0.3mg/kg。

6) What changes, if any, should I expect to see in my child during therapy? (moodiness/hyperactivity etc.)
　　There should be no specific changes in your child's mood or activity on growth hormone therapy. However, children generally will have an improvement in self-esteem which may lead to other improved psychological aspects.在接受生长激素治疗的过程中，孩子们通常无明显的情绪和行为变化，但常常可见其自尊心增强。

7) What are the different types of growth hormone and how often are the injections given?
　　Growth hormone is available as a powder, or as a premixed liquid. It is also available in devices which use a vial that you will mix or that will mix itself when readied for use. Growth Hormone is usually administered 6-7 days per week.生长激素的剂型可以粉剂或注射液。

http://www.magicfoundation.org/images/photos/00075143.jpg8) Should I worry when bubbles appear in the syringe that has been prepared for my child's injection?
　　A few bubbles may be of no consequence. One needs to practice to improve technique. Mixing and drawing require training and practice.用注射器抽取生长激素应避免气泡形成。

9) How long will my child be on growth hormone?
　　Growth Hormone is utilized for until full growth has been attained with a bone maturation of 16 years or more for males and 14 years or more in females or the growth rate is less than 2cm/year.男孩于16岁前，女孩于14岁前若每年生长速率小于2厘米可接受生长激素治疗。

　　Consult your physician for continuing growth hormone therapy under the guidelines for adult growth hormone deficiency. Growth Hormone Therapy may be indicated in adults with Growth Hormone Deficiency and teenagers after full growth has been attained. Growth Hormone stimulation tests are necessary. Peak Growth Hormone values of less than 5mg/ml qualify for continued replacement therapy. Adult Growth Hormone Deficiency patients have impaired quality of life, reduced exercise capacity, high cholesterol, increased body fat, reduced muscle mass and reduced bone density.成人或儿童是否接受生长激素替代治疗请咨询专家，通常生长激素缺乏者应该接受治疗。通常专家们会让您完成生长激素刺激试验，若生长激素峰值小于5毫克/毫升，理应接受治疗。

10) Should my child give his own injections?
　　Children can share in the administration of their injections with supervision. Children 8 years of age and older may decide to give their own injections. Sharing part of the　injection technique may be important to self-esteem.8岁或更大的孩子可以学习自我注射生长激素。

11) What kind of growth should I expect to see in my child?
　　Generally, growth prior to therapy is less than 5 cm (2.5 inches) per year. Growth may be 8 to 12 cm during the initial year of growth hormone therapy. The second and third year may be closer to 7 cm per year. Growth is approximately 1½ inches or less prior to therapy and 3-4 inches per year after initiation of therapy.接受生长激素治疗的第一年孩子们通常可以增高8～12厘米，第二和第三年分别可望增加7厘米。

12) I left the growth hormone at room temperature for several hours. What shall I do?
　　Growth hormone is a protein which can be destroyed by extreme temperatures. Prior to mixing growth hormone, a vial can be left out for 72 hours and then reconstituted with full effectiveness. Once a vial is reconstituted it could be left out at normal temperatures up to 24 hours. Manufactures have devices which protect medicine for a short time. Always refer to the information provided by them regarding the safety of your medications.owth hormone is a protein hormone, which can be destroyed by heat or extreme temperatures, but there are some general recommendations to follow. Prior to reconstitution (mixing) of your growth hormone, a vial can be left out for 72 hours and then reconstituted with full effectiveness. Once a vial is reconstituted it could be left out inadvertently at normal temperatures up to 24 hours.生长激素在使用前应按说明书要求妥善保存。

13) If my child prefers injections in the legs instead of the arms, is it okay in the legs only?
　　Rotation of injection site is encouraged in the arms and legs; other areas may also be utilized. Avoidance of the same location is important to avoid local bumps in the skin called lipohypertrophy.需要长期注射生长激素的人，应该有计划地轮流在不同的部位如上肢或下肢进针，以免多次重复注射某个部位而导致硬结形成。

14) Is it advisable to give the injection when my child is sleeping?
　　This is a asked question only parents can decide. Injections are generally preferred at bedtime. Each child has an individual response or fear of injections.为了避免孩子们受惊，可于睡眠时给他或她们注射生长激素。

15) I don't feel I can give the injections to my child. Is this a normal reaction?
　　This is a normal reaction of conscientious parents who have concern of hurting their children. Children may express discomfort following an injection. Utilizing smaller needles and quicker subcutaneous injections are recommended. The child needs reassurance that the discomfort will diminish when they become used to the injections. The parent can reinforce the benefit of the injection by maintaining a positive attitude. Ask your child’s physician about your options.家长们不敢给自己的孩子扎针，这正常吗？当然，这是正常的反应。通常可以采用小针和快速进针的方法以减轻疼痛，并向孩子承诺因注射导致的疼痛是暂时性的，这种注射是安全和必要的。

16) What if I forget an injection?
　　One can make up for missed injections by adding extra doses on other days. Remember the total weekly dose remains the same.假如你于某一天忘记给孩子注射生长激素，可在另一些日子适当增加注射的剂量，但应注意每周总的剂量应该维持不变。

http://www.magicfoundation.org/images/photos/00075183.jpg17) What if my child wants to discontinue the injections, but there is a potential for more growth?
　　Children need to be encouraged to continue their therapy for full effectiveness. Only an individual family can make a final decision regarding what is best for their child. One needs to examine the child's motive for wanting to discontinue injections when they are obtaining a definite benefit. MAGIC has a free DVD available "Just Say YES To Growth Hormone". (Call to request copy.)是否终止生长激素的治疗，其最终的裁决权在孩子的父亲和孩子自己。

18) What should I do if I run out of growth hormone?
　　It is recommended that you be aware of your growth hormone supply and contact the source of supply prior to running out. Make sure the prescription is refillable and the insurance company has continued the approval. It is advisable to restart the injections as promptly as possible.为了避免治疗中断，应该提前续订药品。

19) How often will my child need to visit the endocrinologist and what additional tests need to be taken during the course of therapy?
　　The number of visits to the endocrinologist depend upon the age of the child and if there are other conditions or hormone deficiencies. The general recommendation is for visits every three months. Periodically, blood testing is necessary such as thyroid function studies and a bone age assessment is recommended yearly. There is an increased incidence for the need of thyroid replacement as well, and indeed other deficiencies may be co-existing.通常在接受生长激素治疗的过程中，孩子应每三个月看一次内分泌专家，以复查相关检查和随访疗效等。

Contributed By:
Louie G. Linarelli, M.D.