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Hey, sorry for the oddball question (I promise not to take this as medical advice, I have an endo and will ask them these questions but would much appreciate some info on this topic if possible): What if you have a 22-year old with growth plates that are still slightly open in proximal tibia, distal femur, proximal femur and proximal humerus, but that person is 3-4 inches shorter than the rest of their generation in their family, with noticeably narrower bones as well?
For background, I was born a bit premature with borderline low birth weight, grew normally up to age 9, and then developed anorexia nervosa at age 9 which lasted right up until age 20, at times mildly underweight and at times significantly underweight, maybe briefly normal weight for a 1-year period around age 12. I have osteoporosis as a result, which I suppose is a sign of how bad the malnutrition was, but I've recovered since, and have not been underweight for 1 year and reached an optimal BMI of 20 now at age 22 (completing recovery from the eating disorder). I take this recovery as a win, but at the same time I am insecure about my frame size, mainly height but also things like hand/foot size, shoulder width, arm length, overall ribcage diameter, and seeming lack of appositional growth of my bones too, although I'm not sure when most of the appositional growth is supposed to happen so I'm not sure if it was the anorexia or lower birth weight that did that.
I have heard of catch-up growth; I've read about cases of hypothyroid men in their mid 20s growing inches after HGH treatment, but I'm not sure if the level of delay in growth maturation is less significant for anorexia than for hypothyroidism, making me wonder whether I have as much potential to "catch-up" as the hypothyroid men due to our having different etiologies of growth retardation. Apparently hypothyroidism is one of the hormonal effects of anorexia so perhaps they're not as different as I currently believe but I'm not informed enough to know whether this is the case.
Would HGH make any sense at all in this situation? If there is any growth potential left, would it just happen naturally now that I'm at a normal weight, without the need for HGH? I'm thinking the minimalist approach would be to let nature take its course now, and if my body can indeed grow more, it will do so, without the risk of hormone treatment. But another side of me wonders whether, due to my age, some sort of kick-start is needed for the growth process to commence?
Also, regardless of etiology of growth retardation, if plates are still technically open but nearly closed in someone's 20s, is HGH worth it or just too risky?
Thank you.
Oh dear. I am really not an endocrinologist or paediatrician.
This is incredibly far outside what I can reasonably consider my expertise, and you have asked a complex question to boot.
Growth plate fusion is very important, and given your age, you'd need an xray to very carefully examine your growth plates to figure out how safe it is.
To put the difficulty of your question in perspective, I'd be barely more at ease if asked by someone if they needed open heart surgery.
I could ask you to elaborate and provide reports and so on, but I'm still not remotely comfortable with the topic, especially at that age, it would entail me cracking open textbooks and research papers and feverishly reading, and it's not laziness that makes me wish to avoid it, it's the fact that I still wouldn't be sure if my advice was sound in your case, especially with the risk of acromegaly.
You absolutely need a different kind of doctor, not a psych trainee, this is genuinely above my paygrade and I would have to be crazy to comment without significantly more experience in the subject, which seems rather unlikely to come about.
My apologies, while I'm not one to gatekeep medical advice, this isn't something I feel qualified to speak about, especially with so many confounding factors. My innate reaction is "probably not a good idea, if the plates are almost fused" but even that isn't a statement from confidence.
Gotcha, no worries man, I totally understand the hesitance, and I appreciate your answer. I just figured I'd ask here of all places because there's usually a lot of lesser-known but enlightening perspectives/info/discussion on here and this is something I've been pondering for a while now. I'll check with an endo I'm going to see soon, my family's opinion is I should just play the minimalist approach and see what nature does now that I'm eating right. But I will ask the endo though, and we'll see what happens from there.
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