The goal of treatment is to replace your growth hormone, to improve both your physical symptoms and quality of life.
In Australia from 1 December 2018, growth hormone has been listed on the Pharmaceutical Benefit Scheme for adults who have severe growth hormone deficiency and a very poor quality of life. This includes adults with either:
- A documented childhood onset growth hormone deficiency due to a congenital, genetic or
- Adult onset growth hormone deficiency due to hypothalamic or pituitary disease.
To be eligible for access to growth hormone through the PBS, your Endocrinologist will need to ensure you have had an appropriate dynamic test to diagnose growth hormone deficiency and you have to complete a questionnaire to demonstrate poor quality of life. Your Endocrinologist must then submit a PBS Written Authority application to the Department of Human Services. To continue growth hormone, you need to demonstrate an improvement in quality of life while you are taking it.
For more information about the changes to the Growth Hormone Program, see the Australian Government PBS Frequently Asked Questions document.
Growth hormone therapy is administered as a daily injection into the layer of fat under the skin of the stomach. This can be self-administered and is relatively painless. The dose of growth hormone needs to be tailored for each person, taking into account their sex, age and any other conditions or medications being taken. For example, higher doses may be required in young adults, women, and those taking medications that contain oestrogen (e.g. hormone replacement therapy, oral contraceptives).
Growth hormone therapy is started at a low dose3. Your doctor will then monitor your hormone levels over time. If needed, your doctor will adjust your dose to keep IGF-1 levels within a normal range and to avoid any side-effects.
Side effects can occur in some people. This can include swelling, joint or muscle pain, increased blood pressure and carpal tunnel syndrome (numbness, weakness or pain in your wrist and/or hand). These side effects disappear quickly by reducing the dose.
Once you have the dose right, your doctor will conduct check-ups every 6 months to ensure symptoms are under control, and your hormone levels are in a normal range. They may also send you for a bone mineral density test (DEXA) every two years to check your bone health.