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Questions about growth.

Find answers to some of the most common questions about growth hormone-related disorders and treatment. If you still have questions, and can’t find the answers on this website, be sure to ask your doctor.

GROWTH HORMONE THERAPY

Hormones are chemical messengers produced in one part of the body that travel to another part of the body to create some sort of change. Growth hormone is made in the pituitary gland, at the base of the brain, and is very important in helping children grow.

When growth hormone is released from the pituitary gland, it makes the liver release a second hormone called insulin-like growth factor-1 (IGF-1). Together, growth hormone and IGF-1 tell the bones, muscle, and many other organs and tissue to grow by adding more cells. The growth of the bones also requires bone cells to add minerals such as calcium and phosphate, which results in bones that are strong and long.

GROWTH HORMONE DEFICIENCY

A deficiency means there is not enough of something. Growth hormone deficiency means just that: your body is not making enough growth hormone.

Lack of treatment for growth hormone deficiency could result in a child being significantly shorter than they otherwise would be when they reach adulthood. Adults who are not treated for GHD may have changes in the body such as weakening of bones, decrease in amount of muscle, and increase in fat and cholesterol.

Usually an endocrinologist (a doctor who specializes in the study of the hormone system in your body) will be able to tell if you have growth hormone deficiency. The doctor will ask many questions about your health and growth history and about the health and growth history of your family. You will have a physical exam. The doctor may also order a growth hormone stimulation test, or "stim" test.

There are different types of growth hormone stimulation tests. Some are able to measure the level of growth hormone when it is at its highest, for example, after sleep or exercise, because both of these activities increase the level of growth hormone. Another type of test uses a medicine to make the pituitary gland release growth hormone. If the pituitary does not produce growth hormone in response to this "stimulation," it is a sign that the person has a deficiency.

There are several organizations dedicated to education, awareness, and advocacy for people with growth-related disorders. Take a look at the Patient Advocacy Groups.

THE STIMULATION (“STIM”) TEST

The pituitary gland produces growth hormone in different amounts at different times of the day. This makes it difficult to test the amount of growth hormone the pituitary gland is releasing with just one blood sample. So, endocrinologists perform what is called a stimulation test, or "stim" test, which uses a series of blood samples to get a more accurate picture.a There is no one approved method for stim testing, but here’s an example of what might occur (talk with your health care provider for specific information):


Your child will be given an IV and the first blood sample will be taken.


Then, the stimulating medicine will be given. Your child will be closely monitored for any side effects that may occur.


Blood samples will be taken over the next few hours. Your child will be able to rest or do quiet activities during this time.


When the last blood sample has been taken and the test is over, the IV will be removed.


The doctor will communicate with you about when you’ll receive the results of the test and what the next steps will be.


aWith all medicines, there are benefits to using them; however, there may be side effects. The medicines used during the stim test may cause side effects. If you have any questions, ask your health care provider.

Explain the test to your child, including why it’s being given. Talk about the IV. You may want to demonstrate on a doll. Your child’s doctor will likely recommend that he or she not eat and limit physical activity for 10-12 hours before the test, to avoid changing the results.


Keep in mind that the test will take at least several hours and sometimes can take most of a day. You might consider bringing activities for yourself and your child to keep busy while you’re waiting.

Selected Important Safety Information

Do not use Norditropin® if: you have a critical illness caused by certain types of heart or stomach surgery, trauma or breathing (respiratory) problems; you are a child with Prader-Willi syndrome who is severely obese or has breathing problems including sleep apnea; you have cancer or other tumors; you are allergic to somatropin or any of the ingredients in Norditropin®; your healthcare provider tells you that you have certain types of eye problems caused by diabetes (diabetic retinopathy); you are a child with closed bone growth plates (epiphyses).

Indications and Usage

What is Norditropin® (somatropin) injection?
 
Norditropin® is a prescription medicine that contains human growth hormone and is used to treat:
  • children who are not growing because of low or no growth hormone 
  • children who are short (in stature) and who have Noonan syndrome, Turner syndrome, or were born small (small for gestational age-SGA) and have not caught-up in growth by age 2 to 4 years 
  • children who have Idiopathic Short Stature (ISS) 
  • children who are not growing who have Prader-Willi syndrome (PWS) 
  • adults who do not make enough growth hormone

Important Safety Information (cont’d)

Before taking Norditropin®, tell your healthcare provider about all of your medical conditions, including if you:

  • have had heart or stomach surgery, trauma or serious breathing (respiratory problems) 
  • have had a history of problems breathing while you sleep (sleep apnea) 
  • have or have had cancer or any tumor 
  • have diabetes 
  • are pregnant or breastfeeding, or plan to become pregnant or breastfeed

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Norditropin® may affect how other medicines work, and other medicines may affect how Norditropin® works.

How should I use Norditropin®?

  • Use Norditropin® exactly as your health care provider tells you to 
  • Do not share your Norditropin® pens and needles with another person even if the needle has been changed. You may give another person an infection or get an infection from them.

What are the possible side effects of Norditropin®?
Norditropin® may cause serious side effects, including:

  • high risk of death in people who have critical illnesses because of heart or stomach surgery, trauma or serious breathing (respiratory) problems 
  • high risk of sudden death in children with Prader-Willi syndrome who are severely obese or have breathing problems including sleep apnea 
  • increased risk of growth of cancer or a tumor that is already present and increased risk of the return of cancer or a tumor in people who were treated with radiation to the brain or head as children and who developed low growth hormone problems. Contact the healthcare provider if you or your child start to have headaches, or have changes in behavior, changes in vision, or changes in moles, birthmarks, or the color of your skin 
  • new or worsening high blood sugar (hyperglycemia) or diabetes 
  • increase in pressure in the skull (intracranial hypertension). If you or your child has headaches, eye problems, nausea or vomiting, contact the healthcare provider 
  • serious allergic reactions. Get medical help right away if you or your child has the following symptoms: swelling of your face, lips, mouth or tongue, trouble breathing, wheezing, severe itching, skin rashes, redness or swelling, dizziness or fainting, fast heartbeat or pounding in your chest, or sweating 
  • your body holding too much fluid (fluid retention) such as swelling in the hands and feet, pain in your joints or muscles or nerve problems that cause pain, burning, or tingling in the hands, arms, legs and feet. Tell your healthcare provider if you have any of these signs or symptoms of fluid retention. 
  • decrease in a hormone called cortisol. Tell your or your child’s healthcare provider if you or your child has darkening of the skin, severe fatigue, dizziness, weakness or weight loss 
  • decrease in thyroid hormone levels 
  • hip and knee pain or a limp in children (slipped capital femoral epiphysis) 
  • worsening of pre-existing curvature of the spine (scoliosis) 
  • severe and constant abdominal pain can be a sign of pancreatitis. Tell your or your child’s healthcare provider if you or your child has any new abdominal pain. 
  • loss of fat and tissue weakness in the area of skin you inject 
  • increase in phosphorus, alkaline phosphatase, and parathyroid hormone levels in your blood

The most common side effects of Norditropin® include:

  • injection site reactions and rashes, and headaches

Please click here for Norditropin® Prescribing Information.

Norditropin® is a prescription medication.

Novo Nordisk provides patient assistance for those who qualify. Please call 1-866-310-7549 to learn more about Novo Nordisk assistance programs.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800- FDA-1088.

Talk to your health care provider and find out if Norditropin® is right for you or your child.