My Son's Height

Dear Doctor,

My son is 13 years old and we took him to a Hospital for bone scans.  The dotor said basically said that there was nothing that could really be done.  His bones aged so much between September and March that growth hormones would only give him an extra 1/2 inch and she said if it were her child she would not put them through growth hormones  for 1/2 of an inch.  He is 5'3.5 " now.  His bones have not fused however.  We heard about a new therapy using Arimidex that could possibly stop the bones from fusing and maybe get a few more inches.  Is there anything else we can try or another treament that may be out there that we can look into?  His bones say he is 16 years old and 4 months.  
Thank you

Rich

I can't find any addtional information on Arimidex and Height

[Deanna L Aftab Guy, MD]

If his bones are more than that of a 16 year old unfortunately growth hormone will not provide much linear growth and he is at risk for more side effect than true benefit. The use of estrogen blockers like anastrazole or Armidex is controversial. This is a drug used to treat postmenopausal women as part of chemotherapy for breast cancer.
We tend to consider use of this drug in the face of significantly early and rapidly progressive puberty. The use theoretically will help prevent further bone maturation due to estrogen but his bones will not get younger per se. I would not advocate use of this, there are side effects.
My question is this, firstly has the endocrinologist reviewed the bone age and are they sure about its reading, also what is the cause of his advanced bone age, is he obese, has he had early puberty, or other concerns that led to the rapid bone maturation.
Who was following him up till this time to see if he was growing well or not.
What is your height and that of his mother ?
I am sure that the endocrinologist has looked at this thoroughly, we get a few kids sent to us who I have to consider the same, often referred at a time when there is not alot I can do to treat.
If his bones are that of a 16 year old boy I would tend to concur and not advocate treatment for growth.

[Frobert]

My son is almost completed with puberty.  Yes, early puberty happened with him.  He started puberty early and they did an initial bone scan, then another in Sept. and they said they still want to just watch it at that point and then had us come back in late March for another bone scan, the doctor was concerned because from the growth chart he was on his way down so we did this bone scan, which when we got into see the endocrinolgoist she was amased that he had almost completed puberty and told us that his bone age is 192 months (he is 13 years and 4 months, I originally said his bone scan was 16 years and 4 months)  So we went online and begged her to do something since our son is very upset about only being 5ft 3inches.    His mom is 5ft 2 inches and I am 6 ft.  I think he would be very gratful if we could get him to 5' 6' or 5' 7'.  On top of this he has a twin that is only in 1st stage of puberty.  We have taken them both to Children's Hopital in Cincinnati so they can study both.

I went online and read the experimental study and very hard to understand it.  It sounded promising but it only looked like in younger bone age children?   Do you think it would be possible at bone age of 16 and if he went on this drug that he could get a few more inches?   He plays hard in select sports and has an athletes heart and he is not overweight, the doctor even commetted that he has no body fat.  I don't remember the exact number.  He actually is trying out for US Junior Olympic soccer team in July.  So it is very important for him to grow, he feels that he won't be able to move on at a higher level in sports.  He is also a straight A and one B student, very bright and very nervous about being short, not just for sports, but everything in life.
He has cried himself to sleep every night this week.  They did do an MRI to rule out a tumor.  I actually called Children's Hospital in Nashville to see about a possible appointment.  I just would like to do something for my son?

What are the side effects of the anastrazole or Armidex?

[debbie_deb]

MY SON HAS A TWO YEAR BONE ADVANCED AGE OF 14 AND HE IS 12. HE IS IN STAGE 5 PUBERTY, AND HE IS ONLY 4'9" HE HAS BEEN ON GROWTH HORMONE FOR 6 MONTHS AND ITS HELPING HIM GROW SINCE WE ARE RUNNING OUT OF TIME. HE HAS NEVER HAD A GROWTH SPURT. I THINK HIS BIGGEST WAS 1/2 INCH.  MY INSURANCE SAY HE IS NORMAL AND REFUSE TO PAY. THIS STUFF IS $2000 A MONTH BECAUSE HE NEEDSS A HIGH DOSE BECAUSE WE DONT HAVE MUCH TIME FOR HIM TO GROW.  HE ALREADY HAS GROWN 2 IN. HOW DO I GET THE PRESCRIPTION COVERED WHEN THEY KEEP SAYING HE IS NORMAL AND DENY IT.  help

[Deanna L Aftab Guy, MD]

If his bones are 16 or older I would NOT advocate treatment, not with growth hormone or with aromatase inhibitors. I know he is upset, this is a very tender subject and it hurts to discuss it with him, but treatment will offer more risks than benefits.
The patient above who is discussing her son who grew on growth hormone has a bone age 2 years younger than your son, so he is able to grow a little more

[Deanna L Aftab Guy, MD]

debbie_deb: there is no way to MAKE insurance pay, if it is denied some growth hormone companies themselves provide some support programs for those who qualify with financial need and this is something your endocrinologist should know how to investigate.
Paying cash for the gh is ridiculous-now a days I am sure you need that money for many many important things and if this is not a medication that is necessary to save a life then it has to be assessed very carefully, work with your doctor to see what your options are so that this does not create undue stress to your family.you really have a little more time than you realize, at least a year or more for growth if treatment is aggressive, so work with your endocrinologist and their nurses that do the approvals, they will see what options you have, it may mean stopping puberty with Lupron(another expensive drug that needs insurance approval :(  .

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