Children with suspected hormone disturbances need careful assessment and investigation by a specialist endocrinologist/diabetologist. You can expect a detailed history of the illness to be discussed with you, a full clinical examination, measurement of height, weight and head circumference and, where indicated, ultrasound and blood testing. In children with growth or puberty disorders, an X Ray of the hand may be required. This allows us to look at skeletal development and calculate a “bone age” as well as remaining growth potential.
Further diagnostic testing looking at chromosomes or individual genes is occasionally recommended. Dr Johnston is trained in counselling for genetic tests and will discuss the advantages and disadvantages of testing with you before you have to take your decision.
In the case of a hormone deficiency then replacement therapy is usually recommended. Today hormones are produced synthetically in modern biotechnology laboratories and any potential side-effects will be discussed before treatment is prescribed. Thyroid and adrenal hormones can be taken orally. Growth hormone and insulin are only available as injections and families receive a personal training session in order to be able to administer this therapy themselves at home. Sex steroids (testosterone, oestrogen and progesterone) come in a variety of formulations and the appropriate one for your child will be recommended.
In the case of hormone excess, a medical therapy is usually given to suppress this.
Occasionally where this is not successful alternative therapies, including surgery, must be considered.