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    Monday, June 23, 2003

    Shooting for the Moon: The decision of an FDA review panel to approve growth hormone therapy for constitutionally short children seems misguided at best. Studies aren’t very convincing when it comes to its effectiveness, and no studies have been done to document what harm it might do in otherwise healthy but short children. One study, supported by Genentech, found that growth hormone in healthy children increased height by 5 to 5.9 cm, plus or minus 5.2 cm. That hardly seems worth the high cost and potential harm, does it? Other studies have suggested that using it in healthy children may result in a shorter height than they would attain naturally, because it prematurely matures the bones. (When the bones become mature early, they stop growing.)

    What seems to be lost in all of this is that predictions of adult height aren’t that reliable:

    How accurate is this prediction? Your child has a 68% chance of being within 2 inches and a 95% chance of being within 4 inches of this predicted height. Keep in mind that other factors may influence your child's growth, including his overall health and nutritional status.

    And of course, there’s no way to study the effect of growth hormone on actual height. You can’t zip the child back in time to try all over again without growth hormone.

    Far better to teach your child to accept who he is:

    But the growth hormone boosters believe it goes beyond the cosmetic, and they trot out statistics suggesting that tall folks have better jobs, more money and a greater range of mates. So if I were taller, I would have more money than Ross Perot? Michael Bloomberg? If Michael Bloomberg were taller, would he be mayor of a better city?

    O.K., neither Ross Perot nor I will ever be president; the taller candidate tends to win the popular vote. But somehow I think that height is not the only thing holding us back. Whatever the statistics might say, I can't imagine wanting a better job, or a more beautiful wife. I can imagine making more money, but who can't? So I decline the mantle of victimhood. I'm short. I'm used to it.


    Full disclosure: I’m short, too. And so are all of my children.

    UPDATE: A reader points out that in the long run we all end up drifting toward the mean:

    My great-grandfather the Doctor was a very tall man. It's hard to tell from his pictures, but I'd guess he was 6'4" or so: pretty big for a man born in the 1840s. He married a very short woman, and thus began the shrinking of the clan. His son, my grandfather, wasn't more than 5'10", and married a woman maybe 5'4". I come in at 5'10", my wife at 5'3": when our daughter was on a heavier dose of inhaled steroids for her asthma than she is now, my wife used to worry that her growth would be impaired: I said, how could we tell (now 12, she grew 3+ inches last year, so there)
     

    posted by Sydney on 6/23/2003 08:18:00 AM 0 comments

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