Frequently asked questions
It is usually best to ask your doctor or nurse any specific questions you may have about your treatment. However this section answers some frequently asked questions about what to expect from treatment and may provide useful guidance. There are three parts:
General treatment information
What does treatment involve?
It is not possible at present to give growth hormone as a tablet because the digestive juices in the stomach would make the hormone inactive. Instead, growth hormone has to be given by injection just under the skin (subcutaneously).
This is much less painful than it may sound! You may remember injections at the doctor’s for immunisation against various diseases, which use quite large needles to inject deep into the muscle. Growth hormone injections use a very short, fine needle, which feels more like a scratch. There are a number of different devices available, including pen delivery systems, to make the process as easy as possible. There are also needle-free delivery systems, which push growth hormone through the skin under pressure. The different options are discussed later.
Injections are usually given every day at bedtime as this fairly closely mimics the body’s natural production of the hormone.
How do I prepare the injection?
Some growth hormone comes as a powder and in order to give it as an injection it needs to be mixed with a liquid (called a solvent or diluent) to make a solution. Both the growth hormone and the solvent need to be kept in the fridge during long-term storage, otherwise they will lose their effectiveness.
Your doctor or nurse will show you how to prepare the injection. There are also forms of growth hormone which are available as a liquid that do not require mixing. Some of the strengths available as in liquid form, do not require refrigeration while in use. Most growth hormone preparations need to be kept in the fridge during long-term storage to maintain their effectiveness. Your doctor or nurse will explain how to store your specific medication both over the long-term (i.e. your 'stock' of medication) and whilst you are using it.
Where do I give the injections?
Subcutaneous injections are best given in the fleshy parts of the body such as the thigh, buttocks or abdomen. It is important to remember to vary the sites of the injections each day, otherwise the area used will become sore and lumpy.
When should I inject?
As with other hormones, there is a daily rhythm of growth hormone release from the pituitary gland into the bloodstream, with the largest amount released in the early night-time hours during deep sleep. This is why growth hormone is often prescribed once-daily in the evening – so as to mimic as closely as possible natural growth hormone release.
What devices are available for giving growth hormone?
There are several injection devices now available to help make giving growth hormone simpler. The major advantage of these devices is that they hold several doses at a time. A needle and syringe can also be used to give injections. To use this you will have to mix the growth hormone powder with the solvent before injecting it.
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Pen devices
Most people find pen devices are easier to use than needles and syringes. There are several options available:
• Some use a ready-to-use liquid growth hormone that needs no mixing
• Others require mixing of the diluent and powder.
Each uses a slightly different technique. Some devices hide the needle and there are auto insertion options.
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Needle-free devices
There are also jet devices that do not use a needle but force the growth hormone through the skin under pressure.
Are there any side-effects of treatment?
Growth hormone treatment is generally well-tolerated, probably because the synthetic version is identical to the natural hormone. Children tend to experience fewer side effects than adults. You may experience slight swelling in your feet or ankles, numbness or tingling of your hands and feet (like pins and needles) or mild muscle or joint pain. These effects are most likely to occur at the start of treatment and often disappear after a few days.
Very rarely, growth hormone causes a headache that does not go away. You should report this to your doctor or specialist nurse; the headache will usually clear if your dose of growth hormone is reduced temporarily. If you are worried about any side effects you should ask your doctor or specialist nurse.
What if I am ill or forget to take an injection?
If you have a cold or bout of flu, or even if you have an infection that requires antibiotics, you should continue taking your growth hormone as usual, unless your doctor tells you otherwise.
To get the most benefit from growth hormone treatment you should try and make sure you take it every day. If you do miss an injection do not try and make up for it by giving yourself a larger dose the next day. Just carry on the next day with your usual specified dose at the usual time.
What about travelling?
If you leave home for a holiday or a business trip, you should make sure you take enough growth hormone with you so that you can keep taking your injections as usual. If you are going abroad you can get a letter from your doctor in order to avoid any embarrassment about taking needles and drugs through customs. However, your GP may charge for this.
Some brands of growth hormone need to be kept in the fridge whilst in use; others do not, provided they are not exposed to temperatures above 25 degrees celsius. During travel, carry your growth hormone in your hand luggage, as it could freeze in the hold of an aircraft.
What is synthetic growth hormone?
Synthetic growth hormone is manufactured chemically in laboratories without using any human cells (in a similar way to modern insulin production). It is identical in structure to natural growth hormone and has exactly the same effects.
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Last updated: April 2008
