I am a radiologist, which is, a doctor who reads x-rays and so
on for a living. 

The main reason your son's doctor wants to take one or two
x-rays of the wrist (or more likely, the hand) is to assess
the maturity of your son's bones - not just to see if the
growth plates have fused, but to know how close they are to
fusing.  This maturity is expressed in the "bone age." 
This matters because it determines how much effect growth hormone
will have on his stature - the earlier the bone age, the more
benefit is possible.

There are tables to estimate how tall he will wind up without
growth hormone, depending on his present bone age, and other
tables to estimate how much to expect from growth hormone.

[Hello Mike... Has it ever occurred to you to think that these
tables might be mistaken? In any case, they do not refer to
boys who inject growth hormone AFTER their bones seem to have
stopped growing.

I have SEEN boys age 19 who grow with growth hormone, when
the tables and their endocrinologists said they would not grow
any more, so the tables AND the endocrinologists were wrong.
I know a boy 19 who grew 2 inches.

Perhaps the tables are right if they do not inject HGH...
but they grew when they injected growth hormone. The tables
and the atlases of bone growth don't refer to boys (or girls)
who inject HGH, and doctors accept the tables as the
unquestionable Truth... and it is False.

I know a boy in Spain who is 21 years old, who was told by
his doctor that HE MIGHT still grow until age 25, with growth
hormone. Maybe it is good to be a doctor in Spain... - Ellis]

Because of the delay in puberty, his bone age is probably LESS
than 14 1/2, but I can't tell how much.  The x-rays would
give you a better idea of how much "bang for the buck" he would
get from growth hormone.

[I agree, that is what the x-rays would tell you... But that
information that was of persons who did NOT use growth hormone,
so you cannot "interpret" the x-rays of somebody who intends
to use HGH from the x-rays of others who did NOT inject growth
hormone. I am TELLING YOU that he will grow. The information
that you can get from an x-ray is not really necessary
since his son is 14 1/2 years old, and what is truly important
is to know will growth hormone make him grow? You
find that out when he grows, or fails to grow. It isn't
a borderline case. He is 14 1/2 years old. HE WILL GROW
because he is 14 years old, and not 23 (which is a borderline
case, for me... I have doubts whether or not he will grow, but
will know without any doubt after he has injected growth
hormone.

What is the reason to recommend not to use growth hormone,
if there are no side effects and there is no reasonable risk
involved? - Ellis

The amount of radiation from a couple of hand x-rays is really
tiny.  It is a low dose per square inch of tissue, and only
a small part of the body is exposed at all.  Also, the hands
are not as sensitive to radiation as some other parts of the
body.  (The risk of cancer from radiation mostly comes from
radiation to more sensitive organs in the body, such as the
thyroid gland, breast (in women), colon, and red bone marrow,
which produces the blood cells. 

In a teenager, the bone marrow in the hands is mostly replaced by
fat (yellow marrow), and the blood cells are being produced by the
marrow in the bones toward the center of the body - mostly the
spine, pelvis, sternum, ribs, scapulae and the skull.)


There also might be an issue with his other hormones.  My
understanding is that it is the sex hormones and to some extent
the adrenals that control puberty, not growth hormone.  Even
though I would not go to an endocrinologist about growth hormone
for anti-aging (which I use), in your case I would strongly advise
that your son see a pediatric endocrinologist, if he has not
already.  The bone age also would give the endocrinologist a
further clue about how much of the short stature is due to a lack
of growth hormone, and how much is due to the delay in
puberty.


Mike Lenker

Thanks Mike, for writing. You are a doctor,
and I am not a doctor, and I don't like to contradict what you
say... but I am sorry I have a different opinion. I do not like
ANY amount of radiation unless it is necessary, and I like to
avoid it if possible. I accept X-rays in the case of broken
bones, but I don't like them only to know IF growth is possible
(especially when I know for certain that it IS possible..) or HOW
MUCH growth is possible.

In any case, whatever it would determine would be THE OPINION
of whoever interprets it, and I think the books that taught him
to forecast growth are mistaken, because they do not consider
if the growth occurs or not, AFTER USING INJECTED HGH. THE FACT
will be the growth that actually occurs. I see it as an
unnnecssary EXPENSE, and also an unnecessary exposure to
radiation, which I don't like.

I agree that Joepizza should take his son to a pediatric
endocrinologist...

but if the endocrinologist tells him that his son will not grow,
or that growth hormone is "not worth the risk", or any other
reason why he should NOT use growth hormone, then he should look
for another endocrinologist, until he finds one who says his son
will grow, because I guarantee he will still grow with
injectible growth hormone even if he is taller than 5'2",
as they have mistakenly said to parents that they will not
grow, and that the "risk" is not worth it, etc.

And if he doesn't find one in the U.S., then he should come to
Mexico and I'll take him to visit a good pediatric endocrin-
ologist here.

Perhaps you think I am exaggerating, but almost every person
who writes to me about growth hormone for their children has
been rejected by a pediatric endocrinologist, because growth
hormone is "too dangerous" or it is "too late" and it will not
work, or the child is "too tall" and it will not work for kids
who are or are projected to be taller than 5'2", etc.

It really and truly saddens (or angers) me to hear about
PEDIATRICIANS who WILL NOT HELP CHILDREN to grow taller because
the pediatrician has a personal hang-up or a moral judgement
about what is "right" or what is "wrong" for children or their
parents to want for their own body.

I agree that perhaps other hormones will be needed, perhaps
testosterone, because the reason the boy is short could be
due to a testosterone deficiency or thyroid deficiency.

Thanks for writing. You can be our resident radiologist
expert, I will write to ask you more questons about interpre-
tation of x-rays. And I would appreciate if you could show us
a table which can predict how tall a child can grow with growth
hormone, assuming that the pediatrician doesn't stop growth
hormone treatment. "According to Ellis" he can play basketball
if he has enough TIME and HGH.

You can be certain that I would recommend that any child who
is short because he is growth hormone deficient should replace
growth hormone for the rest of his life, but unfortunately I am
not a doctor... or perhaps fortunately I am not a doctor, and I
am in Mexico... so who cares? The children who have grown taller
after they were told they would not grow taller care. (My
doctors learn from me, and they are also not tied up...)

Thanks for writing. Three stars for this post. I researched
a little about bone age after reading Mike's comments, and I put
together a page of pictures of x-rays. It is an inexact science
to me, but I'll write more about it... This page is not
finished yet... But I expect it will soon be a very interesting
page. Thanks, Mike!

Predicting Height: Bone Age, Growth Charts - Ellis

joepizza wrote:

Hello

My son, age 14 1/2 has yet to go into puberty. The testes have not
enlarged (usually a sign that puberty is right around the corner,)he
has no bodily hair, his voice hasn't changed and he is off the charts
small. (4' 10", 80 lbs) He is a freshman in high school.

His last physical prompted his doctor to suggest HGH. We must go take
a few tests first. One is to see if his plates are fused.

[This is ridiculous, and I guarantee it is a waste of MONEY
and ALSO unnecessarily dangerous. He is FOURTEEN YEARS old...
I guarantee his bones have NOT fused... take it from there.
- Ellis]

I find that hard to believe. His mom is terrified to the point
of tears, and I am very concerned myself. I am a bit more
knowledgeable about HGH and tried to explain some things about
HGH, but to no avail.

[Why is she terrified? At the thought of HGH, or at the thought
of the unnecessary X-rays? I know you are going to give him the
unnecessary x-rays, but I just wanted you to know they are
superfluous.

As for being "terrified" of HGH, just tell her I have used
HGH every day for 9 years, and I have survived without any
problem... in fact, better than without any problem...- Ellis]

What worries or concerns should we have at this point.

[None. No worries, no concerns about HGH.... be worried and
concerned that the X-rays that doctors are asking for are
unnecessary and risky. - Ellis]

What is the average growth in these cases, and how long does the
process take?

[Depending on the dose of growth hormone, he will grow up to
3 inches MORE THAN HE WOULD HAVE, per year... he will grow that
much as long as you give him HGH... he could be playing on a
pro basketball team by the time he is 20. - Ellis]

He is getting his growth factor measured, what can I expect?

[A large unnecessary bill. I guarantee his "growth factor" is
low... you didn't know this already? - Ellis]

Please no information is unimportant. My boy is at the point of
tears over his slight size and his mom is worried big time.

[Your boy will grow taller, 100% sure, with no side effects,
and there is no reason at all for anybody to be worrried about
anything. He is going to be perfectly well, and the only
side effect is that you will be a little bit poorer. - Ellis]

I want my boy happy and will do anything to facilitate his growth,
SHORT OF INJURY.

[Somebody must have told you some scare stories, maybe so you
spend more money. He is not going to be "injured" in any way,
and he will grow to be 5'6" easily, and 5' 10" or 6'0" if you
give him enough growth hormone. There is no problem, and I
think he might even get better grades in school (ie, his I.Q. will
go UP...) - Ellis]

Please send unbiased info that will put our mind at ease! In the
bit of research I have done, I believe that HGH has gotten a big bad
undeserved reputation.

[Oh, yes, we have known that for many years... I will tell you
what will ease your mind: Before you inject growth hormone into
YOUR SON, inject it into YOURSELF....You will see that it is
going to make YOU feel better too! - Ellis]

PS If this works for my youngest son, and I believe it will, can
it be used on my oldest, 18 years of age ( 5' 2", 105).

[YES... even if DOCTORS tell you it will NOT, I am telling
you it WILL:.. 100% sure. In any case, you have nothing to
lose except MONEY, and money is not worth anything unless you
spend it, and what else better to spend it on than your son's
health and happiness? But you have to hurry... and I would not
say he will be on the pro-basketball team, but I think he might
grow at least 2 or 3 inches, if that helps.

See my page: http://www.rajeun.net/growtaller.html

- Ellis]

It bothers him that he is also the shortest in his class,
even though he HAS gone through puberty. Can he benefit
from HGH therapy.

Many thanks to all.

Smig.

[Puberty has nothing to do with it. It will work because he
is still only 18 years old, and he will grow because he will
grow "according to Ellis"... I know he will grow. - Ellis]