Height Treatment with Growth Hormones
Height Treatment with Growth Hormones
Tokyo Kanda Orthopedic Clinic is an outpatient clinic specializing in growth problems (short stature) in children. We provide treatment to those children who are not short but wish to increase their height.
1．Overview of Height Treatment
1-1．Possible and appropriate ages for outpatient height treatment
1-2．People for whom our outpatient height treatment is recommended
1-3．Information on your first visit to our clinic for (short) stature treatment
1-4．Children who aspire to become professional athletes
1-1．Possible and appropriate ages for outpatient height treatment
Recommended ages for treatment
・Males 5-14 years old （by your child’s 14th birthday）
・Female 5-13 years old (by your child’s 13th birthday)
We do not recommend that male patients over 14 years old and female patients over 13 years old to receive this medical treatment, but in consideration of individual differences, we accept patients under 15 years of age for an initial medical examination.
We can also provide medical examinations for children under 5 years old, if we are consulted in advance.
When receiving a medical examination:
Parents or guardians must be present.
In regard to my (Dr. Yu Tanabe) specialization in the field of increasing height in patients, my expertise is in treating idiopathic short stature (constitutional short stature) and those who are already taller than average but wish to increase their height. Both of these issues are treated at our clinic:
・Those who are not ill but suffer from short stature
・Those who wish to increase their height
If you either of these apply to your child, please feel free to consult us.
1-2．People for Whom our Outpatient Height Treatment is Recommended
✔️Those who were told by other clinics and hospitals that there is no specific treatment
✔Those who want to receive treatment at a hospital with rich experience at their own expense because insurance does not cover the treatment for growth hormone deficiency
✔ Those who were not diagnosed with precocious puberty, but have concerns about it
✔️Those who want to increase their height but do not know what to do
✔️ Those who consider receiving growth hormone therapy for idiopathic short stature (constitutional short stature)
✔️Those who are not short but wish to increase their height
✔️Those who take supplements but aren’t seeing the results they are seeking
✔️ Those who are worried that their children will be short because both the parents are short
✔️Those who want to be as tall as possible because they want to be an athlete or a model
1-3．First Visit to Our Clinic for (Short) Stature Treatment
- (1) Making an appointment
- (2) Visiting the clinic
- (3) Height measurement /Filling out our medical questionnaire form
- (4) Preliminary Examination
- (5) Medical examination
- (6) Lab work
- (7) Those who wish to receive nutritional guidance
- (8) Those who wish to take growth hormone therapy
(1) Making an Appointment
For appointments, please call us at 0305295-2020 or via Line or our website.
(2) When Visiting the Clinic
Please bring your insurance card (if applicable) and as much information/records that you have of your child’s height and growth.
Children cannot visit the clinic alone.
(3) Height Measurement /Medical Questionnaire
We will measure the height and weight of your child.
We will confirm lifestyle habits via a medical questionnaire.
(4) Examination
X-ray of the hand(s) will be taken.
(5) Consultation
・Record of growth and development
・Current height
・Height of parents
・X-ray results (bone maturation and presence of epiphyseal line)
・Lifestyle habits
The doctor will predict your child's final height based on the above items.
(6) Lab Work
Blood samples will be taken to measure growth hormone levels, bone metabolism, vitamin levels, mineral levels, sex hormone levels, thyroid hormone levels, etc., and to gather information on how to grow taller efficiently.
※Blood test results usually come back in about a week.
A follow-up exam will be scheduled to discuss lab work findings（or we will explain them to you via an on-line follow-up exam)
(7) Those Who Wish to Receive Nutritional Guidance
Nutritional guidance will be provided by calculating nutritional requirements based on blood sampling data.
For nutritional guidance, you will need to visit the clinic about every three months to have blood samples taken and height measured.
(8) Those Who Wish to Receive Growth Hormone Treatment
In addition to nutritional guidance, those who wish to proactively increase the height of their child may consider growth hormone therapy as an option.
Initially, follow-up visits will be scheduled for 1-2 months. After that, follow-up visits will be every 3 months.
1-4．Children Who Aspire to Become Professional Athletes
We also recommend that children who aspire to become professional athletes schedule an examination with us.
- Is being tall an advantage to being successful in the professional sports world?
- Messi, the world's biggest soccer star, received growth hormone treatment
- Through blood tests and examination, we will be able to predict the final growth height of your child
As is widely known, there is a certain relationship between sports and height.
Volleyball and basketball players, as well as professional soccer and baseball players are often taller than average.
On the contrary, there are players like Messi, who is about 170 cm tall, who are the face of their sport.
In the case of horse racing jockeys, conversely, it is said that shorter people have an advantage. In martial arts, where there are different categories, so height can either be an advantage or disadvantage.
However, in general, there are many sports where taller people actually have an advantage, and many people want to increase their height due to this.
Messi, the world's biggest soccer star, received growth hormone treatment.
He is now about 170 cm, and he would have been about 160-165 cm without receiving growth hormone treatment.
It is said that he had a disease called growth hormone deficiency for which he was treated with growth hormone replacement therapy, but it is quite possible that he had constitutional (idiopathic) short stature but it was not pathological.
That is because that if the growth hormone secretion was pathologically low, there is a possibility that the growth hormone deficiency may continue to some extent into adulthood, and if that is the case, it is a little doubtful whether he could maintain such superhuman performance.
We do not know the truth, but we believe it is at least true that he has increased his height through growth hormone replacement therapy.
First, we will predict the final expected height of your child.
As stated above, for children who aim to become professional athletes, growing taller can be extremely important.
First, it is desirable for the doctor to predict the final height of the child from x-rays, growth records, and the like at our clinic.
In addition, doing lab work to provide accurate nutritional lifestyle guidance based on blood test results to increase height efficiently is needed.
How to make an appointment
If your child is aiming to become a professional athlete, why not schedule a final height prediction and nutritional guidance at our clinic?
For reservations, please call us at 03-05295-2020 or make an appointment via Line or our website.
2．Guidance on Improving Lifestyle Habits (diet, sleep, and exercise)
Lifestyle habits are important factors in growing taller.
There are cases where improvement in height can be achieved by changing lifestyle habits rather than by implementing medical intervention in the initial stage..
Nutritional Guidance (supplements)
The use of supplements such as zinc, iron, vitamin D, amino acids, or other supplements may be prescribed.
The cost is approximately 30,000 yen/month (depending on weight and blood sample results of your child).
3．Growth Hormone Therapy
3-1．Overview of Growth Hormone Therapy
3-2．Benefits Expected from Growth Hormone Therapy
3-3．Price of Growth Hormone Therapy
3-4．People who Wish to Know More About Growth Hormones
3-1．Overview of Growth Hormone Therapy
Growth hormones play a very important role in increasing height, and although they are produced within the body, they can be administered by injection to help increase height.
Treatment consists of daily self-injections (often given by parents for younger child).
3-2．Benefits Expected from Using Growth Hormone Therapy
The degree of the change in height depends on the individual. We can make a determination what to expect after we have concluded our examination of your child.
3-3．Price of Growth Hormone Therapy
【Medical treatment covered by insurance】
・Turner syndrome
・Achondroplasia、hypochondroplasia
・Prader-Willi syndrome
・Noonan syndrome
・Hypopituitarism (congenital or acquired)
・Short stature due to chronic renal failure
・If your child is “diagnosed” to be short stature due to growth hormone deficiency, the treatment will be covered by insurance (if you have a Japanese health insurance plan) and the charges will be calculated based on that.
【Self-pay medical treatment】
For children who do not have idiopathic short stature, costs for this treatment will not be covered by Japanese health insurance. Therefore, treatment will need to be paid out-of-pocket.
In the field of increasing height, our clinical director (Mr. Yu Tanabe) specializes in treating "idiopathic short stature" and those who are "not short but wish to increase their height".
If other hospitals are not able to provide treatment for your child, please feel free to consult us.
For self-pay medical treatment, the estimate is about 70,000 to 400,000 yen/per month.
Japanese growth hormones cost about (1 bottle: 10mg): 70,000 yen (tax included).
*Please not that there are other growth hormones that exist which cost less, but they are not as effective as the ones we use at our clinic. Furthermore, they may have strong side effects.
The growth hormones we use are selected by our director, who is an expert in this field of medicine.
Below are estimates of how much out-of-pocket expenses for growth hormones may be for parent’s reference (exact costs will depend on the individual child.)
Body weight 20kg: 140,000 yen/month (1,680,000 yen/year)
Body weight 30kg: 210,000 yen/month (2,520,000 yen/year)
Body weight 40kg: 280,000 yen per month (3,360,000 yen per year)
Body weight 50kg: 350,000 yen/month (4,200,000 yen/year)
Exact types of treatment will be determined after your child has been examined.
The cost of growth hormone replacement therapy is determined by body weight. Treatment for a 50kg child will cost approximately twice as much as a child weighing 25 kg.
Exact dosages per body weight will be determined by the doctor based on the results of a medical examination.
There are several methods for determining dosages, and choosing the correct one is of upmost importance.
The following is a list of other miscellaneous expenses that may be incurred.
・100 pieces of alcohol cotton: 1000 yen
・60 units Hexedine one-shot: 600 yen
・(Antiseptic cotton for those who get rashes from alcohol)
・70 needles: 3,000 yen
・Growth hormone injection pen (with hook)：5,000 yen
・Cooling bag set: 200 yen
3-4．People Who Wish to Know More about Growth Hormones
・What are growth hormones?
・The relationship between height and growth hormones
・Effectiveness and safety of growth hormone replacement therapy
・The actual effects of growth hormone replacement therapy
・Should growth hormone replacement therapy be used!? High ethical standards are required
What are growth hormones?
Growth hormones, as the name suggests, are hormones related to growth (height).
The terms "male hormones" and "female hormones" may be familiar to you. Growth hormones are exactly the same kind of substances secreted by the body.
Strictly speaking, growth hormones are a substance secreted by the pituitary gland (a gland located at the base of the brain) and is a protein consisting of 191 amino acids.
The relationship between height and growth hormones
There are many important factors in growing taller.
Adequate nutrition, including protein, vitamins, and minerals, as well as the quality and length of sleep, exercise habits are all important factors in growing taller.
It is important to understand what parts of the above are lacking and need to be changed to help your child grow taller.
There are children who get appropriate nutrition, sleep well, and exercise appropriately, but still have difficulty growing taller. Perhaps the cause lies in growth hormones.
Although everyone secretes growth hormones, the amount secreted varies and there are significant individual differences.
Growth hormone deficiency is known as the cause of short stature, while excessive growth hormone secretion is also known as the cause of overgrowth.
The fact is that height and growth hormone are closely related.
Effectiveness and safety of growth hormone replacement therapy
Growth hormone replacement therapy should not be given to everyone, but should only be given to those who are deeply troubled by idiopathic short stature, and other causes.
・Efficacy and Safety Results of Long-Term Growth Hormone Treatment of Idiopathic Short Stature.
・Effects of Growth Hormone Therapy on Height Velocity in Korean Children with Idiopathic Short Stature: A Phase III Randomized Controlled Trial
The effectiveness and safety of growth hormone replacement therapy have been suggested in various papers as above.
According to these reports,
Growth hormone replacement therapy can nearly double the growth rate or improve it by about 1.2 above the standard deviation (approx. 9 cm in terms of final height) after 3 years of treatment.
In terms of safety, it is considered to be relatively safe to replenish what is produced by the body through external administration.
On the other hand, it is a highly specialized treatment which requires sufficient knowledge and rich experience in treatment.
Efficacy of Short-Term Growth Hormone Treatment in Prepubertal Children with Idiopathic Short Stature
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874918/
This paper presents data when Eutropin, which is said to have a high market share in Korea, is administered at 0.37 mg/kg a week.
The results also show that there is a significant increase in height, and most of the side effects are minor.
Recombinant growth hormone therapy for prepubertal children with idiopathic short stature in Korea: a phase III randomized trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852196/
This is the data when Growtropin®-II (recombinant human GH) is administered at 0.37mg/kg a week.
In other counseling sessions, we will explain the effectiveness and safety while referring to the following literature.
References
“Int J Pediatr Endocrinol
. 2014;2014(1):15. doi: 10.1186/1687-9856-2014-15. Epub 2014 Jul 16.
Growth hormone significantly increases the final height of children with idiopathic short stature: comparison of subgroups and benefit Juan F Sotos 1, Naomi J Tokar 2”
Cited from Abstract, Results:
The objective was to conduct a retrospective analysis of our experience with 123 children with ISS treated with 0.32 ± 0.03 mg/kg/week of rhGH,
Eighty-eight of our children (68 males and 20 females) attained an adult height or near adult height of -0.71 SDS (0.74 SD) (95% CI, -0.87 to -0.55) with a benefit over untreated controls of 9.5 cm (7.4 to 11.6 cm) for males and 8.6 cm (6.7 to 10.5 cm) for females.
The treatment was safe. There were no significant adverse events.
“J Pediatr. 2005 Jan;146(1):45-53. doi: 10.1016/j.jpeds.2004.08.055.
Growth hormone (GH) treatment to final height in children with idiopathic short stature: evidence for a dose effect
Jan M Wit 1, Lyset T M Rekers-Mombarg, Gordon B Cutler, Brenda Crowe, Tracy J Beck, Kristen Roberts, Anne Gill, Jean-Louis Chaussain, Herwig Frisch, Rafael Yturriaga, Andrea F Attanasio”
Cited from Abstract:
Mean overall height gains (final height minus baseline predicted height) were 7.2 cm and 5.4 cm for the 0.37 mg/kg/week and 0.24 mg/kg/week dose groups, respectively, without dose effects on safety parameters.
GH (Growth Hormone) treatment dose-dependently increases height velocity and final height in children with idiopathic short stature.
“Safety of Growth Hormone Treatment in Pediatric Patients with Idiopathic Short Stature
Charmian A. Quigley, Anne M. Gill, Brenda J. Crowe, Kristen Robling, John J. Chipman, Susan R. Rose, Judith L. Ross, Fernando G. Cassorla, Anne M. Wolka, Jan M. Wit ... Show more
The Journal of Clinical Endocrinology & Metabolism, Volume 90, Issue 9, 1 September 2005, Pages 5188–5196”
Cited from Abstract:
Recombinant human GH (Growth Hormones) was approved by the United States Food and Drug Administration in 2003 for the treatment of idiopathic short stature (ISS).
GH (Growth Hormones) appears safe in ISS; however, the studies were not powered to assess the frequency of rare GH-related events, and longer-term follow-up studies of GH-treated patients with ISS are warranted.
“Growth Horm IGF Res . Oct-Dec 2018;42-43:80-85. doi: 10.1016/j.ghir.2018.09.003. Epub 2018 Oct 2.
Efficacy and safety of recombinant human growth hormones in treating Chinese children with idiopathic short stature
Yan-Qin Ying 1, Ling Hou 2, Yan Liang 1, Wei Wu 1, Xiao-Ping Luo 1”
Cited from Abstract:
rhGH has a good growth promoting effect on ISS (Idiopathic Short Stature) children.
A variety of factors may affect the GV (Growth Velocity), and related adverse reactions should be monitored during the treatment.
“Horm Res Paediatr
. 2019;91(4):241-251. doi: 10.1159/000500087. Epub 2019 Jun 11.
Height Gain and Safety Outcomes in Growth Hormone-Treated Children with Idiopathic Short Stature: Experience from a Prospective Observational Study
Christopher J Child 1, Charmian A Quigley 2, Gordon B Cutler Jr 3, Wayne V Moore 4, Kupper A Wintergerst 5, Judith L Ross 6, Ron G Rosenfeld 7, Werner F Blum 8”
Cited from Abstract:
Thus, GH (Growth Hormone) treatment of ISS appears to have a safety/effectiveness profile similar to that of IGHD.
“Clin Endocrinol (Oxf)
. 2018 Apr;88(4):515-528. doi: 10.1111/cen.13502. Epub 2017 Nov 20.
Long-term safety of growth hormone-A combined registry analysis
Kirstine Stochholm 1 2, Wieland Kiess 3”
Cited from Abstract:
Patients with risk factors for malignancy or type 2 diabetes should be treated with caution and monitored during follow-up, but current published data provide reassurance on the long-term safety profile of GH in patients receiving GH treatment.
“J Clin Endocrinol Metab
. 2008 Nov;93(11):4342-50. doi: 10.1210/jc.2008-0707. Epub 2008 Aug 26.
Dose-dependent effects of growth hormones on final height in children with short stature without growth hormone deficiency
Kerstin Albertsson-Wikland 1, A Stefan Aronson, Jan Gustafsson, Lars Hagenäs, Sten A Ivarsson, Björn Jonsson, Berit Kriström, Claude Marcus, Karl Olof Nilsson, E Martin Ritzén, Torsten Tuvemo, Otto Westphal, Jan Aman”
Cited from Abstract:
GH therapy was safe and had no impact on time to onset of puberty
After 5.9+/-1.1 yr on GH (Growth Hormone) therapy, GH treatment significantly increased FH in ISS children in a dose-dependent manner, with a mean gain of 1.3 SDS (8 cm)
“Efficacy of Short-Term Growth Hormone Treatment in Prepubertal Children with Idiopathic Short Stature”
Yonsei Med J. 2014 Jan 1
Cited from Abstract:
This 6-month daily GH treatment in children with ISS (Idiopathic Short Stature) demonstrated increased height velocity, improved height SDS (Standard Deviation Score), and increased IGF-I and IGFBP-3 levels with a favorable safety profile.
“The Challenge of Defining and Investigating the Causes of Idiopathic Short Stature and Finding an Effective Therapy” HORMONE RESEARCH IN PEDIATRICS Published online: October 2, 2019
Cited from this article:
The choice to start or not should be shared with the family [67], informing them that the average increase in height is approximately 5 cm and that the response is highly individually variable.
Cited from this article:
No treatment has been effective in all children with ISS (Idiopathic Short Stature)
The actual effect of growth hormone replacement therapy
Based on my own treatment experience, as well as papers and other public data, the “actual” situation is that the treatment will not be effective unless at least six months of treatment is given, and it is recommended to receive one to two years of treatment. The effectiveness of treatment varies greatly from person to person.
In particular, the timing of treatment initiation has a significant impact on the effectiveness of treatment.
The most effective and appropriate time to start treatment is before the onset of puberty.
Some reports have indicated that the final height is closely related to absolute height at the beginning of puberty.
It is also true that there is a difference in the treatment effects even if growth hormone replacement therapy is performed at the same time.
The possible reason for the difference in treatment effects lies in lifestyle habits such as sleep, exercise, and diet. Genetic factors are also considered relevant.
Growth hormone replacement therapy should not be done!? High ethical standards are required
We understand that growth hormone replacement therapy is not yet a common treatment that everyone can receive.
Short stature in itself is not a disease, but high ethical standards are required for judging whether height should be increased by medical means.
The need for high ethical standards is not limited to height treatment, but perhaps equally so to other treatments.
To what extent should therapeutic intervention be performed if there is no hope of recovery, and the patient does not want to receive the treatment anymore?
There may be insufficient evidence of its effectiveness, but if the patient strongly wishes to receive treatment as a last hope, should therapeutic intervention be continued?
Orthodontic treatment is suitable for extremely misaligned teeth, but should slightly misaligned teeth be treated?
Should therapeutic intervention be performed to treat the nose, which is not a concern to others at all, but is the biggest inferiority complex for the individual?
A fracture can be healed without surgery, but should one undergo a risky surgery to try to achieve more than just healing the fracture?
As mentioned above, treatment selection is often made with high ethical standards in the medical community.
The same is true for growth hormone replacement therapy. Currently, it is not a treatment that can be received by everyone, and it depends on the mindset of the individual's family towards height and their social situation.
4．Other treatments
4-3．Nutritional Guidance (supplements)
4-1．Primobolan
Is an anabolic steroid.
4-2．Leuplin Suprecur
Leuprorelin injections can be used for short stature associated with precocious puberty (early puberty).
4-3．Nutritional Guidance (supplements)
Supplementation with zinc, iron, vitamin D, amino acids, etc. will be provided.
Approx. 30,000 yen/month (depending on weight and blood sample results)
5．How to make an appointment (notes for first-time patients) and price information
5-1．How to Make an Appointment
5-2．What to Bring with You to the Clinic
5-3．Medical Examination Fee（What can be learned from the first visit?）
5-4．Nutritional Guidance (supplements) Fee
5-1．How to Make an Appointment
Appointments are required when wishing to visit our clinic.
Please contact us first via LINE or by phone (03-5295-2020).
Appointments must be made by parents or guardians.
Recommended ages for treatment
・Males 5-14 years (by your child’s 14th birthday)
・Female 5-13 years (by your child’s 13th birthday)
We do not recommend that patients over the age (males over 14 years old and females over 13 years old) receive this medical treatment, but in consideration of individual differences, we accept patients under 15 years old for the initial medical examination. (A Follow-up examination will be conducted even if the patient is over 15 years old.)
Click here for the automatic online reservation system for outpatient height treatment
Approximate price of growth hormone therapy:
The approximate price of high-volume growth hormone therapy (self-pay):
Body weight 20kg: 140,000 yen/month (1,680,000 yen/year)
Body weight 30kg: 210,000 yen/month (2,520,000 yen/year)
Body weight 40kg: 280,000 yen per month (3,360,000 yen per year)
Body weight 50kg: 350,000 yen/month (4,200,000 yen/year)
These are only approximate prices for your reference only, and the method of administration will be decided upon medical examination.
The minimum treatment period is 1 year and the recommended treatment period is 2 years or more.
5-2．What to Bring with You to the Clinic
Japanese insurance card (if applicable).
Height and weight data（Please refer to the mother-child handbook—given out at Japanese hospitals when your child is born)
(Note on height data: Record centimeters by age, but be sure to record the centimeters by age in months.)
Parents' height can be measured at the clinic on the day you visit the clinic with your child.
5-3．Medical Examination Fee: From March 1, 2022
- Initial examination for height treatment
(Including x-rays, nutritional guidance, final height prediction, and lab work)
- Regular
▶50,000 yen (including tax)
- Exclusively for subscribers to YouTube Dr. Height channel
▶30,000 yen (including tax) (from March 1, 2022)
- Patients referred by existing patients who are receiving height treatment
▶16,000 yen (including tax) (from March 1, 2022)
■Follow-up examination of height treatment
- Regular
▶3,000 yen (including tax)
- Exclusively for subscribers to YouTube Dr. Height channel
▶1,000 yen (including tax) (from March 1, 2022)
Click here to subscribe to the YouTube Dr. Height channel↑
What can be learned from your initial visit to our clinic?
By having a medical examination,
・The doctor will directly predict your child’s final height based on five data points.
A two-page document will explain the prediction results and how the prediction outcome was derived.
・We will provide a brief overview of height therapy and give prediction on the height that can be achieved through therapy. At that time, we will also introduce the literature on growth hormone therapy and provide you the information on individualized treatment.
・We will tell you what nutrients you are deficient in and how to replenish them as well as the approximate cost.
・We will explain lifestyle habits along with a 4-page document (it is an explanation of the outline of Dr. Height YouTube)..
In addition, at the first medical examination, we will provide a document with more than 10 pages written for each patient in addition to the above information.
The fee for online reporting of lab test results is also included in the above fee amount.
Click here for the automatic online appointment system for outpatient height treatment
5-4．Nutritional Guidance (supplements) Fee
Supplementation with zinc, iron, vitamin D, amino acids, etc. will be provided.
Approx. 30,000 yen/month (depending on weight and lab results results)
5-5．Blood Test (Lab Work) Fee
Blood Collection: 15,000 yen (including tax)
Below are the items which will be checked through blood work:
・Growth hormone concentration (somatomedin)
・Bone metabolism
・Male hormone concentration
・Female hormone concentration
・Zinc concentration
・Vitamin D concentration
・Renal function
・Liver function
・Glucose metabolism
The above items are required to adjust dosage amounts and predict your child’s final height. Blood tests results will also help determine more accurately whether nutritional guidance is needed and to understand growth hormone levels.
A follow-up blood test will be done every 2-3 months during treatment.
Click here for the automatic online appointment system for outpatient height treatment
6．YouTube (Dr. Height) Channel
Currently, Director Tanabe has a YouTube channel under the name Dr. Height.
The channel provides information about height.
If you wish to increase the height of your child, please subscribe to our channel.
7．Online Medical Treatment/Remote Medical Treatment
About Online Medical Treatment
7.1 About Online Medical Treatment
Online Medical Treatment is for patients currently undergoing treatment at our clinic and those who return for a follow-up visit. (Revised on August 6, 2021)
Appointments can be made by phone (03-5295-2020) or via LINE.
7-2．Online Follow-up Fee
The cost for an online follow-up appointment is 10,000 yen.
