GHD – From recognising the signs to rethinking treatment
- For children, a slowing growth pattern can be an important clue to growth hormone deficiency (GHD). Tracking growth over time can help identify changes that deserve a closer look.
- GHD can also continue into or develop during adulthood, when its effects may include changes in body composition, energy, bone health and quality of life.
- Treatment is changing. South Africa’s first and only SAHPRA-registered once-weekly injection indicated for both children and adults with GHD launched in October.
Johannesburg, South Africa – 02 November 2026 – Themba is nine years old. He is healthy, energetic and doing well at school. Over the past year, though, his parents have noticed that his younger cousin is catching up with him in height. The school trousers they bought last winter still fit comfortably and, when his class lines up for a photograph, Themba is usually one of the smallest children in the group.
Children differ in height for many possible reasons, but a child’s growth pattern over time provides more useful clinical information than a single comparison with other children. Growth hormone deficiency (GHD) is one possible cause.
Parents should focus on their child’s growth pattern over time and use tools such as the Road to Health Booklet (the booklet you take to all your kid’s clinic/doctor visits) to track growth. Taking that historical growth data to your next doctor’s visit provides useful context that may help them make a more informed diagnosis.
“Most children will have their height and weight tracked during routine healthcare visits,” says Kelly du Plessis of Rare Diseases South Africa. “The difficulty for families is often knowing when to be concerned and what to do next.”
Diagnosis brings together the child’s growth measurements, medical and family history, physical examination and, where appropriate, laboratory and other investigations.
GHD beyond childhood
We tend to associate growth hormone with children getting taller, because that is its most visible role. But its work does not stop once we reach adult height. Throughout life, growth hormone is involved in maintaining muscle and bone, regulating the way the body uses and stores fat and supporting energy and general wellbeing.
GHD can persist from childhood into adulthood or develop for the first time in adults, often in association with conditions affecting the pituitary gland. Adults with severe GHD may experience increased body fat, particularly around the waist, reduced muscle mass and strength and low energy levels.
Football star Lionel Messi has spoken publicly about receiving growth hormone treatment as a child. His story has helped draw attention to the importance of recognising growth disorders early, so children who need assessment have the opportunity to receive appropriate care, which can now be achieved with once weekly injections. By minimising disruption to daily life for children and adolescents living with GHD and their families, growth hormone deficiency need not be a barrier to fulfilling growth potential.
Recognising that something may be wrong is only one part of the process. Investigation has a cost, and access to treatment can influence whether people pursue a formal diagnosis, du Plessis emphasises.
“Families can find themselves asking whether it is worth pursuing further tests if a diagnosis is unlikely to change the care they can access,” she says.
She explains that this can become particularly difficult when growth hormone deficiency occurs alongside another condition and treatment for the deficiency is regarded as supportive care rather than treatment of the primary diagnosis.
“There are interventions available, and we need funders and public healthcare providers to consider how patients who could benefit from them can access them,” she adds.
Sara Norcross, General Manager of Novo South Africa, says recognising the signs is important, but awareness also needs to lead to appropriate assessment and care.
Norcross comments, “When a child is not growing as expected, families need to know that it is worth asking why. For adults, GHD may look very different, but the principle is the same: people need access to appropriate investigation and, where treatment is indicated, the opportunity to receive the care they need.”
For children with confirmed GHD, growth hormone replacement may be prescribed to replace the deficient hormone.
In adults with confirmed GHD, treatment goals vary, because linear growth is no longer the issue, and treatment decisions are informed by each patient’s circumstances.
When treatment becomes part of everyday life
Historically, growth hormone treatment has usually involved daily injections. One of the challenges is the burden of daily injections, especially for children and their families. That’s why innovation in this space is so important.
Novo introduced the first SAHPRA-registered once-weekly growth hormone treatment available in South Africa for both children and adults with appropriate indications.
By reducing the number of injections from 365 a year to 52, treatment can fit better into people’s lives while continuing to support effective management of this condition.
Treatment burden is relevant for adults too. In a clinical study of adults already receiving daily growth hormone, once-weekly treatment was rated as significantly more convenient than daily treatment.
Norcross says the launch adds a valuable option for South Africans living with GHD.
“For families managing growth hormone deficiency, treatment becomes part of everyday life. Having a once-weekly option may help reduce the practical and emotional demands of injections, while giving healthcare professionals another treatment choice for appropriate patients,” adds Norcross.
Following the curve
Back at home, Themba’s parents still do not know why he is one of the smallest children in his class. What they do have is something useful to look at: how he has grown over time.
For adults, diagnosis requires appropriate clinical investigation. But at either stage of life, recognising that something has changed can be the first step towards an answer.
As South Africa gains its first SAHPRA-registered once-weekly treatment option for both children and adults with GHD, there is an opportunity to change the narrative: from whether a child is growing as expected to how growth hormone deficiency is recognised, diagnosed and treated throughout life.
To start tracking your child’s growth trajectory, download the Novo Road to Health Booklet. For more information about growth disorders, visit Novo’s growth disorders resource.
About Novo
Novo is the global healthcare company that believes lasting health starts now. For over a century, we’ve combined leading scientific expertise with a deep understanding of people’s lives. We develop treatments and support that help millions of people make progress they can see, feel and sustain now and in the future. Every day, over 67,000 employees around the world advance our purpose to drive change for lasting health. Through our partnerships, programmes and investments, we’re working to prevent disease, expand access to treatments and reduce our environmental impact to help even more people live healthier lives. For more information, visit novonordisk.com and follow us on Instagram, LinkedIn, TikTok, Facebook, X and YouTube.
