DEAR DR. DONOHUE: My grandson is 15 years old, weighs 110 pounds, is 4 feet 11 inches tall and does not exercise. His parents think he is too small for his age. They took him to an endocrinologist, who suggested he take Norditropin shots. These shots are not covered by insurance and cost $26,000 a year. The doctor said my grandson’s growth hormone was deficient. I think that if the boy exercised, nature would take its course. I believe these shots are steroids and not good for kids. — M.K.
Since an endocrinologist, a specialist in the endocrine glands (thyroid, adrenal, reproductive and pituitary glands and the pancreas for the hormone insulin) has tested the boy, you can be sure that the diagnosis is correct. Your grandson’s pituitary gland is not making sufficient amounts of growth hormone. The result is that the boy has not reached normal height and weight. He could exercise for 24 hours a day, every day of the year, and it would not correct the situation. Growth hormone is not a steroid. Growth hormone causes bones to lengthen and strengthen. It stimulates the synthesis of protein, which enhances muscle development. Norditropin is one form of growth hormone.
If growth hormone is started early, before bone growth plates have fused, it will enhance growth and development. Your grandson is approaching the age when his growth plates turn into bone. When that happens, further growth is not possible. The endocrinologist suggested such treatment. He must have grounds to say it will benefit the boy.
The cost is disconcerting. Have his parents appealed the insurance company’s decision to decline this treatment? Did the doctor provide a statement that this boy is in need of such treatment? If the insurance company remains adamant in its position of refusal, the parents should contact the drug manufacturer Novo Nordisk. The number is (800) 727-6500. People there in charge of financial assistance will evaluate the case and see if the boy qualifies for a price reduction. It makes me sick and irate to think that a needed medicine is withheld from a deserving youngster because of an inability to pay.
DR. PAUL DONOHUE is a syndicated columnist with North America Syndicate Inc., P.O. Box 536475, Orlando, FL 32853-6475.