Question:
Hi there,
I am wondering if you can give me some advice? I’m the mother of a 16-year-old boy who has been diagnosed with delayed growth and puberty. He is currently trying to gain weight as he is also underweight and exercises a lot. He had a bone x-ray which the doctor stated showed a delay in bone age of greater than 2 years. His growth hormone and testosterone levels are also low. On the Tanner scale, he is 2.5. He is currently 5 feet 1 inch. What are your thoughts on him reaching what should be his predicted height of 5 feet 11? I’m so worried about him!
Thank you for any help you can provide.
Answer:
Your doctor should be sending your son to an endocrinologist, who is a specialist in hormones. The typical first set of checks is to find out why his hormone levels are so low. It could be simply delayed growth but it could also be caused by some other problem in the body. “Delayed Puberty in Boys” has a list of some of the many possible causes of delayed puberty. Once the obvious problems are eliminated, the endocrinologist will then decide whether hormone treatments are needed to “kick-start” his development. See Delayed Puberty.
Because problems are involved, guessing how tall he will become is near impossible.
Question:
Thanks for getting back to me! My son is under the care of an endocrinologist at the moment. They have ruled out a pituitary tumor. He thinks if he puts on weight, his hormone problems should hopefully correct themselves. I was unsure whether the delay in bone growth is enough to enable him to catch up with his peers.
Many thanks for getting back to me!
Answer:
It sounds like the current theory is that your son is underweight. That can happen with athletic individuals. Thus, your son follows the doctor’s orders and eats a bit more than he usually does.
As long as your son’s growth plates remain open, he will continue to grow.
Question:
Yes, that seems to be the current plan. He had an x-ray of his bones that indicates there is more than a two-year delay which would give him a bone age of just under 14 years old. Are growth plates still open at that stage and for how long would they remain open?
Many thanks for your help.
Answer:
Bone age is a measure of the progress of development. Instead of dividing the progress into five stages as Dr. Tanner did, the Bone Age Test uses the average age of people as they develop. Thus, a bone age of 13 means the average 13-year-old has equivalent bone development as your son. But since this is an average, this means that there are people who are older who have this point of development and there are people younger who have this point of development.
A bone age of 16 is equivalent to Tanner Stage 5 when growth in height stops. Keep in mind that bone age and physical age are not directly related. Your son is currently stuck at a bone age of 13. When he starts progressing again, I don’t know how fast or slow his bones will develop.
Response:
Thanks, Jeffrey, for the information.