Hormones are chemicals that tell cells and body parts to do certain things.
They are essential for a child to grow and develop normally.
When people think about hormones, they tend to think of the male and female hormones testosterone and oestrogen respectively.
However, the endocrine glands in both children and adults produce many other types of hormones that are vital for the body to function normally.
Examples of the major endocrine glands in our body are the hypothalamus, pituitary gland, thyroid gland, parathyroid gland, adrenal glands, ovaries, testes and pancreas.
The right amount, as well as the balance, of hormones is very important for everyone.
Hormones control many functions in our body, including brain development, growth, sleep, glucose levels, body metabolism and reproduction.
They are especially important for babies and growing children.
For example, the pituitary gland in the brain releases growth hormone that is essential for normal growth, as well as hormones that trigger puberty.
And the thyroid gland in the neck produces the thyroid hormones that are essential for brain development, growth and body metabolism.
As such, any disruption to hormone production or balance can result in illness.
The common endocrine conditions seen in children are diabetes (types 1 and 2) and conditions affecting height, growth, puberty and bones.
The two main types of diabetes in children are type 1 (T1D) and type 2 (T2D).
T1D usually happens in young children, but can also develop at any age.
T2D usually happens in older children and teenagers who are overweight.
In T1D, the child’s body no longer produces insulin.
Insulin is a hormone that allows the body to use glucose in the blood as energy.
Without insulin, high levels of sugar in the blood cause life-threatening and long-term complications.
The exact cause of T1D is unknown.
However, what happens is that the body’s immune system attacks cells in the pancreas that produce insulin.
Both genetics and environmental factors appear to play a role in this process.
In T2D, insulin is produced, but too much body fat impairs its function, causing insulin resistance.
Over time, insulin production may also be affected.
T2D used to be common only in adults, but it is now increasingly seen in children who are overweight.
The symptoms of diabetes are:
- Frequent urination
- Recurrent bed-wetting
- Thirst
- Weight loss
- Tiredness.
Growth hormone deficiency is a condition where the pituitary gland does not make enough growth hormone.
It can occur at any age as a result of injury to the pituitary gland, genetic factors, a small or absent pituitary gland, or tumours.
In some cases, the cause of the condition is unknown.
A child is more at risk for growth hormone deficiency if they have experienced a brain injury, brain tumour or radiation treatment to the head.
Children with growth hormone deficiency are usually very short, look younger than their age, and have a chubby body build.
They have slow growth, e.g. less than 4-5 centimetres per year between the age of four years and puberty.
They may also have lower levels of other hormones.
In infants, low glucose levels can cause seizures.
They have normal intelligence.
Puberty is when a child starts to develop physical and emotional changes to become an adult.
In girls, early puberty – also known as precocious puberty – occurs if there is breast development before the age of eight or their menses/period come before they turn 10.
In boys, it is enlargement of the testes or penis before the age of nine.
Puberty is usually triggered by the pituitary gland sending hormones earlier than it should to stimulate the ovaries (in girls) and testes (in boys) to make sex hormones.
In girls, the reason of early puberty is often unknown.
For boys, early puberty is uncommon and is usually related to another medical problem.
Less often, early puberty may be caused by a serious condition, such as a tumour, trauma, or problems involving the thyroid or ovaries.
Environmental factors such as oestrogen exposure from food intake, chemicals and essential oils have been suggested as a cause, but there is a lack of strong evidence to support this theory.
Children with early puberty grow faster at first, but they also stop growing earlier due to early bone maturation, which results in a short final height.
They may also have behavioural and self-esteem issues as they may be too young to cope with the changes and feeling different from their peers.
Some children develop later than others (typically called late bloomers), especially boys.
In many cases, there are also family members who are late bloomers.
However, the cause of the late, or delayed, puberty can sometimes be a hormone disorder or medical condition.
Such conditions include thalassaemia, diabetes, cancer, kidney disease, underweight or syndromes like Turner, Klinefelter and Kallmann, as well as being on steroid therapy.
For girls, the signs and symptoms of delayed puberty are no breast development by the age of 13, no menses by the age of 15, as well as the menses not starting within three years of breast development.
For boys, it includes no enlargement of the testes by the age of 14, and no appropriate penile enlargement within four years of the start of testes enlargement.
The effects of late puberty include:
- Absence of pubertal growth spurt, resulting in short stature.
- Poor bone density, resulting in osteoporosis.
- Poor self-esteem with feelings of being different from their peers.
Regular monitoring
A child’s growth and development should be monitored regularly, and a paediatrician should be consulted if there are any concerns.
This is especially important if a child is at risk for health or hormone problems, e.g. if they are:
- Shorter compared to their friends of the same age and sex.
- Not appearing to be growing over several months.
- Obese.
- Undergoing or have underwent cancer treatment.
- On chronic steroids.
- Born premature or with a low birth weight.
- Having thalassaemia.
- Having or have had experience of injury, radiotherapy or surgery to the brain.
Recognition of endocrine conditions is important because early treatment enables the child to maximise his or her potential for normal growth, development and well-being.
Some conditions such as T1D are not preventable, but others are, depending on the risk factors.
For example, avoiding obesity can help prevent T2D.
For all conditions, it is important for a child to eat nutritious food, stay at a healthy weight (avoid over- and underweight) and have enough exercise.
Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. This is the sixth article in a monthly series called Hormones and Kids. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Already a subscriber? Log in
Get 20% OFF The Star Digital Access
Cancel anytime. Ad-free. Unlimited access with perks.
