Synthetic human growth hormone was approved in 1985 as a treatment for kids who don’t produce the substance naturally. The manufacturers (Genentech and Eli Lilly) would like to find a larger clientele. The disputed NIH trial, now in its second year, is designed to see what effect the treatment will have on kids with normal hormone levels, but who fall at the lowest end of the height curve. Half of the 80 participants get injections of synthetic growth hormone three times a week. The others get dummy injections. To gauge the effects of treatment, researchers will monitor all the kids until they stop growing.
Advocates of the drug’s wider use insist that while short stature is no disease, it can be a social handicap. They cite research showing that short people tend to lag in school, earn less money, even lose elections. Twelve-year-old Marco Oriti has normal hormone levels but has always been small. After six years of treatment he’s still five inches behind some peers, but his mother credits the drug with narrowing the gap. “I figured he would be short,” she says, “but when I found out he wouldn’t grow as tall as me-and I’m only five feet-that was scary.”
Someone else’s parents may find a smaller gap worrisome. Should any child with nervous parents receive years of costly chemical treatment? If the risks are minimal, and the public isn’t paying the tab, maybe there’s no harm. (Synthetic growth hormone isn’t known to cause serious side effects at standard doses.) But the implications are unsettling. If short stature is to be treated as a medical disorder, Rifkin asks, what other perceived handicap will follow? Skin color?
Some researchers share those misgivings but defend the NIH study as an effort to identify the drug’s possibilities. At the moment, no one knows whether it will increase a normal child’s adult height or simply help him attain it faster. If synthetic growth hormone doesn’t provide extra inches, says Dr. Lynnette Nieman of NIH, the debate over treating healthy kids will be moot. Maybe so. But if the drug works, science alone won’t tell us how to use it.
