Short stature is common in people with Kabuki syndrome. Is there anything we can do about it?
Some of our kids have a lack of human growth hormone (hGH), which would of course contribute to short stature. But some of our kids have normal growth hormone levels and still have short stature. There are a number of factors that affect bone growth. Some are hormonal factors, and some are nutritional factors. I have collated some information on some of the factors that may need to be considered for optimising growth. This is not an exhaustive list, but it’s a start 🙂
Hormones that affect growth include:
IGF’s (insulin-like growth factors) – IGF is needed in childhood for optimal bone growth – this hormone promotes cell division at an area at the long end of bones that contains growing bone (an area called the epiphyseal plate). Production of this hormone is stumlated by hGH and can be impaired by undernutrition. IGF1 can actually be increased by increasing protein intake.
hGH (Human growth hormone) – this is a hormone that stimulates growth, cell production and cell regeneration in humans. Please note that HgH is not just responsible for growth – it is considered to be a very complex hormone and many of its functions are still unknown. Recent studies are showing that it can have an effect on mental and emotional wellbeing, as well as helping to maintain energy levels. It has many other functions such as increasing protein synthesis, increasing calcium retention but I wont go into all that here because this post isn’t just about hGH – that needs a book!
Thyroid (T3 &T4) hormones – works in synergy with HgH to promote bone growth. if your child is having issues with growth, then their thyroid hormone levels shoudl be checked, as well as their hGh. Please note that not all blood tests for thyroid hormone are as useful as others – as well as looking at T3 and T4, it is also useful to look at FREE T3 and T4, and reverse T3.
Calcitonin and parathyroid hormone– These are two other hormones made by the thyroid (not measured by looking at T3 and T4). Calcitonin hormone participates in calcium and phosphorous metabolism and help to increase the activity of osteoblasts. Osteoblasts are cells that help to make bone. Parathyroid hormone also helps to regulate the activity of osteoblasts.
Sex hormones at puberty also stimulate a growth spurt.
There are a number of diet related factors that impact on bone growth. To ensure your child has the best chance of growing to their optimal height, the following minerals and vitamins should be available in adequate amounts in your child’s diet (and of course your child’s gut needs to be well enough to ensure that these minerals and vitamins can actually be absorbed and utilized by the body).
•Calcium & phosphorus – directly related to bone growth
•Manganese – helps prevent loss of bone
•Vitamin C – for collagen formation (collagen forms part of the bone matrix)
•Vitamin D – If you don’t have sufficient Vitamin D, then you can’t absorb calcium from food – calcium is required for bone growth and strength
•Vitamins K and B12 – for protein synthesis – protein makes up roughly 50% of the volume of bone and one third of it’s mass.
If you are going to supplement your child with any vitamins and minerals, please remember that our bodies are complex and vitamins and minerals work together.
Sometimes if you add a supplement, you need to add something else to make sure the balance in the body is correct. Some supplements are not suitable for some people depending on their medical history and other medications they may be taking. And some supplements can actually interfere with uptake of other supplements (for example calcium and iron should not be taken at the same time of day, because calcium interferes with iron absorption). So to be sure you aren’t going to do any harm, and that you aren’t going to be spending money on supplements that won’t be absorbed properly, please consult with a professional. I’d suggest that a naturopath ,a nutritionist who has studied nutritional medicine or a biomedical doctor will probably the best practitioners to offer support in this area.
As always – this is just information from an interested mother – I’m not a doctor, I’m not providing advice or suggesting what you should do. Just sharing my own understanding on the factors that are related to growth.
I know this post covers a few different areas, and may be a little technical in parts. But I think it can be good to take a wider view when looking at our (complex) kids, so we can have the best chance of figuring it all out! +