Israel's Growth Hormone Treatment: Navigating Strict Criteria and Long Waits

Thousands of children in Israel who are significantly shorter than their peers are eligible for daily growth hormone injections, offering them a chance to grow and feel more like their classmates. Ziv, a healthy 7-year-old, is one such child receiving treatment at Schneider Children's Medical Center in Petah Tikva because her height was disproportionately small for her age. Her mother noticed the difference when Ziv, at age five, looked like a baby compared to her peers. Ziv's current height is 111.7 centimeters, and the treatment has accelerated her growth rate to about 6.5 centimeters per year, compared to the typical 4-4.5 centimeters for children not receiving the hormone.

The synthetic growth hormone treatment, available since 1985, mimics the natural hormone's function by stimulating growth plates in long bones. For children like Adam, who began treatment at age six and started experiencing social difficulties due to his height, the therapy is crucial. He recounts being called names and feeling isolated, believing no one would want to play with a short child. Experts emphasize that height significantly impacts a child's self-confidence during formative social development stages.

Accessing the treatment in Israel involves a bottleneck of approximately 70 pediatric endocrinologists, leading to wait times of up to six months or more through public health funds, versus two to three weeks in private clinics. Eligibility criteria are stringent, focusing on predicted adult height. Children whose bodies do not produce growth hormone may remain as short as 1.20 meters without treatment, while others like Ziv, who produce the hormone but are significantly short, may qualify if their predicted adult height is below 1.50 meters for girls and 1.60 meters for boys. Some health funds subsidize the treatment, costing around 400 shekels for eligible individuals.

Medical professionals acknowledge the difficulty in setting definitive height thresholds, noting that a child predicted to be 1.59 meters might receive treatment, while one predicted at 1.61 meters might not, despite the latter still being considered very short. A theoretical, unproven concern about increased future cancer risk leads doctors to deny treatment to healthy children with merely short stature. Other potential risks include increased intracranial pressure, effects on blood sugar, and exacerbation of scoliosis.

Looking ahead, experts anticipate that as health concerns are further allayed, eligibility criteria may broaden, potentially allowing children with less severe height differences to receive the hormone to enhance their natural height, similar to the evolving landscape of weight-loss injections. Meanwhile, parents of children not meeting the criteria are advised to focus on emotional support and fostering a low-stress environment, as this can positively impact growth.