A Chance to Be Taller

By Georgia Harbison

"A lot of kids used to say, 'Ha, ha, shut up, shrimp,' " recalls Jonas Devlin. The Stratford, Conn., eighth-grader is not disabled or deformed; he is merely very short. At 13, he is 4 ft. 7 in., or 6 in. shorter than 97% of the kids his age. But Jonas has high hopes: since he began therapy with human growth hormone three years ago, he has started to grow at a normal pace. The height gap between him and his peers is no longer widening, and it may eventually shrink. Jonas already notices the difference: "Now, because I'm growing faster, I don't get picked on as much."

HGH is a natural chemical in humans that helps promote growth. In the past, when the hormone was in short supply because it had to be extracted from the pituitary glands of human cadavers, injections of HGH were given only to treat children who had a serious deficiency of the chemical.

But now that new genetic-engineering techniques have made the production of HGH possible, it is much more widely available and more readily used. Today thousands of youngsters like Jonas, who have normal hormone levels but a family history of shortness, are able to take the hormone.

While medical experts think that HGH therapy may be justified in cases of extreme shortness, they see a dangerous potential for abuse. Notes Dr. Myron Genel, professor of pediatrics at Yale University School of Medicine: "The question of who should and who shouldn't get growth-hormone therapy is a hornet's nest. The criteria are no longer clear." Many parents have been pressuring doctors to try hormone therapy on children who are not abnormally short. One physician recalls a father who asked if his tall son could be made even taller so he would be sure to make the Notre Dame football team. Says Dr. Joseph Gertner, program director of the Pediatric Clinical Research Center at New York Hospital-Cornell Medical Center: "As people realize that they have control over certain aspects of their appearance, as with orthodontia, nose jobs and breast jobs, those people concerned about stature will want to have therapy for it."

Social pressures fuel the desire to reach a greater height. Study after study has found that taller people achieve more success in business and have an easier time socially. Aware of this research, an author of how-to-succeed- in-business books who wanted his son to be taller asked Gertner for help. Argued the author: "I'd rather my son be 5 ft. 10 and a graduate of N.Y.U.'s business school than 5 ft. 6 and a Harvard Business School graduate. These extra 4 in. in height make much more difference in terms of success in a business career than any paper qualifications you have." Gertner refused to put the author's son on HGH therapy, but some physicians may be more receptive to parental demands. Says Dr. Douglas Frasier, president of the Lawson Wilkins Pediatric Endocrine Society: "There's a lot of heightism in our society. And there's a sense that if you're not tall enough, somebody ought to be helping you get taller."

But HGH therapy is not an easy route to stardom in business or sports. The treatment usually runs from six to eight years, often requires daily injections and costs about $20,000 a year. Generally, medical insurance will pay for HGH therapy if children have a hormone deficiency, but not just because they are extremely short.

Children are not the only ones who may want to take HGH. Adults also produce the hormone, which is believed to help the mature body maintain muscle tone and burn off fat. According to a study reported last week in the New England Journal of Medicine, HGH injections can in some cases help adults who have a deficiency of the hormone to lose fat and gain muscle.

But doctors say such preliminary results do not justify indiscriminate use of HGH. Already the hormone has begun to appear on the black market. As sports officials have cracked down on steroids, some athletes have resorted to injecting HGH in a foolhardy effort to build themselves up. Unlike steroid abuse, HGH use cannot be picked up in routine drug tests. Experts warn, however, that the hormone injections may be dangerous. Researchers fear that high doses of HGH taken over a long period of time could produce such side effects as joint-cartilage problems, diabetes, arthritis and heart disease.

Doctors are concerned that the demand for growth hormone has exploded before they really understand what it can do or what its long-term effects are. While HGH is a helpful treatment for a deficiency of the hormone, its benefits to non-HGH-deficient but short children are not yet well documented. Initial results from studies under way in the U.S. and Europe are only mildly encouraging. A preliminary finding of an eight-year project headed by Dr. Melvin Grumbach and Dr. Selna Kaplan at the University of California at San Francisco suggests that while about a third of the treated children grew faster through adolescence than they would have without the hormone, in the end they added only about 1 1/2 in. to their predicted adult height.

Yet for many unhappy kids who suffer from extreme shortness, the prospect of even a couple more inches seems worth the trouble. Jonas Devlin has no dreams of being a Larry Bird or a Michael Jordan. His goal is considerably more modest: "I would like to be tall enough so that when I sit, my feet will reach the floor."