"The Road to "Chasing High" Comics/Gao Yue
● Growth hormone injections generally include three types: short-acting powder, short-acting water and long-acting water, the price increases in turn, and the higher the weight, the higher the cost. Some parents are anxious about their children's height and take the initiative to seek growth hormone
● Although there may be various side effects of growth hormone, which cannot be issued without a doctor's prescription and test evaluation report, there are still parents who rush to it, which has given birth to the purchasing hormone industry chain
● Growth hormone injection in children needs to be indicated, and the need for injection cannot be judged solely based on height. The health authorities should strengthen the training and supervision of doctors, and beware of clinical abuse and overuse of growth hormone
□ Reporter Han Dandong and Zhao Li
□ Liu Jie, intern of this newspaper
The child is 6 years old, only 109 cm tall, according to the "Children's Height Value Comparison Table", belongs to the "short" range - in a panic, He Li, a citizen of Shenzhen, Guangdong, took the child to the hospital for treatment, and asked the doctor to inject the child with growth hormone for a year.
After the injection, the results are noticeable. The child's height grows from 109 cm to 120 cm, and he grows 11 cm taller in a year. But side effects also follow, children often have colds, fevers and other symptoms, but the cause cannot be found.
Do you want to "grow taller" or "healthy"? He Li thought twice and chose the latter. After stopping the growth hormone injections, the child's physical condition gradually returned to normal.
In recent years, growth hormone, which is mainly used in medicine to treat short stature, has become quite popular in the parent circle. Some parents see that their children are taller than their peers, or they want their children to grow taller, so they think of injecting their children with growth hormone.
However, the reporter of "Rule of Law Daily" recently interviewed dozens of parents who had injected their children with growth hormone in Beijing, Shanghai, Guangdong and other places, and found that although their children's height has improved, there are also many side effects.
The interviewed doctors pointed out that growth hormone injections in children need to be indicated, and whether injections are needed cannot be judged solely based on the height of children. At present, there are signs of abuse of growth hormone, which may bring health risks such as endocrine disorders, spondylolisthesis, and scoliosis to users. It is recommended to standardize the use of growth hormone, and the health authorities should strengthen the training and supervision of doctors, and doctors should strictly abide by the relevant guidelines for the diagnosis and treatment of children, and beware of clinical abuse and excessive use of growth hormone. For the violation of profit-driven inducing children to inject growth hormone, the health, drug administration, public security and other departments should form a joint force to strictly investigate and deal with it.
Parents are anxious about their child's height
Actively seek growth hormone
Parents' anxiety about their children's height is on the rise.
On many social platforms, the reporter saw many parents sharing their notes on injecting growth hormone into their children, and many parents left messages in the comment area: "I don't want my child to feel inferior because of his height", "The child is 5 years old and has not yet 1 meter, what should I do", "I have been taking hormones for 3 months, my height is motionless, and I am so anxious......
According to a pediatric endocrinologist in Wuhan, Hubei Province, half of the patients he sees every day are parents who come to consult about their children's height and whether they need to use growth hormone to help them grow taller.
The reporter used a popular search engine to search for "normal height of children", and the first thing that appeared was the "chasing height" advertisement of a private children's hospital: "A 10-year-old girl with normal bone age and short height? The appearance of a child who is lower than the height of children of the same age is a precursor to short stature! Parents should pay attention to the fact that if the child does not grow up, it should be taken for examination in time to clarify the reason and prevent the child from stopping growth prematurely and affecting the child's ......"
The reporter dialed the phone of the private children's hospital and explained his intentions, and the doctor suggested that the child should be made an accurate height prediction through the activity of chondrocytes, and the hospital's full examination fee for height was more than 2,000 yuan. "If you come over on the weekend, it's only 480 yuan. If you need to get a hormone injection after the examination, you can also get another discount. ”
Public information shows that in recent years, with the increase in social demand, the use of growth hormone has been increasing. Between 2016 and 2020, its annual revenue increased by more than 4 times, and more than 90% of its revenue came from growth hormone-related products.
According to doctors in the industry, the full name of children's growth hormone is genetically recombinant human growth hormone, which can only be used to treat growth hormone deficiency, idiopathic short stature, SGA persistent growth retardation after birth, short bowel syndrome, etc., and the scope of treatment cannot be expanded without authorization.
Despite this, some parents still can't avoid anxiety when they see that their children are not growing up, and try to inject their children with growth hormone. An interviewed doctor complained that some parents came to the outpatient clinic and asked for a growth hormone test for their child, but the doctor said that he didn't need to do it and was scolded.
He Li is one of the anxious parents. Both she and her husband are not very tall, and the children may be influenced by genetic factors, and they are thinner than their peers from childhood to adulthood. Seeing that the height of her classmates surpassed her children one by one, He Li was so anxious that she couldn't sleep all night.
She took the child to the doctor and asked the doctor to inject the child with growth hormone. After one year of continuous injections, the child's height grew from 109 cm to 120 cm, compared to only five or six cm the year before without hormones.
Feel free to inject growth hormone
The side effects are very harmful to the body
Although the effect was good, a year later, He Li let the child stop the drug because the side effects were "too great".
"In the year of growth hormone, the child did not perform and react well in all aspects." He Li said that for example, there are often symptoms such as colds and fevers, but the reason for the illness cannot be found, and every time after physical education class, the child always feels muscle soreness, and sooner or later there will be unexplained dizziness symptoms, "these situations have never been seen before taking hormones."
Also because of the side effects after the injection of growth hormone, there is also Xiao He, the daughter of Su Qing, a resident of Beijing.
Xiao He is 9 years old and 134 cm tall. Generally speaking, this height is at a normal level, but Xiao He was detected at a private hospital with a bone age that was two years older, so she followed the advice of the doctors in the hospital and let her child supplement growth hormone to "chase the height".
On the first day after the growth hormone injection, the child will have obvious symptoms of discomfort, dizziness and vomiting, completely unable to eat, and must lie flat to relieve it, and when the situation improves a little, feed some water, and it will also vomit quickly. The next day, the child's dizziness subsided, but he was still unable to eat normally. In the early morning of the third day, the child began to have a high fever, which gradually subsided after taking antipyretics, but the dizziness worsened. It wasn't until the fourth day that the symptoms were relieved.
Su Qing contacted the doctor to consult the situation, and the doctor explained that the child's symptoms of nausea and vomiting may be caused by increased intracranial pressure, but he had never met a patient with such a big reaction before, and the others were generally fine in about half a day.
The doctor suggested waiting for the symptoms to ease before trying to reduce the dose, but seeing that the child's rejection of growth hormone was so great, Su Qing did not dare to take the risk. "In this case, the doctor still asked us to continue the injection, I don't know if we really think there is no problem, or if we don't care about anything in order to make money."
In the interview, the reporter found that parents' anxiety about their children's height is easily used and amplified by informal medical institutions. At present, there are generally three types of growth hormone injections on the market: short-acting powder, short-acting water and long-acting water, and the price is increasing in turn. The two short-acting injections need to be injected every day, the powder cost more than 1,000 yuan per month, and the water dose costs more than 3,000 yuan per month, and the higher the weight, the higher the cost. The price of long-acting water is the highest, and one injection per week requires more than 6,000 yuan per month. For those patients who are unwilling or unable to receive daily injections, some institutions recommend that parents choose long-acting injections if financial conditions allow.
According to industry insiders, some informal medical institutions take advantage of the urgency of parents to make their children taller, touting growth hormone as a "miracle drug". In fact, children with normal growth hormone secretion cannot be injected with growth hormone, otherwise it is easy to lead to endocrine system disorders and other problems.
The reporter learned from a tertiary children's hospital in Zhejiang that if the child's height deviates seriously from the average height, there is a possibility of fighting, and it is necessary to use growth hormone therapy only if the short stature of the disease state is reached. At the same time, it should also be noted that some special short stature diseases are not suitable or even contraindicated, such as achondroplasia, growth hormone is not very suitable; Growth hormone should also be contraindicated for Bloom syndrome.
"Whether you want to inject growth hormone or not, you must find a specialist for a strict evaluation." A pediatrician in a hospital in Hebei told reporters that even if the doctor assesses the physical condition and can take growth hormone, it may also have side effects, such as increased blood sugar, endocrine disorders, and some children may also have hypothyroidism, or accompanied by joint pain, vascular syndrome, myalgia, stiffness, etc.
Purchasing hormones has become an industry
Criminal responsibility for causing casualties is pursued
Although there may be various side effects of growth hormone injections, which cannot be issued without a doctor's prescription and test and evaluation report, the reporter's investigation found that due to height anxiety, there are still many parents who believe that growing taller is a legitimate medical need, and they are eager to do so, which has given birth to the purchasing hormone industry chain. Parents are trying their best to find channels for taking medicine in different places and at low prices on the Internet, and have also set up social groups such as "Grow Tall and High Growth Hormone Exchange Group".
In one of the social groups, the reporter contacted Li Meng, the parent of an 8-year-old child in Cangzhou, Hebei Province. "HGH is too expensive! The ×× brand growth hormone I bought was 30 units each, and the price ranged from 600 yuan to 660 yuan, and the syringes needed to be purchased by myself, which cost about 3,300 yuan per month, while the cost of long-acting water was more than 4,000 yuan per month. Li Meng said, and the doctor only prescribes a one-month amount at a time, and every time he prescribes a drug, he must re-evaluate it, and he will not prescribe the drug if the index is normal.
In order to make the child grow taller, Li Meng had to find other channels to buy medicines. Once, she saw the owner of the above-mentioned social group send a message saying that his monthly cost of using growth hormone water for his child was more than 1,000 yuan.
Li Meng hurriedly asked: "How can I buy growth hormone at this price?" Can the group owner purchase on behalf of the group? Many parents in the group are echoing, and the group owner said that they can buy on their behalf.
The reporter also sent a message to the group owner to "seek purchasing", and the other party replied that "10 units of powder are 60.5 yuan, and 4.5 units of powder are 30 yuan, but they are out of stock this month, and they are all purchased by medical representatives with their real names, and they can be arranged for distribution next month."
The group owner also showed reporters the medicine he purchased from the medical representative: boxed powder, and the outer packaging reads "XX human growth hormone for injection, former name: recombinant human growth hormone for injection".
A few days later, the reporter saw in the group that a group friend sent a message to express his gratitude to the group owner: "I did receive the goods, wrapped in ice packs, and the effect is as good as the hospital after the fight." ”
Wang Yue, deputy dean of Peking University's School of Medical Humanities, said that growth hormone is a prescription drug, but it is not a controlled drug such as psychotropic drugs, narcotic drugs, radiation drugs, and toxic drugs, but it can only be used with a doctor's advice.
"If you buy it for your own use, it's not illegal; However, if the purchasing agent is carried out for the purpose of profit, it is an illegal act, and the relevant departments shall investigate its corresponding administrative responsibility. If the purchased drugs cause disability or even death of the patient, he or she shall be investigated for criminal responsibility. For parents, if the purchased growth hormone is used on a minor, resulting in their disability or even death, the guardian may also constitute a crime. Wang Yue said.
Improve legislation and strictly enforce the law
Regulating use is imminent
Wang Yue told reporters that regarding the use of growth hormone, there are guidelines and norms for the use of growth hormone in the medical community, and doctors should strictly follow the guidelines and norms. However, in practice, all guidelines and norms must be subordinated to the best interests of the patient. Because the specific family history and family history of each patient are different, it is necessary to flexibly grasp the guidelines and norms according to the actual situation. From this perspective, the doctor will treat the individual patient individually.
"In special circumstances, for example, some patients may not necessarily meet the conditions of the guidelines, but are only at the critical value, according to their personal situation and the height of the family, doctors may break the guidelines and guidelines for medication. Guidelines and norms are not absolutely rigid standards. The actual treatment of each specific patient follows a comprehensive assessment. Wang Yue reminded that whether the child can be vaccinated with growth hormone must fully follow the doctor's instructions, and parents have no right to decide.
Ren Zhanmin, executive director of Beijing Guanling Law Firm, said that for the use of growth hormone in children, there are only medical regulations, and there is a lack of legal regulations. In order to curb the problem of random injection of children's growth hormone, it is necessary to strengthen the construction of laws, improve the level of law enforcement, standardize the use of growth hormone from the root, cut off the chain of interests of children's growth hormone, and put an end to all drug abuse that harms the rights and interests of children.
"Doctors need to comply with strict medical norms when using drugs, and must evaluate whether they meet the conditions for medication based on the objective results of consultations, physical examinations and laboratory examinations, and cannot be subjectively influenced by the patient's family. Parents should also observe and understand the doctor's job and refrain from trying to make unreasonable demands on the doctor. If doctors blindly advise children to abuse growth hormone, it is against medical norms and medical ethics. Ren Zhanmin said that in addition, according to the provisions of the "Recommendations on the Clinical Application of Genetically Recombinant Human Growth Hormone in Pediatrics", short stature in a non-disease state should not be treated with growth hormone at will. Misuse of growth hormone can have a negative impact on children's development. If a doctor instigates a patient to abuse growth hormone for an improper purpose such as economic gain, causing adverse consequences, he will be punished by the health authority.
Industry insiders also pointed out that doctors take the initiative to ask or at the request of parents to give growth hormone to children at will, which violates medical norms and medical ethics, and if children are injected with growth hormone improperly, there are growth deformities and other damage consequences, hospitals may also face medical damages. For children with short stature, it is necessary to check the child's bone age, growth hormone secretion level, and rule out various diseases before deciding whether growth hormone therapy is appropriate. For children who do have short stature, growth hormone is currently considered the most effective treatment. Medication at the best time for treatment can promote your child's growth, but it is important to choose a regular medical institution.
For the height anxiety that pervades children and parents, Wang Yue believes that doctors should be good at solving parents' psychological problems, and should alleviate parents' anxiety and eliminate height anxiety through short-term outpatient communication, so that patients can understand that doctors are from the patient's perspective and give suggestions in the best interests of patients; At the same time, it is also necessary to strengthen the popularization of children's growth hormone, help parents establish a correct view of medication, and understand that growth hormone is not something that can be played if you want to, if it is really necessary, it must be prescribed by a professional doctor after relevant examinations.
(The names of the parents interviewed in the article have been changed)
Source: Rule of Law Daily