When is replacement therapy usually stopped?

• A. After reaching adult height
• B. When bone growth stops
• C. After puberty completes
• D. When bone growth stops or when parents determine

Answer: (D)

Growth hormone replacement is given to maximize a child’s final height, so it’s continued as long as there is potential for further linear growth. The key indicator is skeletal maturity: once the growth plates (epiphyses) fuse and bone growth stops, there’s no height to gain from continuing treatment, so the therapy is stopped. Puberty finishing isn’t a universal stopping point because growth can still occur before epiphyseal closure, and some individuals may reach near-final height only after several years of puberty. In practice, the decision involves monitoring growth velocity, bone age, and predicted adult height, with families participating in the plan. So stopping when bone growth stops, with family input in the decision, best reflects how this is managed.