Which factor makes growth hormone replacement therapy most successful?

• A. As soon as growth delays are noted
• B. Timing is not important
• C. Wait until puberty
• D. Begin after growth stops

Answer: (A)

Starting GH replacement early takes advantage of the time when the bones are still growing and the growth plates are open. When a child shows a growth delay, initiating therapy right away allows GH to promote more years of longitudinal bone growth, leading to a higher growth velocity and a greater chance of reaching a normal or near-normal final height. If treatment is delayed—for example, waiting until puberty or after growth has stopped—the growth plates begin to close, leaving less opportunity for height gain and reducing the overall effectiveness of the therapy. That’s why starting as soon as a delay is detected provides the best potential outcome.