There are big hopes for a short kid

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DEAR DR. DONOHUE: My grandson is 15 years old, weighs 110 pounds, is 4 feet 11 inches tall and does not exercise. His parents think he is too small for his age. They took him to an endocrinologist, who suggested he take Norditropin shots. These shots are not covered by insurance and cost $26,000 a year. The doctor said my grandson’s growth hormone was deficient. I think that if the boy exercised, nature would take its course. I believe these shots are steroids and not good for kids. — M.K.

ANSWER: Since an endocrinologist, a specialist in the endocrine glands (thyroid, adrenal, reproductive and pituitary glands and the pancreas for the hormone insulin) has tested the boy, you can be sure that the diagnosis is correct. Your grandson’s pituitary gland is not making sufficient amounts of growth hormone. The result is that the boy has not reached normal height and weight. He could exercise for 24 hours a day, every day of the year, and it would not correct the situation. Growth hormone is not a steroid. Growth hormone causes bones to lengthen and strengthen. It stimulates the synthesis of protein, which enhances muscle development. Norditropin is one form of growth hormone.

If growth hormone is started early, before bone growth plates have fused, it will enhance growth and development. Your grandson is approaching the age when his growth plates turn into bone. When that happens, further growth is not possible. The endocrinologist suggested such treatment. He must have grounds to say it will benefit the boy.

The cost is disconcerting. Have his parents appealed the insurance company’s decision to decline this treatment? Did the doctor provide a statement that this boy is in need of such treatment? If the insurance company remains adamant in its position of refusal, the parents should contact the drug manufacturer Novo Nordisk. The number is 800-727-6500. People there in charge of financial assistance will evaluate the case and see if the boy qualifies for a price reduction. It makes me sick and irate to think that a needed medicine is withheld from a deserving youngster because of an inability to pay.

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TO READERS: Restless leg syndrome is a major problem for many people, especially older people. The booklet on that topic explains it and its treatment. To obtain a copy, write: Dr. Donohue — No. 306, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What is the risk of prostate cancer coming from calcium intake? I cannot tolerate cow’s milk, but drink two glasses of soy milk every day. It has 330 mg of calcium per glass. I am 70. — H.R.

ANSWER: A few studies suggest that calcium might influence prostate cancer. Most authorities don’t subscribe to that idea. The Institute of Medicine, made up of a panel of experts, recently has set the daily recommended calcium intake for adult males and females 50 or older at 1,200 mg. The upper limit is 2,000 mg. If there were a cancer risk, these people would not have published such calcium recommendations. For people other than H.R., I have to mention that not all brands of soy milk have the same amount of calcium as his brand.

DEAR DR. DONOHUE: What do you think of the paleo diet? My 38-year-old daughter follows it. Her fitness expert boyfriend talked her into it. — C.M.

ANSWER: “Paleo” refers to the time when our ancestors lived in caves. Their diets consisted mainly of lean meat, fish, a few vegetables, some fruits and some nuts. They did not eat grains, sugar, legumes (peas, beans) or dairy products. Humans of that time were not engaged in any farming. The proponents of a paleo diet support it because those ancestral genes are not much different from our own. They feel we are programmed for such a diet.

I’m not a fan. The people of that era were not long-lived. Humans have adapted marvelously to foods that modern agriculture provides us. Why take a step backward? How’s your daughter doing on this diet?

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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