Brief Answer:
Few questions

Detailed Answer:
Good day,
Noted your concern.
Height of a person is dependent very much on hereditary and genetic factors.
We need to find out why she stopped growing. At Menarche they will have the accelerated growth of 11-12 cm a year and after 3-4 years, the growth rate will reduce. It could be the case with her. What is her father's and mother's exact height ( in centimeters). Can you tell me the exact DHEA-S report? Was it done in the fasting state 2-3 days after starting of periods?
Did she have a thyroid blood test? How is her period now?
Regards
Binu

---

Brief Answer:
DHEA-S is normal. She is in the range of her genetic height potential

Detailed Answer:
Her genetic potential of height is 160 cm +/- 10 cm ( based on parent's height).
Thyroid blood tests are normal. So in fact she is with in normal range of her height now.

DHEA-S is normal. ( actually it should be done on empty stomach on day 2 or 3 of periods).

Braces doesn't cause any change in height.

You may need to meet an endocrinologist to examine her and also to do an XRAY of wrist to look at bone age.

Regards
Binu

---

Brief Answer:
IGF-1 and Xray reports. Can you attach them?

Detailed Answer:
DHEA-S of 7.1 is just high and can not be considered abnormal. Besides, the time of collection was not right. We consider it significant when the levels are above 10 and alarming if the levels are > 22.

It is quite common for DHEA-S ( an adrenal male hormone secreted in boys and girls) to be little above normal in puberty. DOes she have any excess hair growth in face or chest etc?

What do you mean by 98% in Xray. I wanted to know the bone age. Can you attach the Xray ??

Ashwagandha is an ayurvedic preparation and we unfortunately do not have knowledge about ayurvedic medicines.

You have to realize that the speed of growth reduces by 14 years in girls. ( especially if she had menarche at 10 yrs, her breast development would have started by 8-9 years and she will have rapid height growth for 3-4 years following that. Then the speed reduces)

Did you do an IGF-1 test?

---

Brief Answer:
Dental braces have nothing to do with heigh

Detailed Answer:
Dear XXXXX,

Dental braces have nothing to do with pituitary or height.

IGF-1 of 424 ng/L is quite normal for a 14 year old girl. She is only 14 years and have 3-4 years more to grow. Ofcourse the growth now will be slow, about 3-4 cm maimum per year. ( in her puberty starting time, you would have noticed 10-12 cm growth per year)

There are medicines to slow down the action of estrogen (aromatase inhibitors like Letrazole) on bone so that height can be increased. But before that, i would like to have a look at her XRAY myself when i return to my office tomorrow morning. Do you have a copy of it? Could you attach that to this question? It is very unlikely to be 15!!!!. If that is the case, her bone age is advanced which is associated with some other conditions.

She doesnt require hGH now. It i important to give her sufficient calcium and vitamin D to her. Make her play and keep healthy weight. Improve her general nutrition, but avoid excess weight gain. Avoid steroids of any sort.

---

Brief Answer:
Letrazole

Detailed Answer:
Oh okay. If she had acceleration of bone age, then it is a problem. This could happen if she had premature puberty. But you said she had menarche at 10 years which is normal pubertal age. I don't know if your endocrinologist investigated why she had bone age acceleration.

you could also discuss with endo about starting Letrazole for sometime. This drug blocks estrogen and delays fusion of growth plate of bone. So she could buy some more time to grow taller. It's controversial but sometimes we use it.

---