Hello Dr. Grief, Thank you for taking the time to answer my question. My question is with regard to Kearns Sayre Syndrome and hormone injections . My son is 14yo, he has yet to start (or show signs of starting) puberty . However, this is very common with patients who have KSS. My sons Endocrinologist wants to begin him on hormone injections once a month. I have yet to agree to this. The reason being, (a) I have yet to find any research that proves this is beneficial to my son, (b) his doctor could not support nor refer me to any research that proves this is not going to put my sons disease into progression, (c) the only information that I have found concerning puberty and KSS is that puberty is a difficult period for patients with mitochondrial diseases due to the changes that occur. If you can give me any advice or refer me to a good resource concerning this topic I would truly appreciate it. Again, thank you for your time. Chrissy