Growth & puberty

Growth in thalassaemia often follows a pattern: fairly normal until about 9–10 years, then a slowing of growth, and in the teens a reduced or absent pubertal growth spurt. Early on, anaemia plays a part; later it’s mainly iron affecting the growth-hormone pathway (the GH–IGF-1 axis) and the pituitary gland, and then delayed or arrested puberty.

Keeping ferritin around or below 1,000 with good chelation is what best protects normal growth and the hormone glands. Height, weight and pubertal (Tanner) stage are tracked over time; TIF suggests a growth and puberty check every 6 months from age 13 in girls / 14 in boys.

When growth is slow, the team runs a “growth screen” to find treatable causes — thyroid tests, calcium/phosphate, IGF-1 (a growth-hormone marker), and a check for coeliac disease. Growth-hormone treatment is sometimes used in selected children, and delayed puberty can be helped with hormone treatment (see “Treating delayed puberty”).

MUIY has a dedicated Growth & Puberty section (Health → Monitoring → Growth, for ages 5–20) with charts and a full guide.