How they treat short stature in medicine

Clinical practice. Short stature in childhood--challenges and choices.

"Treatment with recombinant human growth hormone can increase the adult height of children with idiopathic short stature by 1.2 to 2.8 in. (3.0 to 7.1 cm), with wide variation in the incremental gain."<-10,000 to $60,000 per patient per year

"human growth hormone therapy in children with idiopathic short stature increases the growth rate and mean adult height by 1.2 to 2.8 in., or approximately 0.4 in. (1.0 cm) per year of human growth hormone treatment."

"Human growth hormone is administered subcutaneously at a dose of 0.2 to 0.375 mg per kilogram of body weight per week. Daily administration of human growth hormone is superior to less frequent administration. Dose modulation may influence the effect; doses at the higher end of this range and adjustment of the dose to achieve high-normal IGF-I levels lead to faster growth and perhaps to taller adult height"

"For short peripubertal[early stages of puberty boys, growth-promoting alternatives to human growth hormone are low-dose androgen therapy with injectable testosterone and low-dose androgen therapy with oral oxandrolone (e.g., 1.25 to 2.5 mg per day). Both regimens are relatively low in cost, and though they are not FDA-approved for growth acceleration, they increased the growth rate by 1.2 to 2.0 in. (3.0 to 5.1 cm) per year for 1 to 3 years in controlled trials."

"To avoid accelerated estrogen-mediated epiphyseal maturation, oxandrolone (not aromatized to estrogen) is theoretically preferred over testosterone when the bone age is less than 11 years. Oxandrolone is usually discontinued after a documented increase in endogenous testosterone; long-term follow-up studies indicate that treatment is followed by normal pubertal growth and eventual attainment of an adult height equal to or slightly greater than the predicted height before treatment "

"Aromatase inhibitors (which reduce estrogen production and delay skeletal maturation) have been used experimentally in boys to prolong pubertal growth and increase height, but they are more expensive and have less of a growth-accelerating effect than androgens, and actual adult height gains have fallen short of prior predictions of 1.6 to 2.4 in. (4.1 to 6.1 cm)."

Few Notes:

* Pediatric Treatment is extremely narrow:  Only HGH and Testosterone.  This is likely because they want the most expensive option and don't want treatments that could additionally help by say 0.1cm.
* Oxandrolone is the best testesterone supplement as it does not convert to estrogen
* These studies look at a wholistic view i.e. how much does this supplement increase the final height rather than looking at what happens directly at the cellular level.