Pediatric Endocrinologist

09/09/2026

Catch-up growth does not always happen at the same age or for the same reason.
A child may show catch-up growth: • after being born small for gestational age
• after recovery from illness
• after treatment of hypothyroidism
• after treatment of growth hormone deficiency
• later in adolescence with constitutional delay of growth and puberty
The growth pattern—and its timing—depends on the underlying cause.

📞 94444 33000

🌐 www.paedendo.com

09/09/2026

Some children grow later, not less.
In constitutional delay of growth and puberty, growth and puberty are delayed, but many children eventually catch up with time.
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🌐 www.paedendo.com

09/09/2026

Growth hormone deficiency can slow a child’s height gain.
With appropriate treatment, many children show catch-up growth over time, though the response depends on age, diagnosis, and timing of therapy.
📞 94444 33000
🌐 www.paedendo.com

09/09/2026

After recovery from illness, some children regain lost growth and appetite.
This rebound is called catch-up growth, and the pattern depends on the illness, nutrition, and overall recovery.
📞 94444 33000
🌐 www.paedendo.com

24/08/2026

Some children are born smaller than expected for gestational age, but many show catch-up growth during early life.
Close growth monitoring helps identify which children are catching up well and which may need further evaluation.

📞 94444 33000
🌐 www.paedendo.com⁠

20/06/2026

20/06/2026

McCune–Albright Syndrome (MAS): A New Development

The U.S. FDA has granted Rare Pediatric Disease Designation to (Z)-Endoxifen for girls with McCune–Albright Syndrome (MAS).
An important point to note:

✔️ This designation is based primarily on:

* Biological and mechanistic rationale
* Prior experience with estrogen receptor modulation in MAS
* Unmet clinical need in this rare disorder

❌ It is not based on published MAS-specific efficacy trials demonstrating clinical benefit.
Interestingly, Endoxifen is the same molecule approved in India for bipolar mania.

However, the therapeutic target differs:

🧠Bipolar Mania → Protein Kinase C (PKC) inhibition

McCune–Albright Syndrome → Estrogen receptor blockade to counter estrogen excess and peripheral precocious puberty

This highlights how a single molecule may have different clinical applications depending on the biological pathway being targeted.

An exciting development in pediatric endocrinology, but clinical efficacy and long-term outcomes in MAS still require confirmation through dedicated studies.

—
Dr. S. Ramkumar, MD, DM (AIIMS), DrNB

09/04/2026

Happy to share that Andractim (DHT gel) is now available in India 🇮🇳

An important addition for topical DHT therapy, especially in:

• 5-alpha reductase deficiency (5ARD) with Micropen*s

Use strictly under medical supervision.

26/11/2025

https://whatsapp.com/channel/0029VamlZb3AzNbrYHd82W2a/229

Why does treating subclinical hypothyroidism in obese individuals not lead to weight loss?

Because in obesity, a mildly elevated TSH is usually the result of obesity, not the cause of it. Excess adipose tissue produces leptin, which stimulates TRH release from the hypothalamus, leading to a mild, physiological rise in TSH—an adaptive state known as adiposity-driven hyperthyrotropinemia . Importantly, free T4 levels and tissue thyroid hormone action remain normal, so basal metabolic rate, thermogenesis, and lipolysis are not significantly reduced.

Although many people believe that hypothyroidism causes obesity, there is little evidence that mild thyroid dysfunction contributes meaningfully to weight gain. Slight TSH elevations are common in obese children, and TSH normalizes with weight loss, confirming that the rise in TSH is physiological rather than pathological and does not warrant therapy.

Therefore, giving levothyroxine may correct the TSH value, but it does not treat the underlying obesity or increase energy expenditure. Multiple randomized trials show that treating subclinical hypothyroidism normalizes TSH but leads to no reduction in body weight, BMI, waist circumference, or body-fat percentage.

Thus, treating the TSH does not treat the obesity, because the metabolic rate was already essentially normal. Treatment may still be indicated for other reasons, but weight reduction should not be expected.