Is It Safe For A Teenager To Take Anastrozole For Three Years To Make Sure His Growth Plates Do Not Close?

Posted on Sat, 23 Jun 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 23 Jun 2018 Answered on

Mon, 18 Jul 2022 Last reviewed on

Question : My son just turned 14. His endocrinologist says he has a bone age of 14.5. The radiologist says 14.0.
His height is 5' 3.5". His weight is 130 pounds. My wife and I are taller than average. My wife is 5'8" and I am 5'10.5". How tall do you think my son will be?
The endocrinologist is recommending that my son take Anastrozole for three years to make sure his growth plates do not close. Does that make sense to you?
All his blood tests all came back normal.

Answered by Dr. Mirjeta Guni (4 hours later)

Brief Answer:
About Anastrozole treatment for height gain;

Detailed Answer:

Hello,

His predicted adult height is 6'06".

Actually, he is at 30 percentile (that is considered a normal height for his age group) and you may note that many boys get their predicted height at the age of 14-20.

Personally, I wouldn't agree to treat or not with GH or anastrozole.
Anastrozole and GH therapy can be effective in augmenting adult height without significant side effects. However, the long-term safety and efficacy of aromatase inhibitor use in pediatrics remain limited.

If you say that there is no growth hormone deficiency and he is still at percentile 30 I would not recommend treatment with Anastrozole.

Hope the information will help. Feel free to ask further.
Regards,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (20 hours later)

Thank you doctor. Your answer is reassuring.

The endocrinologist thinks that since my son is 14, but his bone age is slightly advanced at possibly 14.5, then there is a chance his bones will close early. The endocrinologist thinks that if my son takes anastrozole then that would assure us that he would reach at least 5'7", which is 30 percentile for adults. Does it make sense to take anastrozole as insurance to make sure my son makes at least 5'7"?

If my son's bone age is 14.5 is there a still a chance his bones will close very soon, or does bone age have to be closer to 16 for closure?

Answered by Dr. Mirjeta Guni (6 hours later)

Brief Answer:
About anastrazole treatment;

Detailed Answer:

Hi,

Your son is just 14, there is still a period of 6 years expected to gain height.
The bone age 14.5 is difficult to differentiate from 14.
I usually recommend anastrazole or GH when the bone age is a couple of years older.

Those with advanced bone ages typically hit a growth spurt early on but stop growing early sooner while those with delayed bone ages hit their growth spurt later than normal.

His bone age corresponds to biological age, so the treatment with anastrazole needs to be discussed further.

Wish him good health.
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mirjeta Guni (5 hours later)

Thank you doctor. Would you then recommend we look at anastroloze again in another six months or 1 year when he is older?

Also, would it make sense to get a bone age x-ray every four months, and if we see the bones start closing, and if my son is still not very tall, then do anastroloze?

Answered by Dr. Mirjeta Guni (11 hours later)

Brief Answer:
About height gain treatment

Detailed Answer:

Hello,

The fact that I disagree to start anastrazole is that actual height percentile is 30%, he should be at least under 1 standard deviation to start treatment for height gain.
So, I would suggest to discuss once again with his endocrinologist about starting treatment and decide for the future follow up.

Regards,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Mirjeta Guni (8 hours later)

One more question doctor.

My son is 5'3.5" and 14 years old or 14.5 if you consider his bone age. I'm not great at reading charts, but I think that puts him close to the 35th percentile. If you assume he stays at 35th percentile then his adult height would be 5'8" or 5'9". His doctor, however, says he will be 5'6" or 5'7" if he stays at his current percentile. Does what the doctor says make sense?

Thank you.

Answered by Dr. Mirjeta Guni (23 hours later)

Brief Answer:
About height gain during adolescence

Detailed Answer:

Hello,

As I mentioned before the boys has usually a peak of height gain from 14-18 years old.
So if he now is at 35 percentile, very probably during the next 4 years he will be at a higher percentile, not a lower one.
So, he will reach at 5'8''.

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Mirjeta Guni (1 hour later)

Thankk you doctor. That makes me feel better. Do you mean at least 5'8"?

Answered by Dr. Mirjeta Guni (13 hours later)

Brief Answer:
About height prediction.

Detailed Answer:

Hi,

He is expected to reach 6'0'', but at least 5'8''.

Regards,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Mirjeta Guni (31 hours later)

Hi doctor, have you heard of the khamis roche height calculator? We are a caucasion family living in the united states, with european roots. Would the khamis roche calculator be accurate for my son? thank you.

Answered by Dr. Mirjeta Guni (14 hours later)

Brief Answer:
About Khemis Roche height calculation:

Detailed Answer:

Hello,

Khamis Roche calculation for the height prediction is very similar to the charters approved to be used by physicians.
If you calculate the height of your son will very probably give the same result as the height prediction we calculated above.

Regards,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Mirjeta Guni (5 days later)

Hi doctor. I know this sounds crazy, but I've been measuring XXXXXXX every week for the past 6 weeks and am very happy that he was been growing fast. 6 weeks ago he was 5' 2.75" and he kept growing steadily and last week he was 5' 3.6". However when we measured him yesterday he was still the same as last week, at 5'3.6". Do you think he is done growing? Do you think his bones may be closing? We are getting nervous because there has been no growth in the past week.

Thank you!

Answered by Dr. Mirjeta Guni (16 hours later)

Brief Answer:
About height gain of your son:

Detailed Answer:

Hello,

Of course, you do not have to worry about 1 week of no height gain, he seems to go very good with the numbers you reported ( as expected).

There is no need to check the height so often, once in three months is the shortest period you can see any difference.

Regards,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (6 days later)

Hi Doctor,

We had an appointment with my son’s pediatrician today. He is not concerned that he is only in the 35th percentile for height. The pediatrician is concerned that he will soon be done with puberty (he just turned 14) and he will stop growing before he reaches his full height.

The good news is that Noah’s testicles are at about stage 3 of the five tanner stages. The bad news is that Noah’s pubic hair is at stage 5. We were told those were the two most important markers of puberty.

Do you think we should now consider anastrozole because my son may soon stop growing?

Thank you so much.

Answered by Dr. Mirjeta Guni (37 hours later)

Brief Answer:
About height gain

Detailed Answer:

Hi,

At this point, you may consider starting anastrozole after discussing with his doctor.
Hope he will benefit from these.

Regards,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee