Vitamin A and iron supplementation is as efficient as hormonal therapy in constitutionally delayed children

Clin Endocrinol (Oxf). 2004 Jun;60(6):682-7. doi: 10.1111/j.1365-2265.2004.02034.x.


Objective: To assess the effect of nutritional supplementation on growth and puberty in constitutionally delayed children.

Patients: One hundred and two boys, 13.6-15.5 years of age, who were referred because of short stature and delayed puberty.

Methods: The boys were randomly allocated to one of the following treatment groups: oxandrolone therapy, 5 mg/day for 6 months (n = 15), testosterone depot, 100 mg monthly for 3 months (n = 15) or for 6 months (n = 20), nutritional programme (n = 17), oxandrolone and nutritional programme (n = 15) or passive observation (n = 20). Boys in the nutritional programmes received 12 mg/day iron and 6000 IU/week of vitamin A. Outcome measurements were of height, weight, pubertal signs, dietary intake, serum vitamin A, iron, GH and IGF-1.

Results: Six months of vitamin A supplementation induced growth acceleration similar to that seen in the oxandrolone- and testosterone-treated children, and significantly greater than in the observation group (9.3 +/- 2.9 vs. 4.0 +/- 0.9 crn/yr, P < 0.001). Whereas in the vitamin A-supplemented group, puberty (increase in testicular volume >/= 12 ml) was induced within 12 months. In all testosterone-treated patients, pubic hair was noted within 3 months and a testicular volume of >/= 12 ml was observed 9-12 months after the initiation of therapy. No pubertal signs were noted in the observation group during this time.

Conclusions: Subnormal vitamin A intake is one of the aetiological factors in delayed pubertal maturation. Supplementation of both vitamin A and iron to normal constitutionally delayed children with subnormal vitamin A intake is as efficacious as hormonal therapy in the induction of growth and puberty.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Androgens / therapeutic use*
  • Delayed-Action Preparations
  • Drug Therapy, Combination
  • Hormone Replacement Therapy / methods*
  • Humans
  • Iron / administration & dosage*
  • Linear Models
  • Male
  • Oxandrolone / therapeutic use
  • Puberty, Delayed / drug therapy*
  • Testosterone / therapeutic use
  • Vitamin A / administration & dosage*


  • Androgens
  • Delayed-Action Preparations
  • Vitamin A
  • Testosterone
  • Oxandrolone
  • Iron