Cbd Oil And Sickle Cell Disease

It primarily affects African Americans, but other racial groups can inherit the condition as well. SCD causes the patient’s cells to become misshapen, looking similar to the crescent shape of a sickle, which is where the disease gets its moniker. Sickle red blood cells die sooner than normal cells, meaning less oxygen gets transported throughout the patient’s body. The scientists conclude that cannabinoids had potential in treating symptoms of sickle cell anemia. And although they didn’t study CBD in particular, we do know that CBD can treat pain and inflammation.

The severe pain and mobility issues that could come with this problem are abated. When blood flow to the bone is compromised, the bone cells start to die and bone degenerates. The inflammatory response is then triggered to fight these foreign elements.

Most people who experience side effects report the reaction to be mild — most commonly involving tiredness or dizziness. A meta-analysis published in 2018 explored the effects of CBD on 607 patients between the ages of 5 months and 67 years with treatment-resistant epilepsy . Researchers reported that CBD was very well tolerated by patients of all ages.

Many are now showing interest in CBD as a natural approach to get back a semblance of normalcy in their lives. As noted above, there are no definite treatments for the disease, but many people have used cannabis and CBD to attempt to cope better and manage the process of dealing with sickle cell anemia. Few people realize that sickle cell anemia is actually one of the most common congenital disorders. In fact, we do not even know how many people are affecting by SCA around the world. Particularly at risk are those in sub-Saharan Africa, southwest Asia, India and the Mediterranean countries. 2020 study published in the journal Hematology attempted to begin understanding if cannabis could be an effective treatment for SCD.

A preclinical study published in 2015 explored CBD’s potential to treat several prominent forms of anxiety disorders . This study reported the primary mechanism of action for the painkilling effects of CBD was through inhibition of mast cells. These cells become activated when blood cells become lodged in the capillaries — leading to a cascade of inflammation and pain.

But so far, scientists are finding that many of these patients have already turned to cannabis for help. In a study published in Cannabis and Cannabinoid Research , authors surveyed fifty-eight SCA patients about consumption of cannabis. Of those fifty-eight, forty-two percent reported consuming cannabis within the previous two years.

Hence, this compound can help you to get protection from different disease-causing pathogens. But the natural abilities of CBD are found to help with these problems. So a lot of people who are suffering from this condition are using CBD for pain. We wish we could include them all, but here’s just a handful of the women making a big impact in the world of medical cannabis. In honour of International Women’s Day, we’re celebrating the women making change in medical cannabis.

Supports Healthy Skin

This is a life threatening complication, which occurs after stem cell transplant. It occurs in at least 35% of the cases even when everything is done right. CBD would work to ease the problem by regulating better blood flow to aiding mitigation of the blockage. This would be incredibly useful once the blindness has already set in. However, before it does it can be prevented by having CBD ease blood flow. This process will do away with the damaged bone then replace it with a new one.

A questionnaire in 2005 showed that 52% of SCD patients used cannabinoids to reduce pain while another 39% used to relax and get rid of anxiety. Opioidsindicated for SCD pain have severe side effects that affect quality of life of the patients. Sickle full spectrum turmeric cbd oil cell disease is a condition in which the red blood cells adopt a misshaped status as opposed to the disc shape, which accords the cells easy mobility through vessels. More research is needed to understand how cannabinoids can help human SCA patients.

It binds with receptors of the endocannabinoid system and gives this whole biological system a boost. As a result, we experience less pain, anxiety, inflammation, depression, high blood pressure, digestive issues and more. The fact that there aren’t enough red blood cells to transport oxygen causes tiredness and dizziness, and can even stop people with this condition from growing up at a normal rate. Anemia can also result from diseases that affect bone marrow, such as myelofibrosis and leukemia.

By regulating this receptor, it’s thought that CBD can increase anandamide levels in the gut, thus reducing IBS symptoms. A review article published in 2013 highlights several in-vitro and animal studies that showed CBD could inhibit several different forms of inflammation most commonly found with inflammatory bowel disease . CBD offers direct benefits towards IBD by inhibiting inflammation, alleviating pain, and supporting the regeneration of damaged cells in the gut lining. The most popular ways of using CBD for IBD are CBD oils and CBD suppositories. There’s a lack of research on the effects of CBD on Huntington’s disease.

Is Cbd Oil Safe To Take For People Who Struggle With Addiction?

From here, red blood cell production eventually drops, causing the symptoms of anemia. If medical cannabis isn’t legal in your state or if sickle cell anemia is not a qualifying condition, consider using CBD products for pain management instead. While it contains many of the same medicinal properties as medical cannabis, CBD legal nationwide and can be shipped to your door. All sarahs blessing cbd fruchtgummis erfahrungen different methods of CBD oil can be beneficial when it comes to pain and inflammation caused by sickle cell anemia. Topicals are one of the most popular options for inflammation because it can help with the swelling upon contact. Using other methods like suppositories, e-cigarettes, tinctures, and pills can help with the invasive pain that makes day to day life difficult.

They contain 10mg of CBD per serving, which is a great starting point for beginners, as well as 3mg of melatonin. Other ingredients include tapioca syrup, beet sugar, fruit and vegetable juice. These are maintenance doses, however – treating iron deficiency anemia is much more difficult and requires much more iron intake.

Clinical trial results indicate cannabis could provide an alternative or adjunctive treatment to sickle cell patients. There have yet to be any studies on consumption methods other than smoking or vaping in sickle cell anemia patients. As such, we can only wonder how oral, sublingual, and transdermal intake (edibles, concentrates, skin patches and gels, etc.) might increase, decrease, or have no effect on cannabis’ impact on sickle cell anemia. Not enough research exists to endorse THC over CBD, or vice versa, for sickle cell anemia. Because, though the distinct effects of each molecule could offer benefits to mood or physical discomfort, a combination of THC and CBD may provide more comprehensive and balanced effects. So, what does all this have to do with cannabis for sickle cell anemia?

The difference between IBS and IBD is that there’s no identifiable cause for the condition with IBS. It’s classified as a syndrome rather than a disease, which means it’s a collection of related symptoms rather than a specific disease process. Additionally, chronic inflammation in the gut can spill into the bloodstream and trigger inflammation in the lungs, brain, skin, and more. Poor digestive health can affect nearly every other organ system in the body. Chronic inflammation can cause particles to “leak” into the bloodstream, interfering with hormones, neurotransmitters, or organ function elsewhere in the body. Parkinson’s disease is a chronic neurodegenerative disorder affecting the nucleus accumbens — which is where most of the brain’s dopamine is produced.

Patients who were certified for medical marijuana were compared with 25 random patients who did not request certification. Fifty adults with SCD were certified for medical marijuana and 29 obtained it. Patients who obtained medical marijuana experienced a decrease in admission rates compared with those who did not and increased use of edible cannabis products. Patients who were certified for medical marijuana had higher rates of baseline opioid use and illicit cannabis use compared with those who did not request certification.

When this happens, oxygen is unable to reach nearby tissues and this often results in sudden attacks and severe pains which are known as a crisis. Research conducted by the University of California -Irvine in July 2020 found that cannabis is a “safe” and “effective” treatment. In this study, conducted by researchers Kalpna Gupta and Dr. Donald Abrams, it was found that cannabis may be the safest way forward to treat patients going through immense chronic pain from sickle cell disease. Professor Gupta said cannabis could also replace opioids to address chronic pain as they are least harmful than the latter. In sickle cell disease, red blood cells, which move in small blood vessels and carry out oxygen to other parts of the body, become hard and sticky.

CBD is not a cure for diabetes, but it does offer useful benefits for supporting insulin function, alleviates side effects like pain, and offers protective effects on the organs most affected by diabetes . This hormone is responsible for moving sugar from the blood to the inside of cells, where it’s converted to energy. If there isn’t enough insulin or the insulin doesn’t work properly — it leads to diabetes. This condition occurs up to a week before the menstrual phase of the woman’s reproductive cycle. Hormonal changes that occur as the body prepares for menstruation result in a series of psychological and physical symptoms.

Sickle cell anemia can leave patients exposed to an increased risk of infections due to damage caused to the spleen. Research shows that the ECS plays an important role in immunity, and receptors occur on a variety of immune cells. Future clinical trials are needed to uncover how cannabis components might improve immunity in sickle cell anemia patients specifically. The symptoms of sickle cell anemia can have a big impact on the quality of patients’ lives.

The final category of anemia is caused by premature destruction of the red blood cells themselves. When talking about CBD oil, perhaps the most significant form of anemia is sickle cell anemia. This means that any damage to the red blood cells could have an effect for 3 or 4 months before a new cell is produced to replace it.

Early death from a heart attack, during the first month after the event, is estimated at 30%, of which more than half of the deaths occur before arriving at the hospital. About 25,000 Israelis have heart disease each year and between 5,000 and 7,000 die from them. This experimental technique mixes stem cells from a sibling with the patient’s own cells. An animal study fed mice a high fat, high-calorie diet for 15 weeks to induce fatty liver disease [Romero-Zerbo 2020]. Half the animals were given daily doses of CBD for two weeks to measure its protective effect.

As research goes on, expect the discovery of new therapeutic and medical uses for this compound. When introduced into the body, CBD can impact the endocannabinoid system’s receptor activity resulting in the reduction of inflammation and the interaction with neurotransmitters. CBD has been with us for hundreds of years, used by ancients as a natural remedy for a lot of common ailments.

If any of these resources become deficient, or any of the stages of development become impeded, red blood cell production begins to suffer. Typically, when a red blood cell wears out, we recycle the iron to make new hemoglobin. The hemoglobin molecule is basically made of protein and what is called a “heme group”, a structure that contains iron. This is the place where oxygen and carbon dioxide bind to the blood cell surface. The functional unit of the red blood cell is a molecule called hemoglobin. Depending on the cause of anemia, other types of blood cells may also be affected, such as the B and T lymphocytes, monocytes, or neutrophils that make up the bulk of our immune system.

The findings were published in a medical journal, JAMA network open and can serve as a steppingstone for further research in the field, helping in finding a way to treat the patients of the disease. The Joint Blog strives to help our readers keep up with the ever-changing landscape of this industry through valuable content and top-notch products. The increase happened concurrently with marketing claims that it could help treat a number of conditions, such as acne, anxiety, and menstrual problems. Currently will delta-10 thc get you high the US Food and Drug Administration has only approved a CBD-derived therapy called Epidiolex to treat Lennox-Gastaut syndrome and Dravet syndrome. The investigators sought main outcomes of cannabidiol testimonials divided in 11 subcategories corresponding with the condition’s medical subspecialty and 2 subcategories corresponding with wellness benefits. Randomization order of cannabis and placebo was computer-generated by the study statistician and managed by an independent research pharmacist.

This study provides an additional option for physicians to treat chronic pain. Pain News Network is a non-profit online news service for information and commentary about chronic pain and pain management. Our mission is to raise awareness, connect and educate pain sufferers, caregivers, healthcare providers and the public about the pain experience. No studies have compared each method in humans with sickle cell anemia, but if you’re curious, we aim to locate some distinctions below. This iron-containing protein occurs in red blood cells and gives them their distinctive red appearance.

Sickle Cell Symptoms

Adverse events were mild and equivalent to those reported by the placebo recipients. In contrast to many of the pharmaceuticals in the clinician’s daily armamentarium, cannabis has been consistently shown to be a generally safe intervention. Kids affected due to this health problem are more susceptible to infection. For now, there’s only one cure for sickle cell disease — bone marrow transport or called stem cell transplant. Bone marrow is a fatty tissue that is present inside the center of the bones. In a bone marrow transplant, blood transfusion happens from one person to another whose bone marrow stops producing red blood cells.

Cannabis And Sickle Cell Disease

This early diagnosis is critical, as SCD is a lifelong disease, even though a blood and bone marrow transplant can help manage complications. The care of people with sickle cell disease may include infection prevention with vaccination and antibiotics, high fluid intake, folic acid supplementation, and pain medication. Other measures may include blood transfusion and the medication hydroxycarbamide .

Besides, CBD also maintains body homeostasis, enhances the endocannabinoid responses, while strengthening the immune system, thereby relieving the discomfort and pain felt by sickle cell patients. CBD is a potent anti-inflammatory and has proven use in auto-immune disorders; however, this does not necessarily mean that it weakens the immune system. In fact, there are studies that show that it can improve the immune system. It may be that the effects of CBD on the immune system are more regulatory in nature, and that it has the potential to regulate a dysregulated immune system.

Through stem cell transplant, the body can be supplied with an avenue to generate new healthy cells instead of the malformed ones it is used to. Low blood flow or blockage of vessels in the CBD Patches penile tissue can cause a painful prolonged erection, which is unrelated to sexual excitement. Many patients suffer blindness or impaired vision due to reduced blood flow to the eye.

In most cases, the clinical condition ends without any complications, as a result, many times the inflammation is not diagnosed. The main causes of myocarditis are viruses, bacteria, prostis, and fungal infections, along with immune diseases. Symptoms of myocarditis can manifest themselves in chest pain and cramps, shortness of breath and difficulty breathing, flu symptoms, and accelerated heart palpitations.

This study offers doctors an additional option for the treatment of chronic pain. “We still need larger studies with more participants to get a better picture of how cannabis can benefit people with chronic pain,” the researcher said. The results showed the effect of cannabis taken in vaporized form without other ways of using the plant being identified as effective. “The pain leads many people to resort to cannabis and is in fact the main reason people give for looking for cannabis in clinics.

These carriers produce both normal hemoglobin and sickle cells, but generally don’t experience any symptoms. In a mice model of sickle cell anemia, a cannabis-based medicine improved sickle cell symptoms. These sickle cells often get stuck in smaller blood vessels, leading to a blockage or slowdown in blood flow. This slowdown affects oxygen flow to different body parts and may be painful for the individual suffering from the disease. Medical professionals around the world have recognized the beneficial effects of the compound and have started recommending it to their patients.

When left untreated, anemia can cause severe fatigue, pregnancy complications, heart problems, or death. The condition can be temporary or long term, and it can range from mild to severe. Hydroxyurea appears to stimulate the production of fetal hemoglobin, a type of hemoglobin found in newborns that helps prevent sickle cell formation. If you are interested in trying CBD to treat medical conditions, for general wellness, or for your pets, checkout CBDbay.app. Metabolic syndrome covers a range of health conditions that all pose cardiovascular complications, that are all interlinked, and that together … Neurodegenerative diseases like Alzheimer’s disease, Huntington’s disease, and Parkinson’s disease are terrifying and relatively common conditions.

While the research into the potential uses of CBD oil continues, it appears that it could be helpful in relieving some of the symptoms of sickle cell anemia. If you want to try CBD oil to reduce pain and support the immune system, talk to your doctor. By further examining which receptors participated in this response, it was discovered that both CB1 and where can i buy cbd oil CB2 receptors can be used to treat different types of pain. For chronic and acute pain, activating the CB1 receptor can reduce hyperalgesia, while CB2 may contribute to pain reduction by modulating the inflammatory properties of sickle cell anemia. CBD oil may present a pain relief option that is easier to tolerate than traditional medical treatments.

As a result, their blood cells can’t bring oxygen to the organs as well as they should. This leads to a host of symptoms, including dizziness, brain fog, deep fatigue, shortness of breath and pale skin. People with anemia have malfunctioning red blood cells; they may have the wrong shape or be missing essential nutrients, or there may simply be too few of them. Most of these benefits regard symptoms of anxiety and stress, rather than the condition itself. CBD itself has little effect on iron-deficient anemia; however, the hemp seed oil often used as the carrier oil in these products is naturally high in iron.

A few examples include heart attack, angina, kidney failure, or peripheral artery disease. CBD oil is a popular natural health supplement to help with the early stages of high blood pressure. However, due to potential adverse interactions between CBD and blood pressure medications, you should always speak with your doctor before using CBD products to help manage your condition. There’s no cure for this condition, and the treatment options are limited. The current treatment approach for this condition is to alleviate side effects, slow the progression of the disease, and improve quality of life.

We recommend going with an oral tincture as this type of product stays in the system for a long period of time. The problem is that sickle cell anemia is notoriously difficult to treat. Because two prominent symptoms are frequent bodily infections and extreme pain, a doctor may prescribe heavy painkillers and antibiotics to be taken as needed. These characteristics of the disease can be so severe that an individual is frequently hospitalized. Most patients (92%) said that they used cannabis for pain, and 79% of patients reported that cannabis use allowed them to use less prescription pain medicines. Further, in most crossover trials , it is necessary to impose a washout period between the 2 drug-exposure periods to eliminate the possibility of carryover effects.

Benefits Of Using Cbd Oil For Sickle Cell Anemia

The study, which was conducted using medical cannabis containing equal proportions of CBD and THC, may be the starting point for similar studies exploring the role of cannabinoids in pain management. Other types of anemia have shown little benefit from CBD oil; however, it may be useful for secondary symptoms of the condition including mood disorders, anxiety, fatigue, and frequent infection. A recent study has shown that using cannabis can improve the mood of sickle cell patients who experience excruciating pains. Cannabis may be a potential treatment option for those with sickle cell disease, according toa new studypublished on the website of the National Institute of Health. The world’s largest randomized controlled trial of acupuncture in emergency departments has found the treatment is a safe and effective alternative to pain-relieving drugs for some patients.

We normally get that iron through our food, and we will lose some of it through the sweat glands and shedding skin cells. When hemoglobin isn’t manufactured correctly, we can end up with anemias such as sickle cell, and thalassemia. One of the most underrated cells in the body is the humble red blood cell. This is a significant source of pain for these individuals, often prompting them to take opioids or other pharmaceutical pain medications. There are many different types of anemia, each with its own set of treatment options, and symptoms. The state Senator Diane Savino also passed remarks on the rules and regulations regarding medical marijuana.

One of the best studies we have available on CBD’s potential benefits for schizophrenia compared the use of CBD with current prescription antipsychotic medications . This double-blind, placebo-control study found that CBD was as effective as amisulpride for treating schizophrenia symptoms. A large meta-analysis published in 2018 highlighted the benefits of CBD oil for post-traumatic stress disorder . The study explored the results of animal studies and clinical trials. The study concluded that CBD significantly improved symptoms of PTSD — including the retention of unpleasant memories. The disorder lowers one’s red blood count, causes high risk of infection, and results in neuropathic pain.

Researchers require to carry out additional research study to confirm this. Research study supporting this shows that CBD oil and CBD have the possible to decrease seizures. Nerve injury induces a tonic bilateral mu-opioid receptor-mediated inhibitory effect on mechanical allodynia in mice. The state offered research licenses only to companies affiliated with medical schools. The medical schools were at Penn State, Drexel, and Thomas Jefferson Universities.

“This way we would be able to reach nearly every patient with sickle cell disease,” he said. CBD is entirely non-psychoactive as long as it’s made from hemp plants instead of marijuana. Achieving and maintaining ideal body weight is one of the best steps you can take to maintain optimal health and wellbeing. While being slightly overweight is unlikely to significantly impact your health, obesity is correlated with a wide range of health conditions long term.

Sickle-cell anemia is a form of sickle cell disease, as its name probably suggests. As most readers probably know, red blood cells are the cells responsible for transporting oxygen throughout the body. A healthy and normal red blood cell is usually flat and has a round profile. This design allows them the flexibility to adapt through tight gaps as they run around the circulatory system.

Most findings have shown CBD’s positive effects on diabetes have been on vermin. This poses an issue because laboratory condition and differentiating characteristics between human and animals can skew study results. Summarily, the fact that CBD works for them doesn’t mean it will work well in people. In patients older than 16 years, TCD velocity criteria are hemp gummies the same as cbd gummies to determine stroke risk is not reliable . The multicenter phase III TWiTCH trial evaluated children with SCA and abnormal TCD velocities without a history of stroke on chronic transfusions. Data showed that hydroxyurea at maximal tolerated dose was noninferior to chronic transfusions for maintaining TCD velocities as primary stroke prophylaxis .

How Can Cbd Be Used To Help With Sickle Cell Anemia?

Each of Extract Labs‘ gummies includes 33mg of CBD– which is more than enough for soothing anxiety, sleeping disorders, modest pain as well as inflammation. As well as having high levels of anti-inflammatory, pain-relieving CBDa, this tincture really delivers on quality. It’s made with organically and huile de cbd pressée à froid sustainably grown hemp, CO2-extracted, and third-party tested. Considering all of these factors, Endoca manages to offer a surprisingly good price on this very potent tincture. So if you’re looking for a very natural CBD product with good anti-inflammatory properties, it may be the one for you.

Cbd In The Treatment Of Epilepsy

The sickle shaped cells are not flexible and cannot change shape easily and this explains why many of the cells burst apart as they move through the blood vessels. According to several studies that are underway, CBD could be an effective treatment option for sickle cell anemia. However, understanding the link between CBD and the endocannabinoid system will help you have an in depth understanding of how CBD works in treating the symptoms of sickle cell anemia.

These statements have not been evaluated by the Food and Drug Administration. The products mentioned on this site are not intended to diagnose, treat, cure or prevent any disease. The products on this site are not for use by or sale to persons under the age of 18.

Cannabidiol use has increased in recent years, as have claims that over-the-counter CBD could be used to treat a variety of health conditions. CBD’s unique effects on the body have to do with the endocannabinoid system that exists in every mammal. This system makes cannabinoids that work to regulate various systems throughout the body such as tolerance to pain, mood and function of the immune system. When a person doesn’t make enough cannabinoids on their own, these systems can suffer. Additionally, one in every 16,300 Hispanic babies is born with sickle cell anemia. In the said study, CBD has been shown to work directly with the cannabinoid receptors of the body to help suppress inflammation.

Sickle cell disease increases the risk of stroke, acute chest syndrome, pneumonia, organ damage, blindness, gall stones, leg ulcers and open sores, and pregnancy complications. These test results show that vaporized cannabis appears to be generally safe,” says Kalpna Gupta, a professor at the University of California at San Francisco, who led the study. They also suggest that patients with sickle cell disease may be able to reduce it with cannabis.

CBD is not a cure for endometriosis and will not prevent the growth of endometrial tissue. However, it can offer benefits for the common side effects of the condition. CBD has been shown to regulate anandamide levels by activating the vanilloid VR1 receptors responsible for controlling the breakdown of this endocannabinoid .

CBD works indirectly by regulating a different type of serotonin receptor , which leads to reduced serotonin in the nausea center — leading to suppression of the nausea reflex. In recent years, a theory has surfaced that suggests anandamide deficiency as a key factor in the condition . Anandamide is a key component of the endocannabinoid system used to regulate nerve and epithelial cell function in the digestive tract. This is also thought to be a potential cause for migraine headaches and fibromyalgia — two common comorbidities in IBS patients. Both conditions involve chronic inflammation in the digestive tract that leads to problems with absorption, constipation or diarrhea, altered gut microflora, pain, and cramping.

The only effective treatments for this condition are diet and lifestyle changes. High sugar and high-fat foods, increased caloric intake, lack of exercise, and use of liver-toxic substances like alcohol and nicotine all need to be cut out to stop or reverse the progression of metabolic syndrome. Endometrial tissue inside the uterus is pushed out of the body through the vaginal cavity. Over many cycles, it can eventually lead to scar formation on the ovaries, uterus, and fallopian tubes. For example, CBD and other endocannabinoid regulators have been shown to reduce blood pressure in rats with induced hypertension [Bátkai 2004].

Glycine receptors are inhibitory receptors located throughout the central nervous system. These receptors play a central role in the perception of nerve pain in particular. Studies have indicated that CBD can potentiate, or increase the effects of, these receptors, reducing the severity of nerve pain. Red blood cells are the most important cells in our body as they carry oxygen from the lungs to other parts of the body.

But the findings from their research—published in JAMA Network Open—are promising. Researchers assessed participants’ pain levels throughout the treatment period and found that the effectiveness of cannabis, which contained equal parts THC and CBD, appeared to increase over time. SCD is a common inherited blood disorder, also called sickle cell anemia in its more serious stage. The low number of platelets causes severe internal hemorrhage throughout the body, which is caused even by minor trauma. Thrombocytopenia can be caused for many reasons, including self-antibodies (ITP Idiopathic Thrombocytopenic purpura- – drug reaction, vitamin B12 deficiency, or diseases that damage the bone marrow . A stroke occurs when there is a sudden interruption in the blood supply to certain brain tissue.

While we would love to have the ideal answer for everyone, it simply doesn’t work that way. The only way to know for sure how much CBD is going to help is by experimenting for yourself. A comprehensive review of all the plant-based medicine which has had both preclinical and human clinical trials conducted about their anxiolytic-like effect.

Results of an anonymous questionnaire had shown that a majority of patients used cannabis to relieve pain, but users also reported seeking to induce relaxation or to relieve anxiety and depression as well. The authors conclude these results show research into the use of cannabis for pain relief would be both important and acceptable in adult patients. Other known symptoms of sickle cell anemia include swelling of the feet or hands, vision problems, and chronic infections. Some research also shows that the lack of adequate oxygen can lead to delayed growth and even puberty.