Robert Wadlow and Growth Hormone

Hormones are chemicals that control a variety of life processes, such as reproduction, growth and metabolism, and their usefulness have made them universal among plants and animals. In humans and other animals, hormones are made by organs called endocrine glands. A well known example is the male sex-hormone testosterone, released by the testes, which stimulates the changes that occur as a boy develops into a man, such as muscle development, beard growth and the male sex-drive. Similarly, the ovaries of a woman release oestrogen, which stimulates the changes that occur as a girl becomes a woman, such as breast development and widening of the hips. The hormone adrenalin, released from the adrenal glands above the kidneys when we perceive a threat to our safety, causes the flight-or-fight response, as set of changes that increases our ability to resist or flee from danger, such as an increase in heart rate, a widening of the airways and increased mental alertness.

In the centre of the head, at the base of the brain, is a pea-sized organ that releases at least eight hormones. This organ, the pituitary gland, is sometimes called the ‘master endocrine organ’ because it releases hormones that control hormone release by other glands. For instance, the pituitary gland releases TSH (thyroid stimulating hormone) which stimulates the thyroid gland in the neck to release its own hormones.

Most of the hormones from the pituitary gland have fairly obvious names, none more-so than Growth Hormone. Someone with a deficit in Growth Hormone will be short, and if short enough, a dwarf. Indeed, someone who is pathologically short due to a deficit in Growth Hormone is called a pituitary dwarf. Similarly, the more Growth Hormone a person releases during the childhood and adolescence, the taller that person will be. Excessive Growth Hormone before adulthood will result in a giant, that is, a person with gigantism. The most common cause of excessive Growth Hormone release is a tumour of the pituitary, and the most dramatic demonstration of this phenomenon was Robert Pershing Wadlow.

Robert Wadlow was born in 1918 in Alton, Illinois, in the United States of America, the oldest of five children. His length at birth was not recorded, but a healthy weight of 3.8 kilograms indicates he was a normal-sized baby; however a pituitary gland tumour saw vast quantities of Growth Hormone released into Robert’s blood. Carried by the blood every corner of his body, the Growth Hormone over-stimulated growth, causing Robert to develop into anything but an ordinary child. By the delicate age of four Robert was already 163 cm tall, as high as many adults. His phenomenal production of Growth Hormone continued unabated, so that by age 8 he had reached 188 cm, making him taller than almost all adults. At age 13 his height of 224 cm made him the tallest boy-scout in the world. At age 18 and 254 cm, Robert was still growing. The fact that he continued to grow beyond this age indicates that the growth plates at the ends of Robert’s bones did not seal as they do in other men of this age.  

Robert was a friendly young man with many friends in his hometown. An extant photograph shows Robert posing with what may have been his class on the evening of his school ball. Robert, relegated to the back of the photo, stands head, neck, shoulders and chest above his contemporaries. It may have been around the same time, in about 1936, that Robert toured the United States with the famous Ringling Brother’s Circus, despite fiercely resenting the label of ‘freak’. Robert also appeared to crowds on behalf of the Brown Shoe Company, who outfitted his size 37AA shoes, which would have otherwise cost him $100 a pair, an enormous sum of money at the time. Despite the enormous and often unwanted attention that his height attracted, Robert remained good-humoured, saying that he “overlooked” people who stared at him. Robert’s stature peaked at age 22 at 272 cm, a height confirmed by Washington University. Although legends abound of people who were taller than this, Robert remains the tallest person ever whose height was confirmed by medical science.

Unfortunately, excess Growth Hormone brings a variety of medical problems, some potentially fatal. Growth Hormone increases blood glucose levels, and abnormally high levels result in diabetes. Although it is not recorded, it is likely that Robert had, or would have developed, diabetes, in an era when the disease was life-threatening. Indeed, diabetes may have been the reason Robert lost sensation in his feet, a fact that is recorded. Other medical problems associated with excessive Growth Hormone production include an enlarged heart, heart failure and kidney failure, and for this reason giants did not live to be elderly in the past. Excess Growth Hormone also brings characteristic changes to the face and voice, the latter of which is evident in a recording of Robert’s voice

that still exists. Also common among giants are problems with the legs, and in his latter years Robert walked with the help of a cane and braces. An ill-fitting leg brace caused a blister on his ankle, and Robert was unaware of the lesion because of his loss of feeling in his feet. This blister became infected, leading eventually to septicaemia, or blood poisoning, which took Robert’s life at the age of 22. Robert was still growing at the end of his life, and would undoubtedly have surpassed 274cm, or nine feet in the Imperial System, making him as tall as the mythical Goliath of the Bible.

Robert was a giant in death as well as life. His enormous coffin was carried by twelve pallbearers, and after a funeral attended by 40,000 people, Robert’s coffin was interred under a layer of concrete to assuage his mother’s fear that Robert’s remains would become a medical curiosity. A life-size statue of Robert stands in his hometown.

Robert most likely had a benign tumour called a pituitary adenoma, and his pituitary would have been far larger than pea-sized. Had he lived in more recent times, Robert’s life would have been far less extraordinary. A pituitary adenoma can now be diagnosed and surgically excised, putting an end to uncontrolled growth. The infection caused by Robert’s badly-adjusted leg brace could now be easily cured with antibiotics. Sadly for Robert, pituitary surgery and antibiotics were not an option in the era in which he lived. Had they been available, Robert may still be alive, living out his twilight years reminiscing about his youth in Alton.