Being too tall hurts
Turns out there are plenty of health benefits to being small, but also some downsides
"I'm not a snack at all, look baby I'm the whole damn meal."
- Lizzo, Juice
Despite all the downsides, I’m destined to live a pretty healthy life due to my diminutive frame.
There are a couple of barriers to what short people are capable of, medically speaking. Particularly short women, for example, are not allowed to give blood plasma. They can give blood, sure, but simply don’t have enough of it for plasma to be extracted safely.
I learned this through a 5’2’’ friend of mine, who was told she would have to put on 5 stone to be able to donate plasma because she didn’t have sufficient blood volume. She was told that, at her height, she would have to weigh in at 13 and a half stone in order to have enough of the red stuff to go around.
I, as a male, would have to be over 5’ and weigh over 7 stone 12 pounds, judging by donor forms available online. Alas, I am not quite that trim. While that sounds like a pretty low weight for a male, it would only put you bang in the middle of a healthy body mass index reading for your height.
There are a few other minor medical anomalies that arise from short stature. One of them, oddly, looks to be your chances of developing hearing loss. In a 2003 paper, academics from the Goteborg Paediatric Growth Research Centre in Sweden looked at some 500 men born in 1974, and another cohort of nearly 500 men, ranging from age 20 to 64, who specifically suffered from noise exposure as part of their jobs.
Controlling for a whole range of other physical factors like weight and pre-existing medical conditions, shortness was twice as likely to coincide in individuals with incidences of hearing loss compared with those with normal hearing.
Shorter workers were three times more likely to report bad hearing than taller ones as they aged, leading the researchers to suggest that hearing differences in short people might be a product of differences at birth, where reduced cell numbers and growth hormone level for those of smaller stature can be correlated with age-related health conditions like deafness appearing earlier in life.
One of my earliest memories of going to the doctor was a visit to Great Ormond Street, London. Essentially, I was not growing as fast as I should have been, and my parents were rightly concerned. After a variety of tests, which involved me running around with a cannula in my arm to check the levels of whatever hormones I was meant to be producing in the blood that flowed from me, I remember the doctor showing me a chart of how likely I would be to reach a particular range of heights.
Your son is never going to be massive, was the jaw-droppingly obvious conclusion the doctor drew, but is likely to end up somewhere in the 5’6’’ to 5’7’’ region.
He lied. I won’t go into the detail of one of the other tests, except to say they were intrusive, and also failed to predict my future height.
But medically speaking, I remain incredibly glad that I am not excessively tall. There are a plethora of physical maladies that can befall the very tallest in society.
Part-time farmer Sultan Kösen, the tallest living man at the time of writing, reached his 8’2’’ figure because of a condition known as pituitary gigantism. Named after the gland that produces growth hormone, pituitary gigantism occurs when the hormone is released in excess quantities. In Kösen’s case, this was the result of a tumour affecting the pituitary gland. He was fortunate enough to receive an incredible piece of surgery on the tumour in 2010 that put a stop to the secretions and any further height growth.
With that level of growth hormone, bones can thicken and joints can become painful. Other incredibly tall individuals throughout history have reported suffering childhood head injuries that led to similar responses from the pituitary gland. In the UK, we call the (albeit rare) condition where the body produces excess growth hormone, leading to rapid body tissue and bone growth, acromegaly when it affects those between 30 and 50 years old, reserving gigantism for when the development strikes before puberty.
The National Health Service lists some of the symptoms of acromegaly as tiredness, weakness, difficulty sleeping, numbness and weakness in hands, thick, coarse, oily skin, headaches, blurred or reduced vision, loss of sex drive, abnormal periods in women, and erectile problems in men. Without treatment, sufferers can risk developing type two diabetes, high blood pressure, heart disease, bowel polyps, which can potentially turn into bowel cancer if left untreated, and arthritis. None of which sounds ideal, I’m sure you’ll agree.
A case study in the Indian Journal of Endocrinology and Metabolism of a 25 year old with pituitary gigantism detailed how she presented with kyphosis, also known as hunchback, lower back, knee, ankle and elbow pain for the previous five years, and a headache for the previous two. That’s a long time for anyone to suffer such symptoms. Just imagine how horrendous a 24-month migraine would be for a start.
The tallest woman ever recorded, at the time of writing at least, China’s Zeng Jinlian, was afflicted by both scoliosis - a sideways curvature of the spine - and diabetes after her abnormal growth kicked off at the age of just four months. American Don Koehler was briefly the record holder for tallest living man, but also suffered from spinal curvature in later life, bending his frame down by a full four inches.
Medical afflictions of the 7-foot plus might not be so relatable to you as a reader, so let me change tack to circumstances you might find more everyday. If you live in Scotland, you’ll report an increased likelihood of being bitten by midges if you’re particularly lanky. If you are unlucky enough to topple over as said big person, a BBC article cites estimates that you will build up twice as much kinetic energy as someone 20 per cent shorter than you. Hip fractures are twice as likely in women if you put on an extra six inches from 5’2’’ to 5’8’’.
Those might sound innocuous. But the rest of this section isn’t, so brace yourselves.
An Oxford University study has found that there is a 21% increase in the risk of developing high-grade prostate cancer for every extra 10cm in a man’s height. Writing for The Conversation, University of Westminster physiology lecturer Bradley Elliot cites a study of Whitehall civil servants in which height was correlated neatly with risk of cancer, stroke and cardiovascular ailments. Of the 10 tallest people ever recorded, Elliot writes, the oldest died at 56.
A University of Pennsylvania School of Medicine journal from last November showed that taller people have an increased risk of developing atrial fibrillation - a heart condition that causes an irregular and sometimes abnormally fast heart rate - and that this might bear a causal relation, rather than just being incidental, to height.
Many physicians have posited that the increased incidence of mutations like cancers found in tall people will naturally occur because their bodies contain many more cells. The more cells, the more chance something goes wrong. Studies in both Sardinia and Spain have found that additional centimetres can shave not months, but years, off life expectancy.
Unfortunately, no one is able to conclusively say why tall people can suffer negative health ramifications. I’m just chancing my arm that whatever made me small also makes me less susceptible to the variety of nasties outlined above.
Yet that doesn’t mean short people don’t feel like they suffer more bodily and psychological maladies, even if they don’t in reality. Perception matters, and for short people, this perception is often a bad one when it comes to their health.
In a 2007 study cited by the Society for Endocrinology, shorter than average people reported worse physical and mental health than people of typical height. We vertically challenged folk judge our state of health to be inferior to that of taller people. That study controlled for other elements that can affect our health perceptions, like age, gender, body weight, long-standing illness and social class, across 14,000 respondents.
The shorter you get, the more stark the effect. It is not necessarily a causal link, the researchers note, but it would be tough to rule out that constantly looking up at people makes you feel less mentally and physically grand as they are.
This is illustrated very well in a cutely-designed 2013 study by Oxford professor of clinical psychology Daniel Freeman. Using virtual reality, participants took a simulated journey on an underground train. They took it once with their viewpoint set at a given height, and on another occasion from the perspective of someone a head shorter.
“The results were dramatic: when they felt smaller, the participants reported increased feelings of inferiority, weakness, and incompetence,” Freeman writes. “And this explained why they were also more likely to experience paranoid thoughts: for example, that someone in the carriage was being hostile or trying to upset them by staring.”
This was despite the fact that the video the participant was played was exactly the same in both instances. Again, there were a number of control conditions, and the order in which the virtual reality plugged the participant into the shoes of a short or tall person was randomised.
Another study of military men suggests that those at least one standard deviation shorter than the average height “may be predisposed to higher rates of depressive... disorders”.
Given all of the above, I was unsurprised - and a little flattened - to learn that shorter men also appear to have a higher suicide rate.
“Greater height is... associated with a lower risk of a series of health outcomes including coronary heart disease, stroke, accidents, and suicide” a 2014 paper in the journal Behavior Genetics notes.