Rav Endocrinology Growth Hormone Deficiency

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GH deficiency in adults can either be a continuation of a childhood condition or be newly acquired. Adults with this deficiency have

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...decreased muscle mass, increased fat mass, and decreased bone mineral density, and many have decreased strength, endurance, and well-being.

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is necessary for diagnosis.

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A GH stimulation test, such as insulin-induced hypoglycemia or use of a combination of arginine and GH-releasing hormone,

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Testing may not be necessary if

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three or more other pituitary hormones are shown to be deficient and insulin-like growth factor 1 (IGF-1) levels are below normal.

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Only approximately one third of children with isolated idiopathic GH deficiency are found to be

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GH deficient when retested as adults; therefore, these patients should be retested before continuing GH as an adult.

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what may be inappropriate

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Given that GH-dependent bone remodeling continues into the mid-20s, stopping childhood GH replacement when final height has been achieved .

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GH treatment of adults with GH deficiency can

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increase lean body mass, decrease fat mass, and improve the sense of well-being without long-term adverse effects.

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The short-term adverse effects of edema, joint pain, and carpal tunnel syndrome can be avoided by

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using a low starting dose and gradually increasing it.