Julie M. Silverstein, MD and Alexandra Martirossian, MD had their article titled, “Diagnosis and Management of Growth Hormone Deficiency in Adults” published online at Consultant360. The authors discuss the physiology and causes of growth hormone deficiency (GHD), a clinical syndrome caused by decreased production of or decreased tissue responsiveness to growth hormone.
According to the authors, measurement of random GH levels is not reliable for diagnosing GHD for multiple reasons. Drs. Silverstein and Martirossian examine several GH provocative tests to aid in diagnosing growth hormone deficiency. These tests include insulin tolerance test, glucagon stimulation test, and macimorelin-stimulated growth hormone test.
Treatment for Growth Hormone Deficiency (GHD) is initiated with rhGH, which contains the identical sequence of amino acids found in HGH. Recommendations on rhGH dosage and follow-up intervals are explained.
The authors concluded, “Growth hormone replacement therapy in adults with confirmed GHD has been shown to be associated with improvement in multiple aspects of health, including body composition, muscle mass, cardiovascular health, bone density, and quality of life. The clinical manifestations of GHD in adults are often nonspecific, so diligence to confirm an accurate diagnosis is essential for avoiding the costs and ethical dilemmas of inappropriate treatment. There are multiple GH stimulatory tests available, each with its own benefits and caveats. Once the diagnosis of adult GHD is established, rhGH should be initiated at low doses and uptitrated based on IGF-1 levels and symptoms, while avoiding adverse effects. Research into longer-acting rhGH formulations and enhanced diagnostic testing is ongoing and will be essential for guiding the management of adult GHD.”