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Updated Guidelines for Treating Adult Growth Hormone Deficiency

Posted Dec 01 2011 3:01am
Better late than never I suppose.  My reading hasn't been so good lately what with my increased responsibilities at the School of Medicine (which includes covering Student Health over at UNLV this week), making home visits all across Clark County (I need to refuel my car twice as frequently nowadays), working with a local hospice, and caring for my own patients.  So I only just stumbled across the Endocrine Society's latest Clinical Practice Guideline for the evaluation and treatment of adult growth hormone deficiency (GHD) published earlier this summer in JCEM .  

I wanted to point out several germane points from this guideline.  First, GHD can be acquired as an adult.  However, in this case, stimulation testing is necessary to confirm or make the diagnosis (as opposed to a known genetic or structural lesions since childhood).  Second, growth hormone (GH) improves body composition, exercise capacity, bone mineral density, and quality of life (the worse one's GHD, the greater the benefit one can expect from GH).  Third, more importantly, risks associated with GH therapy are low as long as one's dosing regimen is individualized.

Ironically, Major League Baseball announced last week that it is prepared to start blood testing for illicit GH use this coming spring training .  While I am not privy to the details, it appears that everyone (~1,200 professional baseball players) will be tested which will provide an interesting assessment as to the average level of innate GH at this high level of competition. Besides raw talent, I've always theorized that professional and high level amateur athletic competition self-selects for those blessed with greater natural GH production, perhaps the highest 2% of normal that are typically labeled as high on any given reference range.
So go get caught upon with your journal reading and familiarize yourself with the latest guidelines on growth hormone testing & use.

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