Adult Growth Hormone Deficiency - Treatment

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Treatment with Growth Hormone

Once a physician has proven GH deficiency, he or she will begin the patient on a small dose of GH and slowly raise the dose until a final maintenance dose is reached. The hormone is given daily by injection. The hormone is given by the patient or a member of the family. Small needles and syringes are used. The physician will see the patient at four to eight week intervals to ask how the patient is doing and to obtain a blood test which can help determine the correct dose. This test is the insulin-like growth factor test ("IGF-1 test"). It is a single blood test which reflects the amount of GH administered, although it is not GH itself. IGF-1 values which are low prompt a larger dose or growth hormone is needed; values which are too high prompt a lower dose. Once a final dose is established, the blood test and office visits will continue approximately every 4 to 6 months. The symptoms of GH excess include muscle or joint pain, retention of fluid (called edema) and carpal tunnel, which consists of pain and/or numbness in the hands. These symptoms, if severe, will also help determine the dose.

There are other ways the physician will monitor GH therapy. If the patient has a pituitary tumor, an MRI will be performed before therapy begins and usually every year thereafter. It is not known whether or not GH can stimulate the growth of residual tumors. The endocrinologist physician will decide when and how often this should be performed. The physician will often elect to monitor blood cholesterol and bone density. Successful therapy is associated with an increase in the density of bones and an improvement in blood cholesterol profile