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Brief and Straightforward Guide on: Human Growth Hormone Deficiency In AdultsGrowth Hormone Deficiency: Adult Form
Growth hormone deficiency in adult patients, is fairly rare and the incidence is about ten per million population. There are two types of Adult Growth Hormone deficiency conditions:
• GH deficiency Childhood Onset: This is characterized by growth hormone deficiency which develops in childhood and continues into adulthood
• GH deficiency Adult Onset: This is characterized by the development of GH deficiency in adulthood due to underlying Pituitary disease.
Both the conditions present with similar symptomatology and are typified by increased body fat resulting in truncal obesity, concurrent decrease in the lean muscle mass, reduced bone mineral density and increased susceptibility to developing atherosclerosis and cardiovascular disorders.
Adult Growth Hormone Deficiency Syndrome (AGHD): Childhood Onset
In many individuals, growth hormone deficiency may continue into adulthood, which is referred to as childhood onset AGHD. In most cases, it is difficult to assess the cause of the disorder and is referred to as ‘idiopathic’ GH deficiency. Some of the known causes are,
• Congenital or developmental defects of the Pituitary gland
• Genetic mutation, which may result in reduced production of HGH. This is observed in conditions like the Turner’s Syndrome and Prader - Willi Syndrome
• Further, damage to the Pituitary gland or the peripheral areas due to infection, head injury or severe trauma, exposure to radiation or tumor may also result in HGH deficiency.
The symptomatic presentation of the condition has already been described above. However, it should be noted that some individuals suffering from GH deficiency in childhood regain their ability to secrete Growth Hormone naturally with time, and do not require GH therapy in adulthood. Scientific evidence is suggestive that most children continue to be GH deficient during their adulthood and hence, require constant supplementation with GH therapy to meet the metabolic and physiological demands of the body.
Adult Growth Hormone Deficiency Syndrome (AGHD): Adult Onset
GH deficiency in some individuals develops in adult hood. The primary cause of the condition is damage to the pituitary gland due to a tumor which tends to compress the pituitary gland, reducing the production of HGH and other pituitary hormones. Other causes may include - trauma due to accident, neurosurgery involving the base of the skull, damage to the blood supply to the Pituitary gland, etc. Radiation therapy, taken as a part of management of malignant tumors in the head region, can also result in pituitary damage and can cause AGHD. Invariably, this form of AGHD is associated with reduced production of at least one other Pituitary hormone along with Growth Hormone. AGHD adult onset is characterized by increased fat deposition, lower muscle mass, reduced bone density, reduced Insulin sensitivity, increase in the LDL levels of blood cholesterol with concurrent reduction in HDL cholesterol levels, making the person prone to atherosclerosis.
• Less than normal response to growth hormone stimulation test is the preliminary criteria. In this assessment, GH levels after hyperglycemia are measured to evaluate the levels of HGH in the blood. This is a special biochemical test and is only conducted in case the healthcare provider suspects growth hormone deficiency.
• Alternatively, multiple blood samples, on different days at different times are taken and the highest and lowest GH values are assessed. This is a relatively, more complicated test, as it depends on the patient’s availability and further requires several pricks to be made on the patient. Some physicians depend upon MRI imaging of the pituitary to make the clinical assessment or depend upon factors like blood cholesterol levels or bone densities.
Treatment and Tracking progress
The treatment of AGHD is HGH replacement therapy. In this therapy synthetically prepared recombinant growth hormone is injected into the body to raise the levels of GH produced in the body. The concept is similar to Insulin injections given to diabetic patients.
To begin with, small doses of synthetic GH are injected and the patient is reviewed and assessed on a regular basis at an interval of six weeks. Simultaneously, a blood test (Insulin like growth factor test) is conducted on the patient to ascertain the correct dose. The test is aimed at measuring the levels of IGF-1 which indicates the level of requirement of the growth hormone, as, the level of IGF-1 is inversely proportional to the dosage requirement of HGH.
After the assessment, for about three months, a final maintenance dose is determined and the patient is expected to follow up every four to six months, for evaluation of the progress and to ascertain whether there has been an improvement in the medical condition.
Safety Information regarding HGH therapy
HGH therapy is not indicated in adults, especially under the following conditions,
• Individuals suffering from glaucoma, retinal detachment or other eye conditions that have developed as a result of diabetes
• Individuals suffering from active brain tumor or cancer
• Individuals suffering from critical illness after a major surgery like a cardiac procedure or an abdominal procedure.
• The therapy is also not indicated in severely injured individuals or individuals who have severe form of respiratory distress.
HGH therapy is known to have potential side effects. In order to minimize the complications and the possibility of developing long term side effects, it is of utmost importance, that you provide the prescribing physician with all the relevant information.
• Detailed information about all the medications taken, including supplements
• Detailed information of any new medication or treatment, especially, prednisone, cortisone or other steroids
• Information about child bearing i.e. are you pregnant or plan to conceive
• All information about any major condition or illness that you have suffered from
Complications of the treatment therapy
HGH therapy may be associated with discomfort, soreness or redness at the injection site, joint pain or edema, severe headache or nausea, pain in the wrist, allergic reaction.
You must inform the doctor about any change or complications that you may experience during and after the course of the treatment.