15th September 2024

Management

All patients with GH deficiency should be considered for growth hormone replacement therapy, especially those who are symptomatic with impaired quality of life, reduced mineral density, adverse cardiovascular risk profile, and reduced exercise capacity.

IGF-1 level is monitored to avoid over replacement, aiming to keep the values within the age-matched reference range. GH treatment is associated with impairment of insulin sensitivity, lipid metabolism and bone density. Therefore, these should be monitored at regular intervals. It can be useful to monitor quality of life using the adult growth hormone deficiency assessment (AGHDA) questionnaire.

Adverse effects of growth hormone replacement include sodium and water retention, weight gain, carpal tunnel syndrome, hyperinsulinemia, arthralgia (possibly due to intra-articular cartilage swelling), myalgia and benign intracranial hypertension which resolves on stopping treatment.