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Q: Can anyone who has experience with human growth hormone tell me what level of IGF-1 is considered "low", thus qualifying a patient for growth hormone replacement?? What is the best standard to use that would offer the most protection in case of medical board or FDA investigation? Thanks.

Jeffrey Mueller, MD
Mueller Institute for Functional Medicine & Research

A1: IGF-1 is not that reliable. Furthermore, you don't have to show that the patient has a low IGF-1. Just document that he/she has symptoms consistent with HGH deficiency and on follow-up document resolution of those symptoms. Same with using thyroid hormone. Get the IGF-1(TSH) for show, but don't rely on it or any other lab test to make your diagnosis.

Roby Mitchell M.D.

A2: Because of increased scrutiny of physicians who prescribe HgH, I'd follow the official recommended guidelines for true Gh deficiency: do either the insulin or arginine induced test. IGF-1 level itself is NOT considered to be an adequate diagnostic test.

Rick Linchitz

A3: I would do the cancer test from germany or greece to make sure there is no cancer. I got a lymphoma from it.
Dean silver, md.

A4: I have a congenital pituitary insufficiency. I was one of the children in the early 1960โ€™s who were given Human GH, from cadaver pituitaries, to grow.
My current diagnosis was made using an insulin challenge, where insulin is administered to bring the blood sugar level below 40, at which time; blood is drawn measuring GH levels.
Even my insurance company pays for my treatment.

Dr. Sandy

A5: The answer to this and many more issues regarding GH treatment can be found in the best book I have ever seen regarding treatment and diagnose of GH deficiency was written by Jackie Springer MD and called "Adult Hormone Deficiency-Treatment and stabilization" This gives one protocols and all the insurance info needed to obtain authorization. Given that, many insurance companies (including bxbs of az still have their heads up their ass and won't ok treatment).
One thing I have seen though, if you have a relatively young person without head injury or another reason to have GH deficiency (or test deficiency) make sure they don't have sleep apnea, this can lead to profound hormone deficiencies which seem to be centrally mediated I think secondary to a watershed phenomena of the pituitary gland.

HGH Side Effects http://www.dreddyclinic.com/forum/viewtopic.php?f=113&t=4071

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