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In the Balance |

Growth Hormone Therapy for Adults: Not Ready for Prime Time?

William L. Isley, MD
[+] Article and Author Information

From University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.


Requests for Single Reprints: William L. Isley, MD, Saint Luke's Lipid and Diabetes Research Center and Saint Luke's Multi-Specialty Clinic, Plaza I, Suite 128, 4320 Wornall Road, Kansas City, MO 64111; e-mail, wisley@saint-lukes.org.


Ann Intern Med. 2002;137(3):190-196. doi:10.7326/0003-4819-137-3-200208060-00011
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Human growth hormone is now readily available and approved for treatment of the growth hormone deficiency syndrome in adults. However, physicians have been slow to adopt this therapeutic modality. Reasons for skepticism about the use of growth hormone for the growth hormone deficiency syndrome include doubts about whether growth hormone deficiency causes increased morbidity and mortality in patients with hypopituitarism; availability of highly efficacious, easier to use, and less expensive agents for certain aspects of the growth hormone deficiency syndrome, especially cardiovascular disease; and concerns about possible toxicity in adults. Long-term studies in patients receiving appropriate comprehensive management for other hormonal deficiencies and for concomitant abnormalities will be required to convince physicians of the utility and safety of growth hormone replacement therapy.

Figures

Grahic Jump Location
Figure 1.
A growth hormone deficiency paradigm to explain excess death rates in patients with hypopituitarism.
Grahic Jump Location
Grahic Jump Location
Figure 2.
An alternative paradigm to explain excess death rates in patients with hypopituitarism. Not all inciting factors will be present in all patients.
Grahic Jump Location

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