The Importance of Replacement Therapy
I have growth hormone deficiency (GHD) and other pituitary hormone deficiencies due to a pituitary tumor. My surgery to remove the tumor did not help any, and when I had the Arginine GH stimulation test this past spring, I did not produce nearly enough GH. GH is pulsatile and needs stimulation in order to be tested correctly. IGF-1 is not a reliable marker of GH production.
Low GH has been tied to depression and apathy. It is also linked to cardivascular risks. In Cardiovascular Risk in Patients with Growth Hormone Deficiency: Effects of Growth Hormone Substitution (free access), the authors state:
The increased CV risk in overweight patients is particularly dependent on a high proportion of abdominal (visceral) fat in comparison with total body fat.[8-12] Insulin resistance (IR), increased inflammatory markers, and microvascular and macrovascular disease are common complications. Patients with GH deficiency demonstrate a high prevalence of obesity and share most of the risk factors of those with simple obesity. Blood pressure, however, is not necessarily increased in patients with GH deficiency.
Nonobese and even lean patients with GH deficiency have a high ratio of abdominal to total body fat.[5,11] They are at a higher CV risk than an age- and weight-matched population. It is recognized that these subjects have a lean body mass deficit of approximately 3 to 4 kg and an increase of 1 to 2 kg in abdominal fat. This pattern is frequently observed in women with panhypopituitarism but is also seen in men.
The article concludes "there is no doubt that adult patients with hypopituitarism and GH deficiency have an increased CV risk (odds ratio of 2 for men and 3.5 to 4 for women). " Improvement of systolic and diastolic pressures, lipid profiles, and plaque formation are also documented. A significant decrease in IMT and CRP were also favorable outcomes of GH replacement therapy.
To read more:
Cardiovascular Risk in Patients with Growth Hormone Deficiency: Effects of Growth Hormone Substitution
Albert G. Burger, MD;1 John P. Monson, MD;2 Anna M. Colao, MD;3 Anne Klibanski, MD4
Endocr Pract. 2006;12(6):682-689. ©2006 American Association of Clinical Endocrinologists