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Risks and Benefits of Growth Hormone Replacement in the Elderly

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Pituitary Disorders throughout the Life Cycle

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Abstract

Growth hormone deficiency (GHD) can have many possible underlying etiologies, and it is most commonly encountered in patients with pituitary and sellar lesions, traumatic brain injury (TBI), or other causes of pituitary damage. Clinical features include decreased quality of life, impaired lipid profile, decreased bone mineral density, and impaired body composition, all of which are more pronounced in the elderly population. Diagnosis relies on provocative testing to stimulate GH, and the choice of test in the elderly population should carefully balance accuracy with a risk for adverse events. GH replacement is based on patient-centric goals of care and guided by symptoms and IGF-1 levels, and priority is given to achieving results with the lowest dose possible. Although GH replacement is safe in elderly patients with an accurate GHD diagnosis, care should be taken to avoid misdiagnosis of GHD as well as over-replacement of GH, as inappropriate use has deleterious consequences.

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  1. Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Artak Labadzhyan & Shlomo Melmed

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  1. Artak Labadzhyan
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Correspondence to Artak Labadzhyan .

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  1. Mayo Clinic, Jacksonville, FL, USA

    Susan L. Samson

  2. Emory University School of Medicine, Atlanta, GA, USA

    Adriana G. Ioachimescu

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Labadzhyan, A., Melmed, S. (2022). Risks and Benefits of Growth Hormone Replacement in the Elderly. In: Samson, S.L., Ioachimescu, A.G. (eds) Pituitary Disorders throughout the Life Cycle. Springer, Cham. https://doi.org/10.1007/978-3-030-99918-6_31

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