What is Adult Growth Hormone Deficiency (AGHD)?

Adult Growth Hormone Deficiency is a condition where the pituitary gland produces insufficient growth hormone (GH) after the completion of linear growth (i.e., after puberty). It can be congenital or acquired, and it significantly impacts quality of life.

Causes:

• Pituitary Tumors: Most common cause in adults.
• Pituitary Surgery or Radiation: Iatrogenic causes.
• Traumatic Brain Injury (TBI): Increasingly recognized cause.
• Idiopathic: No identifiable cause.

Clinical Features:

• Reduced Bone Density: Increased fracture risk.
• Increased Cardiovascular Risk: Dyslipidemia, increased visceral adiposity.
• Fatigue and Reduced Exercise Capacity: Poor stamina and muscle strength.
• Impaired Cognitive Function: Poor memory and concentration.
• Decreased Quality of Life: Depression, social isolation.

Diagnosis:

• Growth Hormone Stimulation Test: Insulin tolerance test (ITT) or glucagon stimulation test.
• IGF-1 Level: Low IGF-1 suggests GHD but is not diagnostic alone (especially in older adults).
• MRI Pituitary: To identify structural causes.

Treatment:

• GH Replacement Therapy: Daily subcutaneous injections of recombinant human GH.
• Monitoring: IGF-1 levels, side effects (fluid retention, arthralgias, carpal tunnel).
• Lifelong Follow-up: Bone density, cardiovascular risk assessment.