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Medical Information | Non-US Health Care Professionals

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In adults, growth hormone deficiency is underdiagnosed1

adult growthhormone deficiency

Adult growth hormone deficiency (AGHD) is an underdiagnosed condition commonly associated with pathology of the hypothalamic-pituitary region. Patients with AGHD tend to live with a poor quality of life and often present with other clinical signs and symptoms.1  

AGHD numbers in the US2

AGHD statistic

adults with a diagnosis

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AGHD statistic

new cases reported annuallya

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AGHD (combining both adult-onset GHD and childhood-onset GHD) is presumed to affect 2 to 3 adults per 10,000, but the true incidence rate is difficult to estimate.1  

aIncludes children with growth hormone deficiency (GHD) transitioning to adulthood.

What is adult growth hormone deficiency (AGHD)?1

Adults can be diagnosed with AGHD in childhood (childhood-onset GHD) and adulthood (adult-onset GHD).

Childhood-Onset GHD

Most frequent causes:
  • Idiopathic

Other causes:

  • Genetic abnormalities and other congenital causes
  • Brain structural defects, including agenesis of corpus callosum,  empty sella syndrome, midline facial defects, and more
  • Acquired causes including perinatal insults, pituitary adenomas, and certain brain tumors

Adult-Onset GHD

Most frequent:
  • Hypothalamic-pituitary tumors and/or their treatments, including surgery and radiation

Also associated with:

  • Traumatic brain injury
  • Subarachnoid hemorrhage
  • Ischemic stroke
  • Central nervous system infections

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Common symptoms of adult growth hormone deficiency1

  • Decreased lean body mass 
  • Increased fat mass
  • Dyslipidemia
  • Cardiac dysfunction
  • Decreased fibrinolysis and premature atherosclerosis
  • Decreased muscle strength and exercise capacity
  • Decreased bone mineral density
  • Increased insulin resistance

Common symptoms of adult growth hormone deficiency1

  • Decreased lean body mass 
  • Increased fat mass
  • Dyslipidemia
  • Cardiac dysfunction
  • Decreased fibrinolysis and premature atherosclerosis
  • Decreased muscle strength and exercise capacity
  • Decreased bone mineral density
  • Increased insulin resistance

Diagnosing AGHD

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Diagnosing adult growth hormone deficiency can be challenging due to a lack of a single biologic endpoint.
  • Random serum growth hormone (GH) levels cannot be used alone, because GH is naturally secreted in a pulsatile pattern by the pituitary gland and changes with age, gender and body mass index.
  • Low serum IGF-1 levels may result from causes other than AGHD, such as protein or calorie malnutrition, renal failure or chronic liver disease.1
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GH-stimulation tests are recommended for appropriate adult patients, but are not required for those with a predictably high likelihood of GHD, such as patients with genetic defects affecting the hypothalamic-pituitary axes, with hypothalamic-pituitary structural brain defects, or with organic hypothalamic-pituitary disease with multiple pituitary hormone deficiency and low IGF-1 levels.1  

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The diagnosis of AGHD is dependent upon the accuracy and reliability of the GH-stimulation test used.1
Multiple methods of testing are available. These are described in clinical guidelines by The American Association of Clinical Endocrinologists and American College of Endocrinology.1  

References:

  1. Yuen KCJ, Biller BMK, Radovick S, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for Management of Growth Hormone Deficiency in Adults And Patients Transitioning From Pediatric to Adult Care. Endocr Pract. 2019;25(11):1191-1232.
  2. Brod M, Pohlman B, Højbjerre L, Adalsteinsson JE, Rasmussen MH. Impact of adult growth hormone deficiency on daily functioning and well-being. BMC Res Notes. 2014;7:813.