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One really wonders if estrogen should ever be given orally at all.  Though this study is small, this is consistent with other studies that show that estrogen therapy, particularly oral therapy interferes with growth hormone signaling and thus action.  Oral estrogen decreases IGF-1, increases growth hormone binding protein, lowers metabolism and reduces protein metabolism as monitored by leucine turnover.

Growth hormone deficiency is safe and effective in those adults with GHD.

Growth hormone deficiency evaluation via the L-dopa-propranolol provocative test.

Insulin Tolerance Test is the gold standard for HGH diagnosis, but this an unpopular test do to long list of side effects.  This study finds a 95% accuracy for IGF-1 less than 84 with 3 or more coexisting pituitary hormone deficiencies.

study evaluated 6 tests for HGH deficiency diagnosis.  Ninety-five percent specificity found with ARG + l-DOPA and ARG alone.  However, the authors found a 95% specificity with IGF-1 < 77.  Although, IGF-1 is false negative in up to 65% of those with HGH deficiency.

low Growth hormone levels in adults shown to be associated with increased cardiovascular disease.  Increased inflammatory cytokines, CRP, glucose, and abnormal lipid profile are all found to be associated with low GH in adults.

Letrazole improves growth potential in boys with HGH deficiency through aromatase inhibition and delayed closure of the growth plates

This study estimates that true adult GH deficiency is < 10%.

Current recommendations on HGH origin, evaluation, and therapy.

GH plays a key regulating role in obesity.  GH deficiency promotes increased cortisone to cortisol production in adipose tissue and liver.  This promotes insulin resistance and obesity. 

the Glucagon Stim test is a useful alternative to the ITT for HGH deficiency evaluation.

Great review on HGH diagnosis, treatment, and follow up in adult onset HGH deficiency.  

very nice article that looks at the balance of ER-alpha/ER-beta and their role in metabolic syndrome.  This article discusses the balance of  these receptors are tissue dependent in their effect.  I like their conclusion: "...but these mechanisms will never be completely understood if they are not considered in the context of a whole system.

Nice, more recent analysis, of HGH testing.

This study looked at long term therapy with GH in adults with GH deficiency.  This study found the long-term therapy to be "well-tolerated".  Though there are limited studies, this study showed good patient tolerability.

Startling study on the knowledge of Testosterone and cardiovascular disease in general practitioners and cardiologists in Canada.  Eight-eight percent did not screen patients with cardiovascular disease for low Testosterone.  A whopping 67% of physicians did not know that low T was a risk factor for cardiovascular disease, yet 62% believed Testosterone would increase exercise tolerance. The lack of knowledge displayed by physicians today is staggering and is an indictment of the governing bodies.  This was a survey conducted in Canada so there are obvious limitations to the strength/conclusion of this study.

in those adults with HGH deficiency, HGH replacement found to improve lipids, IGF-1, and cardiac function.

review of 6 diagnostic test methods for adult onset HGH deficiency.

Nice review of Testosterone levels and some of the evidence linking Diabetes with low T.  However, the conclusion by the authors regarding what is causing the low T in men with Diabetes is baffling.  The literature does not point to one cause, it is clearly multifactorial--obesity, inflammation, high aromatase activity...I would suggest the authors continue their readings in the manner.

Breast cancer is a metabolic disease.  Now, where have I heard that cancer is a metabolic disease?