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Nathan Goodyear

Diagnosing Growth Hormone Deficiency in Adults - 0 views

www.hindawi.com/...972617

HGH GH human growth hormone growth hormone IGF-1

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • it is clear that serum IGF-1 and or IGFBP-3 can be normal in patients with undisputed GHD
  • Various investigators have reported normal IGF-1 values in 37–70% of GH deficient adults
  • The co-administration of arginine and GHRH (the combined test) is a powerful stimulus for GH production and has gained increasing acceptance as a useful method of diagnosing GHD [34]. This test has been advocated as a suitable alternative to ITT
  • ...12 more annotations...
  • The glucagon stimulation test (GST) is a reliable, safe alternative to the ITT in the diagnosis of GHD
  • An intravenous infusion of arginine (0.5 g/kg body weight) together with an intravenous bolus of GHRH (1 mcg/kg body weight) is administered [30]. Serum samples for GH are then obtained every 15–30 minutes for two hours.
  • Obesity, particularly marked obesity, is associated with blunted GH secretion in response to provocative stimuli
  • It has also been suggested that that even mildly increased BMI (25–30 kg/m2) can result in diminished stimulated GH production in 13% of healthy subjects
  • Corneli et al. have defined BMI-specific cut-off points for diagnosing adult-onset GHD using GHRH + arginine—11.5 ng/mL for those with BMI < 25 kg/m2, 8.0 ng/mL for BMI 25–30 kg/m2, 4.2 ng/mL for those with BMI > 30 kg/m2
  • GH levels are higher during the luteal phase in comparison with the follicular phase of the cycle
  • Oral, in contrast to transdermal oestrogen, lowers IGF-1 levels and is associated with increased GH levels
  • Adequate pituitary replacement with thyroxine and hydrocortisone are needed for optimal GH production
  • one cannot rely on a low IGF-1 to diagnose GHD in women taking oral oestrogen preparations.
  • Numerous GH secretagogues are available with the insulin tolerance test being the gold standard and the glucagon stimulation test or the GHRH + arginine as acceptable alternatives
  • ain et al. found the GST to be at least as good as the ITT in provoking GH secretion
  • the GST is safe, with almost no contraindications, it causes nausea and sometimes vomiting in 15–20% of subjects
  • Nathan Goodyear on 04 Nov 14
     
    Nice, more recent analysis, of HGH testing.
Nathan Goodyear

Growth hormone, insulin-like growth factor-I and th... [Horm Res. 2001] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...11786677

HGH growth hormone GH insulin resistance cortisol cortisone obesity adipose tissue adipocytes

shared by Nathan Goodyear on 09 Mar 12 - No Cached
  • GH deficiency effectively increases cortisol production in key target tissues including liver and adipose tissue, promoting insulin resistance and visceral adiposity
  • GH/IGF-I modulation of cortisol metabolism may underpin the pathogenesis of common diseases such as central obesity
  • Patients with central obesity but with no evidence of hypopituitarism have relative GH deficiency and it is exciting to speculate that low-dose GH treatment in this group, by inhibiting cortisol generation within omental fat, may offer a novel therapeutic approach.
  • Nathan Goodyear on 09 Mar 12
     
    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. 
Nathan Goodyear

Therapy of Endocrine disease: Long-term effects of recombinant human GH replacement in ... - 0 views

www.eje-online.org/...R1.full

GH human growth hormone hormone hormones HGH

shared by Nathan Goodyear on 25 Jun 13 - No Cached
  • Nathan Goodyear on 25 Jun 13
     
    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.
Nathan Goodyear

Which Patients Do Not Require a GH Stimulation Test for the Diagnosis of Adult GH Defic... - 0 views

press.endocrine.org/...jcem.87.2.8216

HGH GH human growth hormone growth hormone IGF-1

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • Four studies have reported that the probability of GHD (peak GH criteria ranging from < 2.3 to < 5 μg/liter) in patients with three to four PHDs ranges from 91% to 100%
  • 95% accuracy by the presence of either three or more PHDs or a serum IGF-I concentration less than 84 μg/lite
  • adult GHD could be predicted with 95% accuracy by the presence of either three or four PHDs or a serum IGF-I concentration less than 84 μg/liter
  • ...5 more annotations...
  • Hypopituitary adults with GHD have been reported to have normal serum IGF-I levels in 37–70% of patients in various studies (5, 9, 18, 21, 22). This is owing in part to the fact that multiple factors regulate serum IGF-I concentrations including nutritional status; hepatic and renal function; and circulating concentrations of thyroid hormone, androgens, and estrogens
  • changes in concentrations of IGF-binding proteins (IGFBPs) influence the total concentration of IGF-I in plasma
  • Among patients with an IGF-I sd score above −1 in the present study, 46% had a peak GH less than 2.5 μg/liter and 67% had a peak GH less than 5 μg/liter.
  • In summary, adult GHD can be predicted with 95% accuracy by the presence of either three or four PHDs or a serum IGF-I concentration less than 84 μg/liter
  • We propose that adult patients with three or four PHDs (three or four of the following deficiencies: TSH, ACTH, gonadotropins [LH and/or FSH], and AVP [central diabetes insipidus]) do not require a GH stimulation test to make the diagnosis of adult GHD
  • Nathan Goodyear on 04 Nov 14
     
    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.
Nathan Goodyear

Cardiovascular Risk in Adult Patients With Growth Hormone (GH) Deficiency and Following... - 0 views

press.endocrine.org/...jc.2013-2394

Growth hormone growth hormone GH hormones cardiovascular disease metabolism

shared by Nathan Goodyear on 06 Jan 14 - No Cached
  • Nathan Goodyear on 06 Jan 14
     
    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.
Nathan Goodyear

Sensitivity and specificity of six tests for the diagnosis of adult... - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...11994342

HGH GH human growth hormone IGF-1 growth hormone

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • ARG plus GHRH test, high sensitivity (96 and 95%, respectively) and specificity (92 and 91%, respectively) for GH deficiency were achieved
  • The greatest diagnostic accuracy occurred with the ITT and the ARG plus GHRH test
  • 95% specificity could be achieved with the ARG plus L-DOPA and ARG tests only with very low peak GH cut-points (0.25 and 0.21 microg/liter, respectively) and not at all with the L-DOPA test
  • ...1 more annotation...
  • Although serum IGF-I levels provided less diagnostic discrimination than all five GH stimulation tests, a value below 77.2 microg/liter was 95% specific for GH deficiency
  • Nathan Goodyear on 04 Nov 14
     
    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.
Nathan Goodyear

Growth hormone responses to 3 differ... [Appl Physiol Nutr Metab. 2008] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...18641713

growth hormone GH hormone hormones men male exercise endurance

shared by Nathan Goodyear on 03 Aug 14 - No Cached
  • Nathan Goodyear on 03 Aug 14
     
    Endurance training increases GH more than resistance and sprints/short interval training.  This increase in GH, though seen in all age groups, decreased in older aged men.
Nathan Goodyear

The Growth Hormone/Insulin-Like Growth Factor-I Axis in Exercise and Sport - 0 views

edrv.endojournals.org/...603.long

growth hormone GH IGF-1 exercise health sport growth hormone

shared by Nathan Goodyear on 21 Jan 13 - No Cached
  • Nathan Goodyear on 21 Jan 13
     
    Review of the physiological roles of GH and IGF-1 during exercise.  The focus is on maximizing the normal physiologic response, not supra physiologic.
Nathan Goodyear

Idiopathic Adult Growth Hormone Deficiency - 0 views

jcem.endojournals.org/...2187.abstract

growth hormone deficiency GH growth hormone

shared by Nathan Goodyear on 10 Jun 13 - No Cached
  • Nathan Goodyear on 10 Jun 13
     
    This study estimates that true adult GH deficiency is < 10%.
Nathan Goodyear

Insulin-like growth factor-I, its binding proteins (IGFBP-1 and IGFBP-3), and growth ho... - 0 views

erc.endocrinology-journals.org/...583.long

HGH GH IGF-1 IGFBP-1 IGFBP-3 breast cancer premenopause premenopausal women Nurses Health Study Nurses Health Study II

shared by Nathan Goodyear on 06 Jul 12 - No Cached
  • Nathan Goodyear on 06 Jul 12
     
    GH, IGF-1, IGFBP-1, and IGFBP-3 were not found to be associated with increased risk of breast cancer in premenopuasal women.
Nathan Goodyear

Ghrelin Enhances Appetite and Increases Food Intake in Humans - 0 views

jcem.endojournals.org/...5992.short

ghrelin appetite weight-loss overweight weight GH

shared by Nathan Goodyear on 21 Nov 11 - No Cached
  • Nathan Goodyear on 21 Nov 11
     
    ghrelin stimulates appetite and thus food intake.  It also stimulates GH release
Nathan Goodyear

Ghrelin is a growth-hormone-releasing acylated peptide from stomach : Abstract : Nature - 0 views

www.nature.com/...402656a0.html

ghrelin GH stomach overweight weight-loss obesity insulin resistance IR

shared by Nathan Goodyear on 21 Nov 11 - No Cached
  • Nathan Goodyear on 21 Nov 11
     
    ghrelin is a GH releasing peptide released from the stomach
Nathan Goodyear

Long-term Safety of Testosterone and Growth Hormone Supplementation: A Retrospective St... - 0 views

www.ncbi.nlm.nih.gov/...PMC3104655

hormones Testosterone growth GH hormone PSA cardiovascular male men

shared by Nathan Goodyear on 25 Sep 13 - No Cached
  • Nathan Goodyear on 25 Sep 13
     
    Retrospective study finds that 2 years of Testosterone and GH do not change metabolic biomarkers, PSA, or disease risk.  LDL and TC were in fact decreased in the study arm without statin therapy.
Nathan Goodyear

The acute hormonal response to free weig... [J Strength Cond Res. 2013] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...24276305

hormone hormones strength resistance training exercise Testosterone GH cortisol

shared by Nathan Goodyear on 02 Dec 13 - No Cached
  • Nathan Goodyear on 02 Dec 13
     
    This study found that free weights induced a greater increase in Testosterone, GH, and cortisol, than machine.  This study only looked at serum levels.
Nathan Goodyear

Effects of Acute Exposure to M... [Res Sports Med. 2014 July-September] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...24950112

resistance training exercise cortisol GH Testosterone sports

shared by Nathan Goodyear on 23 Jun 14 - No Cached
  • Nathan Goodyear on 23 Jun 14
     
    Article looked at the anabolic effect of low-intensity resistance exercise.  This study found a decrease in cortisol post-exercise, but no increase in anabolic effects: GH and total Testosterone.  The exercise was in untrained men, which could explain some of the decrease in the anabolic effect with the men in this study.
Nathan Goodyear

Use of amino acids as growth hormone-relea... [Nutrition. 2002 Jul-Aug] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...12093449

GH growth hormone HGH arginine lysine ornithine nutrition

shared by Nathan Goodyear on 30 Jun 14 - No Cached
  • Nathan Goodyear on 30 Jun 14
     
    Study finds that amino acid supplementation does not increase GH release.
Nathan Goodyear

http://download.springer.com/static/pdf/189/art%253A10.1007%252Fs12020-014-0327-6.pdf?a... - 0 views

download.springer.com/...1007%252Fs12020-014-0327-6.pdf

GH growth hormone growth hormone IGF-1 cardiovascular heart hormones

shared by Nathan Goodyear on 30 Jun 14 - No Cached
  • Nathan Goodyear on 30 Jun 14
     
    Nice review of GH hormone and its positive role in the cardiovascular system.
Nathan Goodyear

Growth hormone release during acute and chronic a... [Sports Med. 2002] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...12457419

growth hormone exercise GH hormone hormones

shared by Nathan Goodyear on 03 Aug 14 - No Cached
  • Nathan Goodyear on 03 Aug 14
     
    Exercise is an easy way to increase GH production endogenously.
Nathan Goodyear

http://www.diabetologia-journal.org/files/Narendran.pdf - 0 views

www.diabetologia-journal.org/...Narendran.pdf

exercise inflammation growth hormone GH IGF-1 TNF-alpha IL-6 IL-1beta IL-1Ra interferon-gamma diabetes islet cells

shared by Nathan Goodyear on 28 Oct 14 - No Cached
  • Nathan Goodyear on 28 Oct 14
     
    Exercise is not just for calories out.  Exercise increases growth hormone, IGF-1, glucagon-like peptide 1, IL-6, and IL-1ra.  The effect is to GH increases beta islet cell mass and protects beta cell lines against IL-1beta, Interferon-gamma and TNF-alhpa induced apoptosis.  IL-6 increased production increases GLP-1 and IL-1ra which counters IL-1beta.  Interleukin-1beta induces islet cell apoptosis and thus IL-1ra counters this pro-inflammatory signal.
Nathan Goodyear

Regulation of muscle mass by growth hormone and IGF-I - 0 views

www.ncbi.nlm.nih.gov/...PMC2439518

muscle hormones muscle mass GH growth hormone IGF-1

shared by Nathan Goodyear on 14 Apr 15 - No Cached
  • Nathan Goodyear on 14 Apr 15
     
    good review of GH and IGF-1 impact on muscle growth/muscle loss.
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