Which provocative tests are performed in the evaluation of suspected growth hormone deficiency (GHD)?

Updated: Jan 06, 2021
  • Author: Sunil Kumar Sinha, MD; Chief Editor: Robert P Hoffman, MD  more...
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Several provocative tests have been developed for the evaluation of suspected GH deficiency (GHD), including the following:

  • Insulin-induced hypoglycemia is the most powerful stimulus for GH secretion; however, this test also carries the greatest potential for harm and is the only GH provocative test that has been associated with fatalities.
  • Alternate GH secretagogues used successfully in combination as two serial tests include arginine, levodopa, propranolol with glucagon, exercise, clonidine, or epinephrine.
  • Peak GH level is higher if the patient has been recently exposed to sex steroids, but controversy among pediatric endocrinologists persists regarding the use of sex steroid priming prior to stimulation testing.

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