Growth hormone deficiency

Insufficient pituitary growth hormone secretion. In children causes marked growth failure; in adults reduces lean and bone mass, impairs quality of life, increases visceral fat and cardiovascular risk. Diagnosis by an endocrinologist via stimulation tests (insulin, arginine, glucagon, GHRH-arginine) and pituitary MRI. Per SEEN 2022 and ES 2019, somatropin replacement is indicated only with deficiency confirmed by two independent tests.

ICD-10 E23.01 drug

Also known as: Somatotropin deficiency, Adult GH deficiency, Childhood-onset GHD

Drugs used for this condition

ASomatropinFirst line · Recombinant human growth hormoneConfirmed growth hormone deficiency in children and adults, Turner syndrome, chronic kidney disease in children with growth failure, Prader-Willi syndrome, SHOX deficiency, and idiopathic short stature per FDA criteria. Per SEEN 2022 and ES 2019, the indication requires two stimulation tests by an endocrinologist. Dose: children 0.025–0.05 mg/kg/day, adults 0.15–0.3 mg/day with gradual titration by IGF-1. Subcutaneous injections in the evening.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit