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Growth Hormone Deficiency (GHD)

Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.

Why this still fits

I've been experiencing persistent brain fog -- difficulty concentrating, memory problems, and fatigue that doesn't respond to sleep. I also notice body composition changes. I'd like to screen for growth hormone deficiency with an IGF-1 level, especially given [my history of TBI / pituitary surgery / radiation / other risk factor]. If the IGF-1 is low or borderline, I'd like to discuss stimulation testing.

What would weaken it

  • -Fog clearly predates any pituitary risk factor by years
  • -IGF-1 is solidly mid-range and stimulation test is normal
  • -Symptoms fully explained by documented depression or hypothyroidism
  • -No body composition changes alongside cognitive symptoms

Tests and measurements to discuss

IGF-1 (insulin-like growth factor 1) -- screening test

GH stimulation test (ITT or glucagon) -- confirmatory if IGF-1 is low/borderline

Complete pituitary panel: TSH, free T4, cortisol (AM), testosterone/estradiol, prolactin, LH, FSH

What this helps clarify: Primary male hormone - affects cognition, mood, energy

Range context

500–900 ng/dL (men)

How to use the result

Save the result with date and symptoms from the same week.

ACTH stimulation test if cortisol is borderline

What this helps clarify: Stress hormone - too high or too low impairs cognition

Range context

10–20 mcg/dL (AM)

How to use the result

Save the result with date and symptoms from the same week.

MRI of the pituitary with and without contrast

DEXA scan for bone density (GHD affects bones)

Peer-reviewed references

  1. 1. HTTPS://PUBMED.NCBI.NLM.NIH.GOV/21602453/ [DOI]
  2. 2. HTTPS://PUBMED.NCBI.NLM.NIH.GOV/17895459/ [DOI]
  3. 3. HTTPS://PUBMED.NCBI.NLM.NIH.GOV/16621325/ [DOI]